Toothache and Painful Gingivae

Causes of toothache

Toothache is elicited by stimulation of the nerves in the pulp of a tooth. Common causes are:

• Dental Caries

The bacteria in the cavity of a carious tooth cause inflammation of the pulp tissues, stimulating the nerves in the pulp.

• Exposure of Dentine (tooth sensitivity)

There are numerous microcscopicl tubules in the dentine which connect to the pulp. If these tubules are exposed because of the gum recession or severe tooth wear (e.g. abraded by toothbrushing or eroded by acidic food and beverages), pain will be elicited in the nerves of the pulp through these tubules when the tooth is stimulated by cold, hot, sweet or sour food.
At the same time, the toxins released by the dental plaque may also stimulate the nerves in the pulp through the exposed dentine.

Tooth abraded by toothbrushing

• Fractured Tooth

The exposed dentine and/or pulp tissues resulting from fractured tooth are susceptible to any external stimuli.

Causes for painful gingivae

Painful gingivae are caused by the inflammation of the periodontal tissues. Common causes are:

• Dental Caries

In a severely decayed tooth, the pulp tissues may become necrotic. The bacteria of the necrotic pulp cause infection of the periodontal tissues via the root canal, leading to inflammation and formation of abscess.

• Periodontal Disease

The toxins released by the dental plaque cause inflammation of the periodontal tissues.

• Pericoronitis

Food debris and bacteria are easily trapped in the space between the crown of the wisdom tooth and the overlying gingiva (gum), resulting in the infection of the periodontal tissues (Pericoronitis).

Treatment

Go to see a dentist to receive appropriate treatment as soon as possible:

• Dental Caries:

Treatment: pulp(Endodontic) treatment, filling, crown

• Periodontal Disease:

Treatment: Scaling, root planing, periodontal surgery

• Pericoronitis:

Treatment: Scaling, antibiotic therapy, extraction

• Dentine Exposure:

Treatment: Apply topical fluoride, filling, crown

• Tooth Fracture:

Treatment: Extraction, filling, crown, pulp(Endodontic) treatment