Some Causes and Features of Toothache
Cause | Common Features* | Tests |
|---|---|---|
Periapical abscess (a collection of pus around the tooth's root that can cause acute or chronic symptoms) | Pain may have begun recently or be longstanding Constant pain that worsens when chewing or biting Normally, the person can precisely identify the involved tooth Tooth tender when tapped with a metal probe or tongue depressor (percussed) Sometimes visible swelling of the gum over the affected root and painful swelling of the adjacent cheek and/or lip | A dentist's examination† |
Apical periodontitis (inflammation of tissues around the tooth's root) | Features similar to those of apical abscess but less severe and without swelling over the affected root | A dentist's examination† |
Pain that
Usually a visible cavity or a root surface exposed by gum recession or an abrasion | A dentist's examination† | |
Fracture of a tooth | Sharp pain when chewing Marked sensitivity to cold | A dentist's examination† |
Pericoronitis (usually involving an erupting or partially impacted wisdom tooth) | Constant dull pain, especially when chewing Visible swelling, redness, and sometimes pus around the affected tooth Commonly spasms of the chewing muscles (trismus) may occur and limit opening | A dentist's examination† |
Pulpitis (inflammation of the tooth pulp) | Pain that occurs without stimulation and/or that lingers for more than a few seconds after stimulation May have difficulty identifying the affected tooth | A dentist's examination† |
Pain in several upper teeth on one side, especially molars and premolars Sensitivity when chewing and when the upper teeth are tapped (percussed) Often a nasal discharge and tenderness when the sinus is tapped Pain when changing positions, especially lowering the head (as when bending down to tie shoe laces) | A doctor's examination, sometimes with CT of the sinuses A dentist’s examination if no sinusitis is detected | |
Discomfort and fussiness during tooth eruption in young children Commonly drooling and chewing on things (such as the crib rail) | A doctor's examination | |
* Features include symptoms and the results of the doctor’s examination. Features mentioned are typical but not always present. | ||
† Dental x-rays are usually taken. | ||
CT = computed tomography. | ||