10 reasons of toothache and why you shouldn’t self-medicate a symptom

Self-medication is practiced more often than we realize. Imagine a situation when you have mild pain or cold. You tend to take some medicine by yourself. The best part: IT WORKS! Although not always wrong, self-medication is a practice that should be limited to a very few conditions and the “actual” over the counter (OTC) drugs.

Unfortunately, Tooth pain is NOT one of the conditions that can be self-medicated.

Most of the tooth conditions are perceived as pain. The nerves in the tooth only perceive PAIN. As a result, any condition of the teeth will give you a feeling of pain. The self-medication thus taken will either just be a painkiller or might be wrong, as the underlying condition isn’t determined. This ends up with you taking more medicines than what was actually required. Consuming more/ wrong medicine not only damages the body, but also results in “antibiotic resistance” damaging the entire community. Over time making conditions like flu or diarrhoea fatal. With the concept of diagnosis before taking the medication in place, let’s define what all reasons can cause toothache and why is it NOT advisable to self-medicate

1. The most common cause of toothache is Tooth Infection. Tooth infection along with causing toothache is generally associated with swelling or foul smell in the mouth. This type of pain is very severe and requires immediate attention. Treatment Options: Just taking pain killers doesn’t help and the pain recurs after the effect of the painkiller is over. This type of toothache requires multiple medicines including antibiotics. The antibiotic isn’t of one specific type and depends on the type of infection, how long the infection has been around and if there is a swelling present or not. Pinpointing the type of infection present and the antibiotic required can be found out with a description of the pain and subsequent leading questions. It does NOT generally require a check-up or an X- ray. The important point about toothache due to tooth infection is that the invasive dental treatment SHOULD NOT be started till the Infection Subsides. Thus, the first appointment only involves the prescription of the correct medication.

2. Toothache could also be due to Gum Infection. Around 80% of the world population suffers from some sort of gum disease. Gum disease can present in a very initial form as bleeding from gums while brushing to loosening and the final loss of teeth. Treatment options: The pain of the gum infection can be deciphered easily with the description/ when it occurs and with subsequent leading questions without any physical check-up. The medicine required to treat the tooth pain due to gum infection involves painkillers and antibiotics. The antibiotics used for gum infection are different from that of tooth infection due to the difference in the bacteria causing the two infections.

3. A Broken tooth due to a fall or an injury can also cause tooth pain typically while chewing. The region of the tooth that is broken influences the symptoms and thus the treatment. If the crown (the part of the tooth that is seen is in the mouth) is broken, the diagnosis and treatment is pretty straightforward and simple. The difficulty is in understanding the pain that arises due to the tooth breaking in the root region (the part of the tooth embedded in the bone). A break in the root of the tooth is complex to diagnose and has to be treated similar to a fracture of a bone. Treatment options: Depending on the area broken a fractured tooth requires specific treatment and painkillers would just provide treatment for the symptoms and antibiotics aren’t required.

4. Suddenly biting on something hard while chewing. Having a fancy name of Trauma from occlusion. This pain occurs when you bite on something hard like a stone while chewing on something soft. The pain can vary from dull and boring to sharp while chewing causing inability to chew from that side. Treatment options: An evaluation of the extent of damage to the tooth/teeth is required to determine the treatment.

5. Another cause of toothache is Grinding of the teeth at night. This is a habit that might at times go on for a very long time with no other symptom than wearing off of teeth, this could be followed by sudden sensitivity of the teeth which could be associated with a mild pain or soreness in the head, face or neck on waking up. Treatment options: This type to toothache WILL NOT require antibiotics and might in very severe cases require some stress relieving medication. In a more common scenario this tooth pain is generally treated by preparing custom made mouth protecting splints that need to be worn at night.

6. Toothache in the back tooth region could be due to Mal- aligned wisdom tooth. This occurs due to multiple reasons that has been explained in a separate post. The underlying cause of this toothache is the food being stuck in this region. A mal-aligned wisdom tooth can also cause damage to the adjacent teeth and thus requires timely and proper evaluation to limit the damage caused by such a condition. Treatment options: The treatment option might vary depending on the degree of mal-alignment. It might be either a simple medication with maintenance of good oral hygiene in the region, to the removal of the wisdom tooth. Swelling that occurs around the last tooth region shouldn’t be ignored as these swellings can spread to the throat and subsequently to the chest and heart.

7. Pain with or without swelling could be associated with an abnormal growth in the bone or the roots of the tooth. The growth could be cancerous/ precancerous or a birth defect. Treatment options: Being non-infectious this type of tooth pain cannot be treated with antibiotics. Moreover, OTC painkillers do NOT work in relieving pain. Ignoring this kind of pain can be dangerous. Get a proper evaluation done before any sort of treatment is started for such a condition.

8. A relatively rare kind of toothache might be due to a nerve known as Neuralgia. This kind of pain presents very differently from a tooth infection pain and might be limited to one tooth/ few teeth or might extend to the face as well. It is generally triggered on touching the area that is supplied by the nerve and is very severe and unbearable. Treatment options: The pain DOES NOT subside with a painkiller. The treatment is generally non- interventional and is treated with medication. A proper evaluation of the cause of the nerve pain is required for proper treatment and recovery.

9. Tooth pain or more correctly jaw pain can also be felt in case of a Heart attack. This type of a pain is sudden and sharp and generally involves the left side of the jaw Treatment option: DO NOT try to self- medicate. Get it evaluated immediately and get the proper medications.

10. A long standing infection that has been ignored also results in intermittent tooth pain typically while chewing Treatment options: It does require antibiotics, but the combination is different from that required for a recent infection. Just like a heart attack can present as a jaw pain, at times tooth pain can present differently with pain not in the tooth but somewhere else.

Pain due to tooth related reasons can present as

A tooth infection might also have the same symptoms as flu and if the flu isn’t subsiding it might require a dental evaluation as well. As important as it is to avoid self-medication. Special attention must be given to ANY swelling that occurs in the front tooth region of the upper jaw (the region just beneath the nose). The veins in this area interact with the veins of the brain and can carry the infection along with them to the brain which could be fatal.

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