What is toothache?

Toothaches and gum problems are common. But you can usually prevent them by taking good care of your teeth and gums. Keeping your teeth, gums, and the bones around your teeth healthy requires regular brushing, flossing, and good nutrition. Brush your teeth twice a day with a fluoride toothpaste that's approved by the American Dental Association (ADA). Clean between teeth daily with floss or an interdental cleaner.

Toothaches

Sometimes you may have tooth pain when you touch a tooth or when you eat or drink foods that are hot, cold, sweet, or sour (a sensitive tooth). Mild sensitivity can be caused by shrunken (receded) gums or a worn-down tooth. Moderate to severe sensitivity can mean that you have a cracked tooth, a dental cavity, or a lost filling. Seeing a dentist for treatment can prevent the tooth from dying.

The most common cause of a toothache is tooth decay. But you might not have a toothache in the early stages of decay. Other reasons for a toothache might include:

• An infection of or around the tooth (abscess). A red, swollen, painful bump may be found near or on the side of the sore tooth. The tooth may hurt more when you bite down.
• A tooth that has not broken through the gum (impacted tooth). Gums may be red, swollen, and sore. The area around this tooth can ache, throb, and be quite painful.
• Problems with or injury to the nerves in the center of the tooth (pulp). These can be caused by an injury to the face or from grinding or gnashing the teeth.

Sometimes a toothache can be caused by another health problem, such as:

• A heart attack, a cluster headache, or a sinus infection. These can cause referred pain into the teeth or jaw.
• Viral infections, such as shingles.
• Diseases, such as diabetes.
• Nerve-related disease, such as trigeminal neuralgia.
• Alcohol or drug abuse, especially methamphetamines.
• Vitamin deficiencies, such as too little vitamin B12.

Gum problems

Healthy gums are pink and firm and don't bleed easily. Now and then, your gums may bleed if you brush your teeth and gums too hard, use a hard-bristled toothbrush, or snap dental floss hard against your gums. Be gentle with your teeth. Use a soft-bristled toothbrush and floss carefully to help prevent bleeding gums.

Gingivitis is a gum disease that causes red, swollen gums that bleed easily when brushed. Because gingivitis usually doesn't cause pain, many people delay treatment. If not treated, gum disease can cause more serious problems with the gum tissue.

Periodontitis is severe gum disease. It's caused by long-term infection of the gums, bone, and other tissues that surround and support the teeth. It can progress until the bones that support the teeth are damaged. In this late stage, teeth may become loose and fall out or need to be removed. Early treatment of gum disease is important to prevent tooth loss.

Other causes of gum bleeding, swelling, and pain include:

• Pregnancy, blood-thinning medicines, and bleeding disorders. Each of these can cause gums to bleed easily.
• Lack of vitamins, such as vitamin K or vitamin C, or medical problems, such as anemia, that interfere with how well the body can absorb certain vitamins.
• Teething in babies and young children.
• Medicines such as Dilantin or calcium channel blockers.
• Dentures or a dental appliance that irritates the gums.
• An infection around the root of the tooth. Swelling and redness, sometimes with pus, may appear at the base of a tooth.

Smoking and using other tobacco products increases your risk for gum disease. Smokers have a higher chance of having gum disease throughout their mouths than nonsmokers. But you might not have symptoms of bleeding or swollen gums. That's because the normal bleeding immune response is affected by tobacco use. Chewing tobacco or using snuff may push back the gums in the area of the mouth where the tobacco is inserted. Constant irritation caused by tobacco products increases your risk of oral cancer.