What Your Mouth Is Telling You

illustration by REBECCA WANG

illustration by REBECCA WANG

by TENI KARIMIAN

A toothache is your mouth’s way of saying something is wrong. Regular episodes of debilitating toothaches can be avoided by maintaining good oral health. However, when a toothache strikes, it may help to know what is actually causing the pain. By getting to know your toothaches better, it can shed light on what lifestyle changes may be required and what kind of treatment to seek

 

PAINFUL EATING

Pain upon eating will feel like a sharp shooting pain when chewing with that tooth. This can be caused by tooth decay or a small fracture. In the case of tooth decay, restoration such as a filling or root canal will be required, depending on the extent of the decomposition. On the other hand, cracks and fractures are caused by grinding, trauma to the tooth, or from years of wear and tear. To treat a cracked tooth, a dentist will apply a protective covering over the crack or the entire tooth depending on the size and depth of the fracture. If the crack, however, reaches the root of the tooth, that tooth is deemed “unrestorable” and would have to be extracted since there is no way to fill the crack. At that point a bridge restoration or implant would replace that tooth.

illustration by REBECCA WANG

illustration by REBECCA WANG


CHRONIC TOOTHACHE

An acute, long-lasting pain indicates nerve damage. This could result from grinding teeth, severe tooth decay or trauma to teeth (through injury). Treatment for tooth decay requires restorative treatment such as a composite or amalgam filling. Treatment for severe tooth decay that has reached the nerve of the tooth requires a root canal.


INTENSE, THROBBING PAIN

This kind of pain is intermittent and felt in a general areas as opposed to on a specific tooth. It is usually indicative of an infection or abscess and is often accompanied by a swollen face. It can be caused by severe gum problems or a tooth that’s close to dying. Immediate dental attention is required and treatment for an infection or abscess starts with antibiotics and pain treatment, which then gives way to root canal treatment. Depending on the severity of the decay and the resulting abscess, the last step is strengthening of the tooth with a filling, crown or veneer. IF an infection is ignored, the tooth may die, which will result in permanent loss of the tooth.


BACK OF JAW PAIN

A pain felt in the back of the jaw is indicative of either wisdom teeth that are impacted or temporomandibular disorders (TMD), which result from problems with the jaw or surrounding facial tissues. More commonly TMD refers to grinding of the teeth. Pain caused by grinding is also likely to be felt in other areas of the face such as the cheekbones, eyes, and ears. If the pain is caused by teeth grinding, a dentist will make a mouth guard which will be used during sleep and can help protect the teeth from fractures, unevenness, and a shift in bite, which can all be caused by grinding.

Back of jaw pain resulting from problems with the third molars (wisdom teeth) can arise from several different situations. In some instances, wisdom teeth may surface and not cause problems at all, impacted wisdom teeth however refers to the third molars physically growing into the second molars causing destruction. This can crowd and shift other teeth, which can be a source of great discomfort. Additionally, wisdom teeth may only partially erupt creating an “uncleansable” area where food and bacteria can get stuck under the gums causing infection. Most of the time, treating pain associated with wisdom teeth requires oral surgery to remove the teeth.

illustration by REBECCA WANG

illustration by REBECCA WANG

 

BLEEDING GUMS

Bleeding gums usually are first noticed with bleeding after brushing teeth. This can be a sign of more serious problems such as cardiovascular disease, diabetes, stroke and tooth loss, among other things. Further signs accompanied by bleeding gums that indicate gingivitis (infection of the gums) are sore and swollen gums, formation of deep pockets between teeth and gums, loose or shifting teeth, changes in bite and receding gums.

The main cause of bleeding gums and, in turn, gingivitis is the bacteria in the mouth that will grow exponentially when proper care is not being given to the teeth and mouth. The bacteria will trun into plaque and over time cause inflammation of the gums. Depending on the severity of the gum disease, patients will require either a deep cleaning from a dentist or specialty care from a periodontist who specializes in diseases of the gums.

 

SENSITIVITY

This kind of pain is a sharp, stabbing sensation that comes and goes upon exposure to certain stimuli. Teeth can be sensitive to different things such as cold, heat and sugary foods. Paying attention to what brings about the pain can give insight to the root of the problem.

Sensitivity of teeth to cold (air, food, or drinks) is most likely caused by gum recession, wear and tear of a cavity or enamel loss, which results in exposed dentin (the dense bony tissue underneath the enamel that makes up the bulk of a tooth). Sensitivity to heat may indicate a small cavity, an abscess (infection), a crack in a tooth or severe decay. Sensitivity to sugary foods is most likely caused by decay. To treat tooth sensitivity, it is important to see a dentist to ensure that the sensitivity is not caused by cavity or abscess. These issues will require professional treatment. Sensitivity resulting from enamel loss and exposed dentin, however, can be treated by applying desensitizers, which can be applied at the dental office. This will require re-application when sensitivity returns. Over-the-counter desensitizers can also be helpful.

 

CHRONIC BAD BREATH

Although bad breath may seem easy to fix, chronic bad breath, or halitosis, is persistent and is usually a sign of far more complicated and severe problems. Halitosis can be caused by the sulfur-producing bacteria on the tongue and throat, tooth decay, gum problems and abscesses and infections in the gum that produce bad smelling pus. Dental attention is required to identify the source of the problem and proper oral hygiene is required to prevent reoccurrence.

 

CAUSES OF TOOTH DECAY

Cavities, more specifically called dental caries, are a demineralization of the hard tissues of the teeth, the enamel, dentin and cementum, and destruction of the organic matter of the tooth, by production of acid in breakdown of food debris on the tooth. Although there is not one specific cause for tooth decay, there are several components that factor into why some people have more cavities than others. The most obvious of these reasons is a person’s willingness to maintain their oral hygiene through brushing, flossing, and regular check-ups.

Diet and nutrition also play a big role in the causation of tooth decay in that they are responsible for the construction of teeth and as such, poor nutrition make teeth more vulnerable to decay. Although a balanced diet is essential, vitamin D in particular has been linked to development of healthy teeth as well as prevention of tooth decay. Additionally, a 2001 study in the Journal of Dental Research indicates that the role of sugars and other fermentable carbohydrates is directly correlated to tooth decay. More specifically, the presence of sugar around a plaque-covered tooth is necessary for tooth caries, or decay, to develop, and some sugars such as sucrose are more carcinogenic than glucose, fructose or maltose. In addition to nutritional factors, there is also a genetic component to tooth decay. A person’s unique bacterial composition, salivary components and immunological factors also play a role in tooth decay.

 

PREVENTION

Prevention is the best medicine when it comes to cavities and to do so diet and nutrition should be of the utmost importance. Replacing sugary foods and sodas with crunchy fruits and vegetables like carrots, apples, broccoli and cucumbers help protect teeth by promoting saliva production and stimulating the gums. In doing so, the saliva breaks down sugar and food particles present on the teeth. Cheese also neutralizes the pH of the mouth and stimulates saliva production, which further reduces acidity, leaving teeth less susceptible to acid erosion. Additionally, fluoride is also linked to prevention of dental caries. Drinking black or green tea for the naturally occurring fluoride can protect teeth from decay.

 

Bottom line

Overlooking oral hygiene until there is some kind of pain may be more damaging, both to your overall health and your wallet, than taking the steps to ensure there is no toothache to begin with. Maintaining a good relationship with a dentist and getting check-ups every six months, and practicing good oral hygiene will almost guarantee that.

 

Winter 2012 | Vol. 12 | Issue 2