Situation-related toothache

It is also possible that the toothache may occur depending on the situation: Toothache.

… while chewing
… with a cold
… in the open air
… at night
… during pregnancy
… after alcohol consumption
… lying down
… during stress (crunching)

A cold is a sign that the body is infested with a pathogen. The immune system is therefore basically already weakened.

Therefore, even a seemingly harmless cold can cause pain in the dental area. The reason for this is the close relationship between the jaw or teeth and the sinuses. To the sinuses belong the two maxillary sinuses, which are located below the eyes and above the upper teeth.

Often, the maxillary side teeth or canines even protrude into the maxillary sinus, so that changes in the maxillary sinus directly affect the roots of these teeth. In case of a cold, on the one hand the sinuses are filled with nasal secretions and on the other hand they are usually inflamed. This means that a certain pressure is built up by the fluid in the cavities.

The bony structures of the caves cannot give way, so pressure is created when they fill with the secretion. In addition, the secretion flows down to the floor of the maxillary sinus due to gravity. But there the roots of the upper teeth protrude into the cavity.

So the liquid can press there on the nerve, which pulls into the tooth. There are patients who react very sensitively due to the feeling of pressure and the inflammation prevailing in the nasal cavities. If there is pain in the nose or forehead, the pain also radiates into the mouth and jaw.

In addition, the poor general condition can lead to the jaw muscles being tense. This affects the jaw joint and teeth. Toothache when chewing can have various causes.

When chewing, force is exerted and the tooth is pressed into its tooth socket. If the mucous membrane and gums in the tooth socket are inflamed, pressure is exerted on inflamed tissue during every chewing process, which causes pain. The inflamed tissue in so-called apical periodontitis (inflamed root tip) is characterized by the fact that the gums under the root tip are also swollen.

The swelling causes the tooth to stand a little higher than normal and thus has a pre-contact. If the patient now bites, he bites on the affected tooth first and this tooth receives more stress. This can damage it, break off.

The pain already occurs when the rows of teeth are simply brought together without applying strong pressure. Another possible case occurs when the patient receives a filling (or crown) that has not been optimally adapted to the opposing teeth. In this case there is also a pre-contact and the tooth must withstand more pressure than usual, which it cannot do in most cases.

If the tooth is subsequently ground in, the discomfort often disappears quickly, but if the tooth retains the pressure in this way, the nerve inside the tooth can become inflamed, resulting in root canal treatment. Even in the case of a dental prosthesis, pain may occur during chewing if a pressure point is present. The jaw is constantly changing with decreasing, increasing and with age.

As a result, pressure points can occur which cause pain when chewing and eating with the dentures.In this case, affected areas of the prosthesis must be ground out so that the soft tissues heal and no longer cause discomfort when chewing. If the teeth, especially the molars and jaw, hurt in cold outside temperatures, an ear infection or an inflammation of the parotid gland is a possible cause. Due to the close connection between the ear and the temporomandibular joint, the inflammation can spread from the ear to other structures.

At the very least, the pain radiates from the ear to other areas of the head. Stress causes hormones to be released which, among other things, lead to increased blood supply to the gums. Increased pressure can thus lead to gum inflammation and bleeding of the gums.

As compensation, the experiences of one day are processed at night. This usually manifests itself in teeth grinding or clenching. The temporomandibular joint is loaded with a very high pressure.

This results in abrasion of the intercartilage, which causes the bones to rub against each other. In addition, surrounding structures such as the ligaments and temporomandibular joint muscles are incorrectly loaded. The main nerve can become trapped, which leads to radiating pain into the teeth.

Due to the close connection between the muscles of the jaw and the head, headaches can also occur. The therapy for stress-related toothache is either physiotherapy or the creation of a relaxation splint for the night. Toothache can subjectively be perceived as much more severe when lying down than when standing.

On the one hand, this is due to the fact that inflammation caused by the warmth of the bed or a warmer environment is intensified by the better blood circulation when lying down and is more likely to spread. On the other hand, when lying down shortly before or while sleeping, there is usually no distraction whatsoever from everyday activities and the person affected concentrates solely on himself. Thus the feeling of pain only comes to the surface, as the patient is not distracted.

Furthermore, toothache can occur more often when lying down on the upper teeth when the patient has a cold. Due to an inflammation in the maxillary sinuses or the nose, the pain can radiate to the teeth due to the anatomical proximity and cause discomfort primarily when lying down, when the patient already gets bad air anyway. A reason for increased toothache at night can be a cold.

Since the patient usually spends the night lying down, the head including teeth and gums is well supplied with blood. The blood pressure is then higher when lying down than it is when standing or sitting during the day. According to the law of gravity, the fluid does not run out of the head.

The secretion in the paranasal sinuses presses on the dental nerves. At night, inflamed gums are more strongly supplied with blood, which leads to stronger pulsating pain in the gum pockets. Wisdom teeth that have not completely erupted and are still covered by gums offer a good niche for bacteria.

The gums around the wisdom teeth are usually also inflamed, which can cause throbbing pain there at night. If the nerve inside the tooth is inflamed, it will also cause more pain during the night, because as described above, the blood circulation through the tooth pulp is increased. This results in a higher pressure.

However, since the tooth cannot give way, the pressure cannot be diverted anywhere else except through the hole at the tip of the root. There, however, the nerves enter and exit, which are squeezed by the increased pressure. By crunching and pressing during the night, the strong forces can cause a tooth to break off or a filling to break out, which can lead to spontaneous pain.

In addition, the body’s own pain elimination is lowest at night, which means that possible pain was eliminated during the day, but which reoccurs at night. Painkillers or globules help through the night, and the next day you should see a dentist, even if the pain subsides in the morning. The painkiller (analgesic) recommended by orthodox medicine for toothache during pregnancy and also during breastfeeding is paracetamol.

There is sufficient clinical experience with the use of paracetamol. However, the intake should be kept as short as possible, not be overdosed, not taken in combination with other medications, and must be discussed with the doctor to be treated. Self-medication is not recommended in any case.

Paracetamol is able to cross the placenta barrier. The liver of the foetus can only break down the foreign substances to a limited extent. This can lead to liver damage in the unborn child if the dosage is not correct.Recent research shows that taking it could also later lead to asthma in the child or cause developmental disorders.

Aspirin should be avoided during pregnancy if possible and if, only used under strict indication. In the last three months of pregnancy, however, it is completely discouraged. Aspirin can pass through the placenta and the Botalli duct at the heart of the unborn child can become blocked.

The Ductus Botalli connects the aorta (main artery) with the Truncus pulmonalis (pulmonary artery). Bleeding may occur during the last third of pregnancy and the newborn baby is also more susceptible to this. Aspirin should be avoided during pregnancy if possible and if, only used under strict indication.

In the last three months of pregnancy, however, it is completely discouraged. Aspirin can pass through the placenta and the ductus botalli at the heart of the unborn child can become blocked. The Ductus Botalli connects the aorta (main artery) with the Truncus pulmonalis (pulmonary artery).

Bleeding may occur during the last third of pregnancy and the newborn baby is also more susceptible to this. Toothache after alcohol can have various causes. First of all, the way in which alcohol is consumed must be considered.

Thus, it is often the drinks consumed with alcohol that cause the toothache and not the alcohol itself. Alcohol itself does not damage the tooth enamel, but dilates the vessels, which under certain circumstances can cause nerve irritation. Toothache can also occur after some dental work.

After drilling
After a filling
After a root canal treatment
Under a crown

Drilling on the tooth can irritate the dental nerve, depending on its depth. This often causes pain that persists for some time after the treatment. These usually subside by themselves.

In rare cases, the pulp is damaged, which bacteria can now penetrate and cause an inflammation (pulpitis). Toothache can also occur after a freshly placed filling, regardless of which filling material is used. This may be due to the fact that every time caries is removed, the tooth is irritated by the mechanical rotation of the drill.

This irritation can have the effect that the tooth still causes pain when chewing a few days after the finished filling. If the caries is in a very advanced stage (“caries profunda”), that it reaches close to the pulp with the blood and nerve vessels, it is possible that the tooth will hurt after the treatment. Usually, in the case of deep fillings, a drug containing calcium hydroxide is applied under the filling so that the tooth forms hard tooth substance on its own, the so-called irritant dentine.

In many cases, however, the caries has progressed so far that when the tooth is removed, the drill is so close to the pulp that the nerve can be damaged. This then has the effect that after the filling more and more pulsating and throbbing pains occur and chewing is almost impossible. If the nerve becomes inflamed and damaged, it has to be removed from the pulp and followed by root canal treatment in order to preserve the tooth.

The following two weeks after the filling is placed are considered to be critical. If after two weeks the tooth is completely free of symptoms or a strong reduction of symptoms is achieved, the nerve is in most cases intact and the tooth calms down completely. If strong pain is still present after two weeks, another visit to the dentist is necessary to find the cause.

In the first days after a root canal treatment, pain is normal, because the procedure itself is always associated with a certain irritation of the tooth. The patient is informed about this before the treatment. These complaints usually subside completely after one to two weeks.

However, if the symptoms persist longer and do not subside, a dentist should be consulted. It is possible that bacteria have not been completely removed by insufficient rinsing and thus cause pain. The bacteria produce antigens and toxins, which can only escape downwards through the sealed root filling and thus trigger an inflammatory reaction.

Complaints of a crowned tooth can have harmless but also serious reasons. Probably the most harmless reason is the washing out of the luting cement. After some time, the cement beneath the crown loosens and a gap is created which is normally covered by the cement.If the crown does not loosen by itself, the patient will only notice something when slight pulling pain occurs.

Bacteria and food remains can penetrate into the gap, which can irritate the grinded tooth. If the crown is removed and reattached, the discomfort usually disappears immediately after insertion. If the bacteria had the chance to get under the crown over a longer period of time, caries may also have formed, which causes lasting pain.

In this case the crown must be removed and the caries treated before the crown can be reattached. After grinding a tooth for a crown and fixing it, it is quite possible that the nerve inside the tooth chamber may become inflamed afterwards. If the tooth does not recover after the irritation of the grinding, it must be treated in the root canal before the discomfort disappears.

Furthermore, toothache under a crown can also be caused by bacteria from an enlarged gum pocket, which is falsely perceived by the patient as pain under the crown. In this case, cleaning the pocket and applying an ointment is usually enough to alleviate the symptoms permanently. Atypical odontalgia is a neuropathic permanent pain of the teeth. Those affected suffer from long-lasting pain, which usually occurs after dental treatment, but is not attributable to a specific cause.