Probably everyone has already made the unpleasant acquaintance with toothache. But why do people perceive the strength of toothache so intensively? Or are they even more unpleasant than pain in other parts of the body?
Are there systemic diseases that influence toothache and can stress change the pain and even increase it? Why do teeth hurt when you have a cold? This might be of interest to you: What to do about toothache?
General causes of toothache
Toothache can have many different causes, which is why it manifests itself in many different ways and is often not easy to diagnose. Probably the simplest or most typical cause of toothache is caries. It attacks the tooth from the outside and dissolves the hard protective tooth surface, the enamel of the tooth.
This is the problem: once the outer layer has caved in, i.e. a “hole” has been created, bacteria can penetrate more easily and penetrate further into the inside of the tooth. In general, exposed dentin that is no longer covered by the enamel causes a greatly increased sensitivity to pain. To relieve the pain, the exposed dentin must be covered.
If the bacteria penetrate into the tooth pulp, they infiltrate nerve and blood vessels and metabolize them. This condition of the inflamed pulp is called pulpitis and is associated with severe acute pain, which occurs spontaneously even at night and when lying down. Typical is the sudden onset and constantly shortening pain-free phases.
Characteristic for an inflammation of the pulp are radiating pains that the patient often cannot indicate which tooth is affected. If the inflammation continues to progress, apical periodontitis, the inflammation of the root of the tooth, occurs, in which the tooth is sensitive to knocking and the person affected feels a pressure pain. The apical periodontitis can also affect the entire periodontium and lead to severe hypersensitivity of the gums and bleeding.
Another possible case of toothache is the exposed neck of the tooth. If the gums on the tooth have receded, for example, due to brushing too vigorously with a toothbrush, the protective layer is missing. Cold, heat or mechanical forces are felt excessively.
Furthermore, the breaking through of teeth can cause pain when changing teeth, in young adults often the breaking through of wisdom teeth. If these cannot break through their position, they press more on neighbouring teeth, which leads to pain. The damaging effect of excessive stress on the human body has already been scientifically proven and even toothache can be influenced by it.
When stress occurs, the stress hormone cortisol is produced and released in increased quantities, which can increase the perception of pain and thus lead to a stronger feeling of pain. The daily peak of the cortisol production is during the early morning hours (3-6 o’clock at night), which is why the perception of pain is highest during this time, at midnight pain is less noticeable due to the low concentration. However, if production increases due to stress, the pain is also felt more intensively.
Furthermore, while sleeping in a dream, the person processes events of the day. During this process, the sleeper unconsciously presses and rubs his teeth together and the enamel is rubbed off. This so-called grinding ensures that the chewing muscles tense up.
The chewing forces during the night are so strong that the periodontium cannot withstand these forces and develops pain. Complaints can also occur in the temporomandibular joints. Due to the anatomical proximity to the head and neck, it is possible that complaints radiate from the oral cavity.
This can result in cluster headaches or neck pain, which often cannot be attributed to the person affected. In the case of increased stress situations during the day, the crunching during the night is strongly favored, as this is an attempt to process the day’s events. By a splint therapy at the dentist these complaints can be relieved quickly, so that the teeth are prevented from grinding at night by a plastic splint and muscles and joints can relax.
This could also be interesting for you: How can I reduce stress? Toothache, which occurs despite healthy teeth and periodontium, is usually the result of an illness. A rare but relevant disease associated with toothache is trigeminal neuralgia.This is a disease or sensory disorder of the fifth cranial nerve, the trigeminal nerve, which sensitively supplies the entire masticatory apparatus.
Patients complain of unbearable pain, which sometimes makes touching or shaving a beard impossible. As this disease is very difficult to diagnose because of its multiple effects, patients often have all their teeth extracted at their request because of toothache, without any improvement until only the trigeminal neuralgia can be considered a disease. Furthermore, cluster headaches radiate to the neck and also to the dental area and can lead to the sensation of toothache despite having healthy teeth.
Rather rare, but possible, is pain in the tooth area in the case of a heart attack or acute angina pectoris. Toothache can occur after a severe cold that has affected the sinuses. This is true for the posterior teeth of the upper jaw because of the close spatial relationship.
When coughing and sniffing snow or tilting the head forward, the patient feels a knocking toothache, but this usually disappears after a week as the cold heals. Due to the anatomical proximity of the upper jaw teeth to the maxillary sinuses, a simple, uncomplicated cold can cause the teeth to hurt. It is not uncommon for the roots of the upper teeth to protrude into the maxillary sinus, creating a direct relationship between these structures.
In this way, bacteria from the maxillary sinus can reach the teeth unhindered and cause inflammatory pain. It is characteristic that the affected person cannot localize the pain on one tooth, but rather groups of teeth or the entire upper jaw area is affected. In the majority of cases, these complaints subside completely after the rhinitis has subsided.
Infections in the neck and throat area can also trigger toothache, as the oral cavity and throat area are connected. The patient complains of burning sore throat and severe discomfort when swallowing. These pains can also radiate and be transmitted to teeth.
The inflammatory cells can spread from the throat region and reach the gums and the tooth bed. Thus they can lead to gingivitis, inflammation of the gums or periodontitis, an inflammation of the entire periodontium. These diseases not only cause severe pain in the soft tissues, but can also cause unpleasant pain in the teeth.
It is characteristic that cold weather relieves the pain and eating ice cream, for example, is beneficial, while warm drinks and food make the pain even worse. It is advisable to consult a doctor to treat the original throat infection. In most cases, the dental problems disappear after the treatment of the sore throat.
If this is not the case, a dentist should also be consulted. In most cases caries is responsible for chewing pain. The decayed tooth has a caved in surface and the tooth structure is no longer hard enough to protect the pulp, the tooth pulp where the nerve vessels are located, against the forces that occur during chewing.
Eating sweets can already cause pain because they are broken down into acid in the mouth; this acid has a low pH value and is corrosive and further destroys the tooth structure. The so-called chewing pain can also be caused by an inflammation of the tooth root, since an inflammation and thus swelling develops below the root tip, which leads to a lifting of the tooth. Although only the slightest changes in position are involved, it can lead to the tooth being subjected to much more stress than before, which can make mere clenching painful. When chewing, the tooth is loaded with more force than usual, since it is the first to make contact, and is pressed into the inflamed tissue, which leads to unbearable pain.
