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Tooth Pain Toothache
North Carolina Charlotte Dentists NC 

Dentist Charlotte NC North Carolina Holistic Biological Biocompatible 

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Causes of Tooth Pain 

Traumatic occlusion: 

There are many things that can cause a toothache. Often times when I am diagnosing the cause of tooth pain on my Charlotte NC area patients, it is an obvious cavity or root canal infection. However, there are many other causes for a toothache. A common cause for mild to very intense pain is a traumatic bite. This occurs when the opposing tooth is hitting the tooth with pain in a way to cause inflammation of the ligament around the tooth. As an experienced and minimally invasive dentist, I cannot tell you how many times I relieved even severe pain with just a simple adjustment of the bite on a painful tooth. Previous to coming to me, some of these patients were told they needed root canal to treat the pain.

"This initial increased vascularity results in a more compressible periodontal ligamnet and increased clinical mobility. Changes in the apical periodontal ligament vascular patterns can also result in increased vasodilation of the pulp with increased sensitivity and pain to hot and cold stimuli secondary to traumatic occlusion." 

Cracked tooth: 

A common cause for tooth fracture is an unbalanced bite. Depending how the tooth fractures will determine whether the tooth can be treated and saved. Teeth with fractures along the root surface cannot be treated and need to be extracted. 

tooth can be treated 

tooth cannot be treated 

tooth cannot be treated 

vertical root fracture, tooth had to be removed 

- Cardiac Toothache: 

"Heart problems such as angina pectoris or acute myocardial infarction, refer pain to the shoulder, arm and even to the jaw. We know that these conditions can refer pain to your teeth as well. Sometimes it is associated with chest pain but occasionally it is not. When a toothache has a cardiac origin, it usually increases with exercise and decreases with medication specific for your heart (such as nitroglycerin tablets). Treatment is directed to the underlying heart problem, usually after your dentist has evaluated the tooth." (American Academy of OroFacial Pain)

A cavity or root canal infection:

Periodontal or gum infection: 

Often times one of my Charlotte NC area patients presents to my office with what they think is a toothache, but is actually gum pain. This is caused by excess bacteria accumulation on the neck of a tooth or teeth. Once the bacteria is removed, the gum tissue heals and the pain goes away. 

- Acute trauma/injury (e.g. car accident, punch in the jaw, a fall): 

fractured tooth and displaced teeth from trauma 

Ischemic bone disease:

Necrotic tissue near nerve supplying teeth.

- sinusitis: 

Sinus/Nasal Toothache 

"Problems in the maxillary sinuses and/or paranasal mucosa can refer pain to the upper teeth. The pain is usually felt in several teeth as dull, aching or throbbing. Sometimes it is associated with pressure below the eyes and it can increase with lowering the head, putting pressure over the sinuses, coughing or sneezing. Tests performed on your teeth, such as cold, chewing and percussion, can increase the pain from sinus origin. A history of an upper respiratory infection, nasal congestion or sinus problem should lead to suspicion of a "sinus tootache." Diagnostic tests, such as visual nasal exam, sinus X-rays or MRI, will reveal this condition. Also, application of topical anesthesia to the offending area should eliminate the pain. Treatment with antihistaminics, decongestants and antibiotics will help."(American Academy of OroFacial Pain) 

Roots of upper molar teeth are in close proximity to the sinuses and often time penetrate it. 


Note: Sinusitis can also be caused by dental infection. 


- Tumors and other Pathologies" 

"Neoplasias and Other Lesions in the Head Some tumors, aneurisms (abnormality of a blood vessel), and other intracranial disorders can cause pain in your mouth or teeth. The tooth symptoms are generally accompanied by other nerve malfunctioning or systemic symptoms, such as weight loss, fatigue, etc. These accompanying symptoms suggest more than a localized tooth problem is occurring. Tumors can also appear in the areas near the nerves of the teeth, which may cause the teeth to be loose or displaced. Proper imaging of the face, jaw and head is important to evaluate for these problems. Although possible, these problems are very rare, and treatment needs to be directed to the specific problem."(American Academy of OroFacial Pain) 

- Salivary Gland Dysfunction: 

"Patients with salivary gland dysfunction can experience dental pain through different mechanisms. It may occur through referred pain from the glands to the teeth. It may also occur through compromising the health of the teeth and supporting structures and by the absence of the protective saliva. In such case, a comprehensive evaluation of the salivary glands is needed."(American Academy of OroFacial Pain)