Toothache: It is also know and Odontalgia ( Odonto-Tooth, Algia-Pain ) , it means pain in the tooth. Most of the times the cause of the pain is not in the tooth but surrounding the tooth like the gums and the soft tissue surrounding it.

The cause can be Inflammation (or) infection of the pulp tissue which causes this excruciating pain.

Why is toothache the most painful ???

The nerve supply and blood supply in the whole body is freely spread and it has space for expanding (due to odema) in cases of inflammation, But in case of the pulp tissue which is surrounded by the hard walls of Dentin around it there is no space for expanding so the pain exerted during the inflammation, this causes the excruciating pain.

Causes Of Tooth Ache/Odontalgia:

1) Dental Caries / Decay of Tooth:

The Bacterial infection which demineralizes the tooth structure is themost common cause of tooth ache. Dental caries starts showing pain when it reaches the Dentinal layer of the tooth which is supplied with nerve endings. So Dental caries is the most common cause of tooth ache.

2) Sensitivity:

Sensitivity of the teeth is also a major cause of toothache, as we take in cold and hot stuff the sudden sensitivity leads to toothache. The temperature change anlong with the Exposed dentin due to the loss of surface Enamel leads to the pain.

3) Inflammation of the tooth pulp

Also called pulpitis. It may be a result of trauma, such as thermal insult from repeated dental procedures or it may be caused by a dental caries. When the pulp becomes inflamed pressure begins to build up in the pulp cavity exerting pressure on the nerve of the tooth and the surrounding tissues. Pressure from inflammation can cause mild to extreme pain, depending upon the severity of the inflammation.

4) Impacted tooth

An impacted tooth is any tooth that is prevented from reaching its normal position in the mouth by tissue, bone, or another tooth. The teeth that most commonly become impacted are the wisdom teeth. These are the last to develop when the jaws have stopped growing and may be too small to accommodate these four additional teeth.

5) Fractured tooth:

When there is a fracture in the crown of the tooth we can see that whenever we chew due to the masticatory forces we get pain, the fracture may be due to an accident, or bitting on hard substance etc.

6) Irritated tooth nerve

The tooth pain is caused when the bullet proof enamel is lost causing exposure the dentin and the tiny nerve endings. Temperature changes like cold and hot or changes like sweet and sour foods cause the fluid in the tubules to move. This fluid movement tugs on the tiny nerves causing sensitivity and pain.

7) Abscess

Represents another cause of toothache. A dental abscess is an infection of the mouth, face, or throat that begins as a tooth infection or cavity. Bacteria can extend into the gums, the cheek, the throat, beneath the tongue, or even into the jaw or facial bones. A dental abscess can become very painful when tissues become inflamed.

8) Decrease in salivation:

This is a cause which many dont consider, the decrease in the salivary flow leads to many other diseases which indirectly lead to invasion by microorganisms which lead to many conditions which cause toothache.

9) Gum diseases

Periodontal (gum) diseases are serious infections that, left untreated, can cause toothache and tooth loss. Gum disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. It can affect one tooth or many teeth and usually begins when the bacteria in plaque causes the gums to become inflamed. Gum diseases also can expose tooth roots making them more sensitive to hot and cold foods, causing toothache.

Dental pain is the main reason why a patient comes to a doctor especially a dentist because the dental pain is the worst pain of the lot.

Predisposing factors: Dental pain is can be caused due to many reasons regarding the parts surrounding the mouth like the jaws and teeth, but the most common reason is a cavity in the tooth or a tooth decay which leads to sharp, severe and throbbing unbearable pain or tooth impactionand sometime due to the third molar which grows sidewards.

Pain in the tooth should not be neglected as it is the symptom of the diseased condition which needs immediate attention of a doctor.

Causes: dental pain is caused mainly by tooth cavity, tooth decay, tooth fracture, exposed tooth root, gum disease, TMJ joint problems etc. 

Diagnosis: Tests for the sensitised teeth are done: Heat test, Cold test etc  

Temporary treatment till you get to a doctor: During pain it is best to avoid hot and cold substances and to mainly avoid hard substances as they aggrevate the problem, clove oil applied on the affected area has beed considered to be the oldest and best known temporary cure for tooth ache, . These precautions can help you relieve the pain till you get to the doctor and get the real cause treated.

Precautions: As all say precaution is better than cure, so it is better we avoid any harmful substances which cause discomfort and can lead to dental pain, like taking very hot and cold substances should be avoided as well as hard subtances which can expose the sensitive layers of the tooth and cause pain.