Toothache and Gum Problems
Toothaches and gum problems are common but fortunately usually can be prevented with good dental care and dental hygiene. Keeping your teeth, gums, and the bones around your teeth healthy requires regular brushing, flossing, and good nutrition. You should brush your teeth after every meal and floss once a day to remove plaque, a cause of tooth decay and gum disease. For more information on proper brushing and flossing techniques, see the topic Basic Dental Care.
Sometimes a tooth is sensitive when touched or when it comes in contact with foods or drinks that are hot, cold, sweet, or sour. These sensations are easily transmitted to the nerves in the center of the tooth (pulp). Mild sensitivity can be caused by receded gums or a worn-down tooth. Extreme sensitivity to temperatures or sweet or sour tastes can mean that the pulp has been injured or exposed by wear, a tooth has cracked, a dental cavity is present, or a filling has been lost. Prompt dental care can prevent the tooth from dying.
The most common cause of a toothache is tooth decay, although toothache may not be present in the early stages of decay. Other reasons for a toothache might include:
An infection of the tooth (abscess). A red, swollen, painful bump may be found near or on the side of the sore tooth. The tooth may especially hurt when you bite down.
An impacted tooth. Gums may be red, swollen, and sore. The area around this tooth can ache, throb, and be quite painful.
Problems with or injury to the pulp, which can be caused by an injury to the face or from grinding or gnashing the teeth.
Sometimes a toothache can be caused by a another health problem, such as:
A heart attack, cluster headache, or sinus infection, which can cause referred pain into the teeth or jaw.
Viral infections, such as shingles.
Diseases such as diabetes, alcoholism, or drug abuse, especially methamphetamines.
Nerve-related disease, such as trigeminal neuralgia.
Alcohol or drug abuse.
Vitamin deficiencies, such as too little vitamin B12.
Healthy gums are pink and firm and do not bleed easily. Occasionally your gums may bleed if you brush your teeth and gums too hard, use a hard-bristled toothbrush, or snap dental floss hard against your gums. Be gentle with your teeth; use a soft-bristled tooth brush and floss carefully to help prevent this problem.
Early-stage gum disease (gingivitis) causes red, swollen gums that bleed easily when brushed. Because gingivitis usually doesn't cause pain, many people delay treatment. If not treated, gum disease can cause more serious problems with the gum tissue.
As gum disease progresses, the gums pull away from the teeth, leaving deep pockets where plaque can hide and cause further damage. This stage of gum disease is called periodontitis or periodontal disease and is caused by long-term infection of the gums, bone, and other tissues that surround and support the teeth. It can progress until the bones that support the teeth are damaged. In this late stage, teeth may become loose and fall out or need to be removed. Early treatment of gum disease is important to prevent tooth loss. As gum disease gets more severe (periodontitis), it becomes harder to treat.
Other causes of gum bleeding, swelling, and pain include:
Pregnancy, blood-thinning medications, or bleeding disorders; each can cause gums to bleed easily.
Lack of vitamins, such as vitamin K or vitamin C, or medical problems, such as anemia, that interfere with the body's ability to absorb certain vitamins.
Teething in babies and young children. For more information, see the topic Teething.
Medications such as Dilantin or calcium channel blockers.
Dentures or a dental appliance that irritates the gums.
An infection around the root of the tooth. Swelling and redness, sometimes with pus, may appear at the base of a tooth.
Smoking and using other tobacco products increases your risk for gum disease. Smokers have a higher chance of having gum disease throughout their mouths than nonsmokers. You may not have symptoms of bleeding or swollen gums because the normal bleeding immune response is affected by tobacco use. Chewing tobacco or using snuff may push the gums back in the area of
the mouth where the tobacco is inserted. Constant irritation caused by tobacco products increases your risk of oral cancer.
Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.