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Six Common Causes of Tooth Pain

Your dentist knows best: Brush at least twice a day, floss every day, and be sure to brush your gum line. Taking good care of your teeth greatly reduces the likelihood and severity of tooth pain. Common causes of tooth pain are often related to poor oral hygiene. But if you are experiencing persistent tooth pain, visit your dentist as soon as you can.

Here are some common causes of tooth pain:

1. Tooth Decay

"Tooth decay is the most prevalent disease in the world," says Rich Homer, DMD, a dentist and head of Dental Conservation and Restoration at the University of Utah School of Dentistry. What's the main culprit behind tooth decay? When you eat, the bacteria in your mouth consume the sugars and carbohydrates and produce acids as a byproduct. Your mouth becomes more of an acidic environment that causes the minerals in your enamel to leach out. If remineralization does not occur (through saliva or fluoride), it can lead to tooth decay, called caries

Age may also be a factor in tooth decay, so you may need to be more vigilant about oral hygiene as you get older. When the enamel and minerals in a tooth are broken down over time by bacteria, cavities can form. If left untreated, your teeth may become sensitive when nerves become exposed. That's when the pain really strikes. And if neglected for too long, the tooth can become infected and abscessed.

2. Receding Gums

Bleeding and/or receding gums are a sign of poor oral hygiene of the soft tissues. Gums become inflamed when bacteria get caught between the gum and tooth. Initially, it causes gingivitis, which is reversible if treated. But if left untreated, it may cause permanent bone loss and recession of the gums or periodontitis. 

Periodontitis is an irreversible disease that must be treated by a periodontist to avoid tooth loss and/or infection. With receding gums, the more sensitive part of the tooth is exposed. Hot and cold beverages, as well as sweets, usually trigger sharp pain in these areas. It's important to turn your brush head 45 degrees toward the gums to ensure you brush the gum line that arches along your teeth during your daily routine to help reduce bacteria build-up.

3. Tooth Trauma

Injury to a tooth will most likely cause pain. This, of course, is an obvious cause-and-effect relationship. 

"However, pain due to tooth trauma might not show up for days or years after the event," Homer says. 

Perhaps you hit your front tooth on the monkey bars when you were a kid. It probably hurt for a short period of time, then the pain went away. The pain may resurface years later, seemingly for no reason at all. Life is unpredictable, and it's nearly impossible to prevent all injuries. But if you engage in sports or extreme physical activities, it's always a good idea to wear mouth protection. If you experience major tooth trauma, see your dentist immediately.

4. Teeth Grinding

There are many symptoms of stress. Teeth grinding can be among the most painful due to tooth trauma and/or temporomandibular disorder (TMD). Jaw pain, headache, temporalis muscle tenderness, or radiating tooth pain upon waking are common symptoms that may lead to a prognosis of tooth grinding or clenching. 

Those who experience high levels of stress or anxiety often grind their teeth during sleep. You could help alleviate the pain by addressing the stress itself through self-help, therapy, and/or medication. A custom guard made by a dental professional can further protect your teeth and decrease TMD pain.

5. Wisdom Teeth

The extra set of molars that sit under the gums usually emerge between the ages of 18 and 25. As wisdom teeth come in, the process can be painful, as they erupt from the gums. If a tooth partially erupts through the gums, bacteria may get stuck in pockets created by the soft tissue. This may lead to inflammation or infection of the tissue and ultimately cause pain. 

If a wisdom tooth comes in crooked, it can interfere with your bite or surrounding structures, such as teeth, gums, and cheek. The tooth that sits above or below a crooked wisdom tooth may bite in an awkward way, which can cause inflammation and create pain. If the wisdom tooth isn’t touching the tooth in front of it correctly, food may get trapped, causing dental cavities or gingival inflammation. 

The solution: consult with your dentist to see if your wisdom teeth are fully erupted and in the proper location. If the teeth may cause damage to surrounding structures or will not erupt completely, you should consider wisdom tooth removal.

6. Heredity

Heredity may play a role in tooth sensitivity. Some people are born with more sensitive teeth than others due to dental enamel and root cementum not completing a seal around the tooth during formation. If this is the case for you, you can thank your ancestral lineage. Unfortunately, there aren’t many dental treatments available, but you may try a sensitivity-reducing toothpaste or have a fluoride varnish applied when you visit your dentist.


updated: 5/11/2023

original: 4/30/2019