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Toothache and Gum Problems
Topic Overview
Toothaches and gum problems are common but usually can be prevented by taking good care of your teeth and gums. Keeping your teeth, gums, and the bones around your teeth healthy requires regular brushing, flossing, and good nutrition. Brush your teeth twice a day with an American Dental Association (ADA) accepted fluoride toothpaste. Clean between teeth daily with floss or an interdental cleaner. For more information on proper brushing and flossing techniques, see the topic Basic Dental Care.
Toothaches
Sometimes you may have tooth pain when you touch a tooth or when you eat or drink foods that are hot, cold, sweet, or sour (a sensitive tooth). Mild sensitivity can be caused by shrunken (receded) gums or a worn-down tooth. Moderate to severe sensitivity can mean a tooth has cracked, a dental cavity is present, or a filling has been lost. Seeing a dentist for treatment can prevent the tooth from dying.
The most common cause of a toothache is tooth decay, although a toothache may not be present in the early stages of decay. Other reasons for a toothache might include:
- An infection of or around 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.
- A tooth that has not broken through the gum (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 nerves in the center of the tooth (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 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.
- Nerve-related disease, such as trigeminal neuralgia.
- Alcohol or drug abuse, especially methamphetamines.
- Vitamin deficiencies, such as too little vitamin B12.
Gum problems
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 toothbrush and floss carefully to help prevent bleeding gums.
Gingivitis is a gum disease that 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.
Periodontitis is severe gum 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.
Other causes of gum bleeding, swelling, and pain include:
- Pregnancy, blood-thinning medicines, or bleeding disorders. Each of these 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.
- Medicines 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.
Check your symptoms to decide if and when you should see a doctor.
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
Check Your Symptoms
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Pain in adults and older children
- Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
- Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
- Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
- Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.
Many prescription and nonprescription medicines can cause mouth problems. A few examples are:
- Antibiotics.
- Some seizure medicines.
- Medicines used to treat cancer (chemotherapy).
- Steroid medicines.
- Medicines used after organ transplant.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:
- Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
- Long-term alcohol and drug problems.
- Steroid medicines, which may be used to treat a variety of conditions.
- Chemotherapy and radiation therapy for cancer.
- Other medicines used to treat autoimmune disease.
- Medicines taken after organ transplant.
- Not having a spleen.
Symptoms of a heart attack may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
The more of these symptoms you have, the more likely it is that you're having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your dentist today to discuss the symptoms and arrange for care.
- If you cannot reach your dentist or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your dentist in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your dentist. You may need care sooner.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your dentist now to discuss the symptoms and arrange for care.
- If you cannot reach your dentist or you don't have one, seek care in the next hour.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
After you call 911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.
Home Treatment
Tooth sensitivity
To reduce sensitivity to heat, cold, or brushing, consider using a toothpaste specifically designed for sensitive teeth. Brush with it regularly or rub a small amount of the paste on the sensitive area with your finger 2 or 3 times a day. Floss gently between your teeth.
Toothache
To reduce pain and swelling of a toothache, use an ice pack on the outside of your cheek; do not use heat. Avoid very hot, cold, or sweet foods and drinks if they increase your pain.
For short-term relief, adults can apply an over-the-counter benzocaine gel to the tooth. Do not use teething gels for children younger than 2. The U.S. Food and Drug Administration (FDA) warns against using teething gels that contain the medicine benzocaine because it can harm your child. Be safe with medicine. Read and follow all instructions on the label. If your pain lasts longer than a few days or it gets worse, call a doctor.
Try a nonprescription medicine to help treat your fever or pain: |
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Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine. |
Be sure to follow these safety tips when you use a nonprescription medicine: |
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Gum problems
If your gums are mildly swollen and red, use a tartar-control toothpaste that contains fluoride and also use a mouthwash that contains fluoride. Make sure you brush after meals and snacks and floss every day. If you cannot brush after eating, chew sugar-free gum, use a tooth pick, or rinse your mouth with warm salt water. You can make your own salt water by mixing 1 tsp (5 g) of salt in a medium-sized glass [8 fl oz (240 mL)] of warm water.
Tobacco can cause many gum problems, decreases your ability to fight infection of your gums, and delays healing. Do not smoke or use other tobacco products. For more information, see the topic Quitting Smoking.
Do not use illegal drugs, such as methamphetamines, which cause tooth and gum problems.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
- Signs of infection develop.
- Gum or tooth problems last for more than 2 weeks.
- Symptoms persist or become more severe or frequent.
Prevention
Keeping your teeth and gums healthy requires good nutrition and regular brushing and flossing. To avoid a tooth or gum problem:
- Brush your teeth twice a day, in the morning and before bedtime. Floss once a day.
- Use a toothpaste that contains fluoride.
- Avoid foods that contain a lot of sugar. Sugar helps plaque grow.
- Ask your dentist or dental hygienist about tongue cleaning. You can use a tongue cleaner or a soft-bristled toothbrush, stroking in a back-to-front direction. Tongue cleaning is particularly important for people who smoke or whose tongues are coated or deeply grooved.
- Ask your dentist or hygienist whether he or she recommends using a mouthwash that contains fluoride and ingredients to reduce plaque.
- Schedule regular trips to the dentist. Most dentists recommend exams and cleaning 2 times a year. Some experts believe those who are at low risk for dental problems need only a yearly exam.
- Get regular checkups or recommended blood tests ordered by your doctor if you are on a blood-thinning medicine or you have a bleeding disorder.
- Do not smoke or use other tobacco products because it decreases your ability to fight gum infection and delays healing. For more information, see the topic Quitting Smoking.
- Do not use illegal drugs, such as methamphetamines, which cause tooth and gum problems.
Preparing For Your Appointment
You can help your dentist diagnose and treat your condition by being prepared to answer the following questions:
- Do you have tooth pain?
- When did the pain start?
- Has the pain been constant or does it come and go?
- Does anything make the pain better or worse?
- Does the pain awaken you from sleep or interfere with any other activities?
- Do your gums bleed?
- When did the bleeding start?
- What makes your gums bleed?
- How often do you brush and floss your teeth?
- When was your last dental examination? Do you visit a dentist regularly?
- Have you had a dental or gum problem in the past?
- What home treatment measures have you tried? Did they help?
- What nonprescription medicines have you tried? Did they help?
- What prescription and nonprescription medicines do you take?
- Do you have any health risks?
Related Information
Credits
ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Adam Husney, MD - Family Medicine
John Pope, MD, MPH - Pediatrics
Kathleen Romito, MD - Family Medicine
Current as ofNovember 20, 2017
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Current as of: November 20, 2017