A Toothache Without a Cavity
Pain in a tooth is commonly linked in the minds of many with a dental cavity. Yet the complexities of the inside of a tooth and its connections with surrounding tissues make tooth pain without a cavity a common finding. Understanding the possible causes can eliminate confusion caused this condition occurs.
Trauma
According to an article published in the Australian Dental Journal, accidents around home and school account for most injuries to permanent teeth. Some of these injuries require immediate attention due to the tooth being fractured. In other instances, the visible portion of the tooth is not harmed and no dental treatment is sought. However, the soft tissue on the inside of the tooth may have been injured. This leads to inflammation and possibly infection that causes pain until the diseased tissue is removed from the tooth.
- According to an article published in the Australian Dental Journal, accidents around home and school account for most injuries to permanent teeth.
- Some of these injuries require immediate attention due to the tooth being fractured.
Cracked Tooth
Causes of Pain in a Filled Tooth
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A crack or chip in a tooth creates a pathway for bacteria to gain access to the nerve tissue on the inside of a tooth according to the American Association of Endodontists. This causes inflammation of this tiny amount of tissue. Because it is trapped within the hard structures of the tooth, there is no room for it to swell and prevent pain from developing. This leads to a severe toothache as pressure is increasingly exerted on sensitive nerve fibers.
- A crack or chip in a tooth creates a pathway for bacteria to gain access to the nerve tissue on the inside of a tooth according to the American Association of Endodontists.
- Because it is trapped within the hard structures of the tooth, there is no room for it to swell and prevent pain from developing.
Sinus Infection
The back teeth of the upper jaw are in close proximity to the maxillary sinuses. Some of these roots protrude into the sinus cavity. This is the reason that sinusitis patients often complain of achy teeth in their upper jaw according to the American Academy of Otolaryngology 2. A correct diagnosis is critical in this instance to prevent unnecessary dental treatment from being performed.
- The back teeth of the upper jaw are in close proximity to the maxillary sinuses.
- This is the reason that sinusitis patients often complain of achy teeth in their upper jaw according to the American Academy of Otolaryngology 2.
Resorption
Molar Toothache Pain
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The dental pulp on the inside of the tooth and the periodontal ligament on the outside of the root contain cells that can be triggered to start dissolving the hard tooth structures. This is known as internal or external resorption. This can be the result of such medical conditions as scleroderma, according to the Scleroderma Foundation. Dental trauma is another possible cause. It is possible that this process will begin for no apparent reason. When it continues untreated it may cause a toothache without a cavity being detected in the tooth.
- The dental pulp on the inside of the tooth and the periodontal ligament on the outside of the root contain cells that can be triggered to start dissolving the hard tooth structures.
- When it continues untreated it may cause a toothache without a cavity being detected in the tooth.
Medical Condition
A toothache must be addressed immediately not only for maintenance of good oral health but because it may be the manifestation of a more serious underlying medical condition. According to the Yale Medical School an angina attack may be confused with a toothache.
Prevention/Solution
Regular dental checkups can help prevent toothaches from occurring. Further dental and medical complications can be minimized by seeking the appropriate care when any pain around the oral cavity develops.
Related Articles
References
- Australian Dental Journal: Epidemiology of Dental Trauma: A Review of the Literature
- American Academy of Otolaryngology: Fact Sheet: Sinus Headaches
- Renton T. Dental (Odontogenic) Pain. Rev Pain. 2011;5(1):2-7. doi:10.1177/204946371100500102
- Lin M, Genin GM, Xu F, Lu T. Thermal Pain in Teeth: Electrophysiology Governed by Thermomechanics. Appl Mech Rev. 2014;66(3):0308011-3080114. doi:10.1115/1.4026912
- Rajeswari K, Kandaswamy D, Karthick S. Endodontic management of patients with systemic complications. J Pharm Bioallied Sci. 2016;8(Suppl 1):S32-S35. doi:10.4103/0975-7406.191962
- Markowitz K, Moynihan M, Liu M, Kim S. Biologic properties of eugenol and zinc oxide-eugenol. A clinically oriented review. Oral Surg Oral Med Oral Pathol. 1992;73(6):729-37.
- Hersh EV, Ciancio SG, Kuperstein AS, et al. An evaluation of 10 percent and 20 percent benzocaine gels in patients with acute toothaches: efficacy, tolerability and compliance with label dose administration directions. J Am Dent Assoc. 2013;144(5):517-26.
- Bei M. Molecular genetics of tooth development. Curr Opin Genet Dev. 2009;19(5):504-10. doi:10.1016/j.gde.2009.09.002
- Hasan S, Singh K, Salati N. Cracked tooth syndrome: Overview of literature. Int J Appl Basic Med Res. 2015;5(3):164-8. doi:10.4103/2229-516X.165376
- American Dental Association. The American Dental Association. Do You Have a Cracked Tooth?
Writer Bio
Dr. Steve Tuggle has been writing dental, health, fitness and wellness articles since 2007. He has been published in the “Journal of Endodontics” and is the author of “The Relaxed Root Canal” ebook. He completed his dental degree and endodontic residency at the Medical College of Georgia School of Dentistry.