What causes a toothache?
It all begins with a sore, tender jaw, pain around the inflamed tooth and generally your little one will be feeling unwell and tired. But whatever the symptoms, if your child is suffering from a toothache, chances are you’ll hear about it. Toothache can come on at any time and yes, it’s called an ache for a reason, it’s super painful! Sources of toothache in children can vary, but can be categorised into two factors: local or external - so, lets get down to the science.
Local factors
Tooth
Decay off tooth surface can be causing sensitivity when eating or drinking.
A dental infection or abscess with spontaneous pain and often swelling of surrounding gum or more severe spread with swelling of face in the area of the tooth.
Fracture/break in tooth structure due to decay or trauma, exposing internal hard tissues and/or nerve tissue.
Gum
Inflammation/ulceration of gum due to trauma.
Swelling of gum and pressure pain due to eruption of teeth/tooth.
Infection of gum due to local abscess or systemic infections like viral infections (eg. Hand foot and mouth, coldsore/ primary herpes, glandular fever)
External factors
Disease
Many viral infections present with oral/ mouth involvement as mentioned earlier.
Nerve pain/ neuralgias can refer to face and dental structures.
Trauma – directly to the teeth or indirectly to the supporting soft and hard/ bony support tissues.
Structural/Anatomical
Referral of jaw joint (TMJ) pain.
Assymetries in jaw growth creating functional trauma to dental structures.
Functional
Parafunctional habits like clenching and grinding habits causing muscular, joint and dental trauma and pain often referring to all these structures.
Attrition of dental structures from excessive wear of dentition – a more common issue in the baby dentition due to its thinner and softer enamel compared to adult teeth.
Erosion of dental structures from chemical/acidic exposures – soft drinks, juices, gastric reflux issues, bulimia/excessive emesis.
Psychosomatic
In paediatrics, learned behaviour for attention or gratification can often mask the diagnostic work-up for determination of toothaches/pains (phantom pains).
In summary
When your child has a toothache the short term goal is to alleviate their discomfort as quickly as possible. If your child is suffering from a toothache, they can rinse their mouth out with salty water whenever they feel pain, a cold pack against the cheek can also reduce painful twinges and a weight appropriate dose of paracetamol or ibuprofen. Whilst they’re getting comfortable and the pain is subsiding, sneak off and call us to arrange an appointment!