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Throbbing Toothache

July 10, 2023

How a Throbbing Toothache Feels Like

A throbbing toothache is an intense, pulsating pain that can feel like a relentless hammering inside your mouth. It’s as if your heartbeat has relocated to your tooth, each pulse amplifying the discomfort. The pain can be sharp and piercing or dull and persistent, often radiating to the jaw, ear, or even the head. It’s a relentless, distracting agony that can make it difficult to concentrate on anything else. Eating, drinking, and even breathing can exacerbate the pain, especially if the tooth is sensitive to temperature. The throbbing often worsens at night, making sleep elusive.

Throbbing toothache commonly prompts questions about causes, home remedies, dental visits, nighttime aggravation, and potential seriousness.

Common inquiries regarding throbbing toothache include its causes, home remedies, dental consultations, nighttime exacerbation, and potential severity.

What Causes a Throbbing Toothache?

The sensation of a throbbing toothache is often associated with the inflammation and increased blood flow that results from the following conditions:

Throbbing Pain Caused by Tooth Decay

When you have tooth decay, it starts with damage to the outer layer of your tooth, which is called the enamel. This happens because of bacteria in your mouth that eat sugars and produce acids that can weaken and damage this layer. At this point, you may not feel any pain because the enamel has no nerves. However, if the decay continues and reaches the next layer, called the dentin, you might start to feel discomfort. This is because the dentin is more sensitive, and it’s connected to the tooth’s nerves. If the decay continues even further and reaches the tooth’s pulp, which is the innermost part of the tooth where the nerves and blood vessels live, this is where things can get really painful. When the pulp gets infected and inflamed due to the bacteria and acids, it creates pressure inside your tooth because the pulp is in a closed, rigid space and can’t expand to relieve the inflammation. This pressure is what leads to the throbbing pain you feel. Also, there are specific pain-sensing nerve fibres in the pulp that respond to things like temperature changes, pressure, and chemicals produced by bacteria. When these nerve fibres are stimulated, they send signals to your brain that are perceived as pain.

Throbbing Pain Caused by Dental Abscess

A dental abscess is a pus-filled pocket caused by a bacterial infection. This can happen if bacteria get inside your tooth or gums, usually through a cavity, a cracked tooth, or gum disease. When these bacteria start to multiply inside your tooth, your immune system responds, and this causes the inside of your tooth to become inflamed. If the infection isn’t treated quickly, the bacteria can cause the tissue inside your tooth to die, creating an abscess. The abscess is stuck in a confined space in your tooth or the bone around your tooth, and as it gets bigger, it creates pressure. This pressure is one of the things that can cause pain. Your body also responds to bacterial infection with inflammation, which is a process that increases blood flow to the area. This can cause swelling and throbbing pain. Plus, your body releases certain chemicals during inflammation that not only cause swelling but also directly contribute to pain. The pressure and inflammation stimulate your pain nerves, which send signals to your brain that you’re feeling pain. The throbbing nature of the pain is likely due to the rhythmic flow of the blood coupled with the pressure from the abscess. Sometimes, the pain from an abscess can feel like it’s coming from a different place than it actually is. For instance, an abscess in a lower tooth might cause pain that feels like it’s in your ear.

Throbbing Pain Caused by Gum Disease

Gum disease, or periodontal disease, is when your gums and the tissue around your teeth get inflamed and infected by bacteria. This usually starts with dental plaque, which is a sticky layer of bacteria and sugars that forms on your teeth. Here’s how it leads to throbbing pain:

Gum Irritation and Early Gum Disease (Gingivitis)

If you don’t clean off the plaque, it irritates your gums. This makes them red, swollen, and easy to bleed. This is the first stage of gum disease, called gingivitis. You can reverse gingivitis with good brushing, flossing, and professional cleanings.

Advanced Gum Disease (Periodontitis) and “Pockets”

If gingivitis is left untreated, it can turn into periodontitis. This causes your gums to pull away from your teeth and form spaces known as “pockets.” These pockets trap more plaque you can’t clean out with regular brushing, allowing more bacteria to grow.

Immune Response and Tissue Breakdown

Your body fights off the bacteria by sending in your immune system. But this immune response also breaks down the supporting structures of your teeth, including ligaments and bone.

Pain

As the disease worsens, it can expose your tooth root, which is more sensitive and can cause discomfort and throbbing pain. The bacteria and your body’s response to them can stimulate pain receptors in your gums, which sends pain signals to your brain.

Tooth Movement and Loss

As the disease progresses, the destruction of ligaments and bones can make your teeth loose. If not taken care of, this can eventually lead to tooth loss, causing more pain and discomfort. Gum disease can lead to throbbing pain because bacteria irritate your gums, and your body’s response to fight off the bacteria also harms the supporting structures of your teeth.

Throbbing Pain Caused by a Cracked Tooth

Crack in the Tooth

When you have a cracked tooth, the inside part of the tooth (called the dentin) can become exposed. This part of the tooth is directly linked to the tooth’s nerves, which are located in the centre of the tooth. Nerve Irritation If the dentin is exposed, things like hot or cold drinks or sweet or sour foods can irritate the nerves, causing sharp pain.

Hidden Cracks and Biting Pain

Sometimes, the crack might be too small to see or hidden under the gum. This can still cause pain when you bite down or release the bite as the crack opens and closes, which irritates the nerves inside the tooth.

Inflammation and Throbbing Pain

If the nerves keep getting irritated, they can become inflamed. This inflammation, which happens inside the solid structure of the tooth, can cause pressure and a throbbing type of pain.

Infection and Abscess

If the inflammation isn’t treated, the nerve tissue can die, and bacteria can cause an infection and a pus-filled pocket (an abscess). The abscess creates pressure on the surrounding tissues, causing intense throbbing pain.

Pain Synced with Your Pulse

The throbbing pain you feel can be in time with your pulse. This is because the inflamed area has extra blood flow, and the pain signals get sent to your brain along with each pulse. So, in simpler terms, a cracked tooth can lead to throbbing pain because the crack exposes the inside of the tooth to irritants, causes nerve inflammation, and can lead to infection and abscess if not treated. Regular dental check-ups and good oral care can help prevent this. If you have a cracked tooth, emergency dentists in Brisbane can fix it with treatments like fillings, dental crowns, or sometimes a root canal.

Throbbing Pain Caused by a Damaged Filling

Fillings Are Like Shields

Dental fillings are like shields. They protect the inside of your tooth after a cavity has been cleaned out. If the filling gets damaged or falls out, the shield is gone. The inside of the tooth is now exposed.

Sensitive Inner Tooth

The inside of the tooth comprises a layer called dentin, which leads to the tooth’s core (the pulp), where the nerves are. When the dentin is exposed, it can let things like cold, hot, sweet, or sour foods and drinks reach the nerves and cause sharp pain.

Toothache and Constant Pain

If the nerves keep getting irritated, they can become inflamed, and this inflammation can cause a constant, throbbing type of pain. This is called pulpitis.

Infection and Intense Pain

If the inflammation is not treated, bacteria can invade the pulp, cause an infection, and a pus-filled pocket (an abscess) can form. The abscess creates pressure on the surrounding tissues and causes intense throbbing pain.

Pain in Sync with Your Heartbeat

The throbbing pain you feel can be in time with your heartbeat. This is because the inflamed area has extra blood flow, and the pain signals get sent to your brain with each heartbeat. In simpler terms, a damaged filling can lead to throbbing pain because it leaves the inside of the tooth exposed to irritants, causes nerve inflammation, and can lead to infection and abscess if not treated. If you notice a damaged or lost filling, it’s best to contact your dentist (or Paediatric dentist for Children) immediately. They can fix it with a new filling, a crown, or sometimes a root canal treatment.

Throbbing Pain Caused by Sinusitis

Swelling

When your sinuses, the spaces behind your face that produce mucus, are irritated or infected, they become swollen and make more mucus. This swelling can push on other parts of your face and head and cause pain.

Blocked Drainage

Your sinuses are normally empty mucus into your nose, but when they’re swollen, this drainage gets blocked. The mucus build-up can increase pressure in your sinuses, leading to throbbing pain.

Shared Nerves

The same nerves that help you feel your face and the front of your head also reach your sinuses. When your sinuses are inflamed, these nerves can signal pain in other areas they reach, like your upper teeth. This can feel like a toothache.

Pressure Changes

Actions like bending over, coughing, or sneezing can increase the pressure in your sinuses, making the throbbing pain worse.

Inflammation Triggers

When your sinuses are inflamed, your body releases chemicals that make your pain receptors (the parts of your nerves that signal pain) more sensitive, making the pain feel worse.

Widening Blood Vessels

Inflammation also makes your blood vessels widen, increasing blood flow and pressure in your sinuses. The changes in pressure can contribute to the throbbing pain. So, sinusitis can cause throbbing pain due to the combination of swelling, blocked drainage, shared nerves, changes in pressure, and the release of chemicals that increase pain sensitivity. Treatment usually involves tackling the root cause (like fighting off an infection or controlling allergies), reducing swelling, and managing the pain.

Throbbing Pain Caused by Temporomandibular Joint Disorders (TMD)

  1. Swelling: Temporomandibular Joint Disorder (TMD) can cause swelling in and around the jaw joint, which can irritate nerves and result in throbbing pain.
  2. Misplaced Cushion: Your jaw joint has a cushioning disc. If it gets out of place, it can cause irregular joint movement, leading to discomfort and throbbing pain.
  3. Muscle Tightness: TMD can cause the muscles around your jaw to tighten or spasm, which can cause throbbing pain.
  4. Wear and Tear: Sometimes, TMD can be associated with wear and tear, similar to the wear and tear in other joints that can happen with age (osteoarthritis). As the joint wears down, you might feel throbbing pain as bones rub together.
  5. Nerve Pain: Damage to the nerve that gives feeling to your face and jaw can result in a throbbing or burning type of pain.
  6. Shared Pain: TMD pain can sometimes be felt in areas other than your jaw due to shared nerve pathways. This means that you may feel pain in your ears, neck, or teeth due to problems with your jaw.
  7. Increased Blood Flow: Your automatic nervous system controls functions like blood flow without you thinking about it. If this system is overactive, it can change the blood flow and pressure in and around your jaw, contributing to the throbbing pain.

So, the throbbing pain you might feel with TMD can come from several sources: swelling, misplaced joint cushion, muscle tightness, wear and tear of the joint, nerve pain, pain felt in other areas, and changes in blood flow. Treatment usually involves reducing swelling, managing pain, improving joint movement, and addressing any underlying causes.

Throbbing Pain Caused by Pulpitis

Pulpitis is when the inside of your tooth gets inflamed, causing pain. Think of the tooth’s inner core, the “pulp,” as a small room filled with nerves and blood vessels, all surrounded by hard walls.

Swelling and Pressure

When pulpitis happens, this small room swells up, just like how your ankle might swell after a sprain. But unlike your ankle, the swelling inside your tooth has nowhere to go because those hard walls surround it. This causes a lot of pressure on the nerves and blood vessels, which results in pain.

Pain Signals

When the pulp gets inflamed, it releases chemicals that are like little alarms. These alarms signal your nerves, telling them something is wrong, which we perceive as pain.

Cut-off Blood Supply

Sometimes, the swelling can get so bad that it presses on the blood vessels, cutting off the blood supply to the pulp. This is like stepping on a garden hose, stopping the water flow. This lack of blood can kill the pulp tissue, which causes even more pain.

Throbbing Pain

The throbbing pain is similar to feeling your heartbeat in your tooth. Because the inflamed pulp is so sensitive, every pulse of blood going through your tooth can feel like a beat of pain. In essence, pulpitis can cause a lot of pain because the inflammation leads to pressure build-up, the release of “pain alarms,” and potentially cutting off the blood supply, which can kill the pulp tissue. It’s important to get this treated right away to stop the pain and save the tooth.

Pain management for throbbing toothache

Dental treatments for relieving throbbing toothache