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Toothache

It refers to pain around teeth or around the jaw. Dental (tooth) infection, decay, injury, or loss of a tooth is the most common causes of dental pain. Pain may also occur after an extraction (tooth is pulled out). Pain sometimes originates from other areas and radiates to the jaw, thus appearing to be tooth pain.
 

Causes-
Dental cavities- The most common cause of a toothache is a dental cavity. Dental cavities (caries) are holes in the two outer layers of a tooth called the enamel and the dentin. Small shallow cavities may not cause pain and may be unnoticed by the patient. The larger deeper cavities can collect food debris. The inner living pulp of the affected tooth can become irritated by bacterial toxins or by foods that are cold, hot, sour, or sweet-causing toothache.
Gum disease- The second most common cause of toothache is gum disease. Gum disease refers to inflammation of the soft tissue (gingiva) and abnormal loss of bone that surrounds the teeth and holds them in place. Gum diseases include gum bleeding without pain. Pain is a symptom of more advanced gum disease as the loss of bone around the teeth leads to the formation of gum pockets.
Tooth root sensitivity- The roots are the lower 2/3 of the teeth that are normally buried in bone. The bacterial toxins dissolve the bone around the roots and cause the gum and the bone to recede, exposing the roots. The exposed roots can become sensitive to cold, hot, and sour foods. The sensitivities may be so severe that the patient avoids any cold or sour foods.
Cracked tooth syndrome- it refer to the toothache caused by tooth fracture. . Biting on the area of tooth fracture can cause severe sharp pains. These fractures are usually due to chewing or biting hard objects such as hard candies, pencils, nuts, etc.
Temporo- mandibular joint syndrome- Diseases of the temporo-mandibular joint(s) can cause pain, usually in front of one or both ears. The TMJ hinges the lower jaw (mandible) to the skull. Pain in the temporo-mandibular joint(s) can be caused by acute trauma (such as a blow to the face), inflammatory or degenerative arthritis, or by the mandible being pushed back towards the ears whenever the patient chews or swallows. Sometimes, muscles around the TMJ used for chewing can go into spasm, causing head and neck pain and difficulty opening mouth normally. These muscle spasms are aggravated by chewing or by life "stress," which cause the patients to clench their teeth and further tighten these muscles. Temporary muscle spasms can also be caused by dental injections that are used to deliver local anesthetic for dental work or by the trauma of extracting impacted wisdom teeth.
Impaction and eruption
Earache
Sinusitis
 
Symptoms-
Toothache and jaw pain are common complaints. There may be severe pain to pressure, or to hot or cold stimuli. The pain may persist for longer than 15 seconds after the stimulus is removed. As the area of inflammation increases, the pain becomes more severe. It may radiate to the cheek, the ear, or the jaw. Other signs and symptoms that may lead you to seek care include the following:
Pain with chewing
Hot or cold sensitivity
Bleeding or discharge from around a tooth or gums
Swelling around a tooth or swelling of your jaw
Injury or trauma to the area
These signs and symptoms may sometimes be associated with dental decay or gum disease (periodontal disease). Dental decay or an area of redness around the tooth's gum line may point to the source of pain. If you tap an infected tooth, it may make the pain more intense. This sign may point to the problem tooth even if the tooth appears normal.
A toothache needs to be differentiated from other sources of pain in the face. Sinusitis, ear or throat pain, or an injury to the temporomandibular joint (TMJ) that attaches the jaw to the skull may be confused with toothache. Pain from a deeper structure (called referred pain) may be passed along the nerve and be felt in the jaw or tooth.
Diagnosis-
Medical history and physical examination-
X- ray of tooth and jaw.
ECG- when cause is something other than dental and jaw problem.
 
Treatment-
Medication to get relief from pain.
To prevent tooth decay, use good oral hygiene. A low sugar diet is recommended along with regular flossing, brushing with fluoride toothpaste, and regular professional cleaning. Sealants and fluoride applications by the dentist are important for preventing tooth decay.
 
Role of homoeopathy-
Homoeopathic medicines will help in treating acute phases of toothaches as well as in reducing the recurrent attacks of toothache. The medicine is selected on the basis of  the cause and symptoms presented by the patient.

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