Non-dental Toothaches 

by 

Dr. Kumudu Wijesinghe Suriya

    
The causes of toothache can be dental and non-dental.  The majority of cases fall into dental origin.  For this reason, my previous article on Sensitive to Teeth Sensitivity focused first on toothaches of dental origin.  

This article conceptualizes on some reasons related to toothaches of non-dental origin.   When a patient believes that a toothache is originating from a tooth, the expectation is to treat that tooth.  If a dentist finds a problem in the tooth that a patient is isolating, the treatment of the tooth is often the solution.  When the toothache is present even after a procedure, it may not be a result of an unsuccessful treatment.  It is possible that in addition to a dental problem in the isolated tooth, the patient has unresolved toothaches of non-dental origin.  It is in this sense that looking only for problems in teeth can make diagnosis as well as treatment of teeth problematic.  It is also important to investigate on causes of non-dental origin that can contribute to toothaches.

Here are some non-dental causes of toothaches.

Strain on jaw muscles can refer pain to teeth.

Migraines and cluster headaches 

Headaches that result from changes to nerves and blood vessels in our heads may feel as toothaches.

When heart problems refer pain to shoulder, arm and jaw, it is also possible to spillover pain to teeth.  

Problems in maxillary sinus 

Pain to upper teeth may be a pressure build up in maxillary sinus.  Usually this type of pain is felt in several teeth as well as pressure below eyes.

Salivary gland dysfunction In absence of protective saliva, the health of teeth and supporting structures will be compromised.  In addition, when salivary glands are dysfunctional, referred pain can occur in teeth.

Trigeminal neuralgia Trigeminal nerve provides sensations to face and teeth.  Trigeminal neuralgia is a nervous disorder that affects trigeminal nerve, causing intense pain in areas of face and sometimes mimicking a toothache. 

With advances in medicine and technology, there are new solutions to toothaches.  However, while elimination of pain is possible for some of these situations, other times it is only possible to manage pain.

In attempting to identify causes behind these toothaches, other health issues may be uncovered.  General dentists may need to refer patients to specialists or work in consultations with specialists when dealing with patients who have toothaches of non-dental origin.  When you visit a dentist, try to have an open dialogue without limiting to teeth.

Dr. Kumudu Wijesinghe Suriya, BDS (Peradeniya), DMD (UBC), is a dentist who practices in New Westminster & Surrey.  She is a Clinical Instructor at the University of British Columbia and was a Lecturer at the University of Peradeniya.

Sri Lanka Times (BC, Canada), February 2013

by

Dr. Kumudu Wijesinghe Suriya

I can’t remember anyone talking about sensitive teeth when I was a kid.  Now I see many people who are concerned about their teeth sensitivities.  Does this mean that people are becoming more expressive on their teeth sensitivities?  Is it possible that teeth sensitivities are on the rise?  In any event, for sure, teeth sensitivities are not ignored now.

A painful tooth can stem mainly from four distinct situations – decayed tooth, post-operative sensitivity (last for a period of time after a filling), referred tooth pain and dentin hypersensitivity.  A future article will focus on referred tooth pain.  This article focuses on dentin hypersensitivity, enabling you to take preventative steps.

The part above the gum line of a tooth is called a crown.  A layer of hard material called enamel protects the crowns of your teeth.  The part below gum line of a tooth is not fully protected with enamel.  A layer as not as hard as enamel called cementum covers the largest area below gum line.  Underneath both enamel and cementum is dentin.

Dentin is not as hard as enamel and contains tiny microscopic tubes (tubules).  About twenty percent of tubules have nerve fibers penetrating inner dentine by no more than a few microns.  When gums recede, dentin may also be exposed.  The result is dentin hypersensitivity or commonly known as teeth sensitivity.

What are the major causes of teeth sensitivity?

• brushing too hard 

• grinding teeth 

• keeping mouth acidic 

• neglecting oral hygiene 

• gum disease

• Don’t brush too hard.  Avoid hard toothbrushes.  Brush with a soft-bristled toothbrush. 

• Brush twice a day with a proper technique to prevent plaque build up.  This will also reduce the chances of periodontal disease that can cause receding gums. 

• Rinse your mouth to flush out acid build up in your mouth.  Rinsing is especially important when you consume acidic drinks (orange, lime, pop-drinks, etc.) or food. 

• Use fluoridated dental toothpaste to help strengthen enamel.  This is important in light of the fact that BC tap water is mostly non-fluoridated.  You may also want to use toothpaste recommended for sensitive teeth. 

• Avoid using unsafe teeth-whitening products. 

• It is easy to avoid grinding teeth during the day as you can control your action while you are awake.  If you grind during night, you cannot control your actions.  You could use a mouth guard. 

• If you have a small cavity, do not wait till it becomes a major one to see a dentist.

With increasing life-expectancy, you have more years to chew.  If you take preventative measures, you will have a pleasant experience when drinking and eating.

Dr. Kumudu Wijesinghe Suriya, BDS (Peradeniya), DMD (UBC), is a dentist who practices in New Westminster & Surrey.  She is a Clinical Instructor at the University of British Columbia and was a Lecturer at the University of Peradeniya.

Sri Lanka Times (BC, Canada), November 2012