Toothache is a topic covered in the 5-Minute Emergency Consult.

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  • Tooth pain is caused by irritation of the root nerves located in pulpal tissue:
    • The pulp is the tooth's center and its neurovascular supply
  • Other etiologies, both inside the mouth and referred to the oral cavity, may cause oral pain


  • Dental:
    • Dental caries (hard structures demineralized by bacteria)
    • Pulpitis (inflamed pulp secondary to infection)
    • Reversible pulpitis is mild inflammation of the tooth pulp caused by caries encroaching on the pulp
    • Irreversible pulpitis is the result of an untreated carious lesion causing severe inflammation of the pulp and severe, persistent, poorly localized discomfort
    • Periapical abscess (necrotic pulp and subsequent abscess)
    • Postextraction pain (dry socket, infection)
    • Cracked-tooth syndrome (pain, cold sensitivity, crack difficult to visualize)
  • Periodontal disease:
    • Gingivitis and periodontitis (gingivitis with loss of periodontal ligament attachment)
    • Periodontal abscess (gum boil)
    • Pericoronitis (gingival inflammation from malerupted tooth)
    • Acute necrotizing ulcerative gingivitis (gingival pain, ulcers with/without pseudomembranes)
    • Denture stomatitis
    • Herpetic gingivostomatitis
    • Aphthous ulcers (canker sores)
    • Traumatic ulcers

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