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Toothache

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

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Emergency Central

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Basics

Description

  • 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

Etiology

  • 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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Citation

Rosen, Peter, et al., editors. "Toothache." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307621/all/Toothache.
Toothache. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307621/all/Toothache. Accessed April 24, 2019.
Toothache. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307621/all/Toothache
Toothache [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 24]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307621/all/Toothache.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Toothache ID - 307621 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307621/all/Toothache PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -