Toothaches and gum problems
are common but usually can be prevented by taking good care of your teeth and
gums. Keeping your
gums, and the bones around your teeth healthy requires regular brushing, flossing,
and good nutrition. Brush your teeth twice a day with an American Dental Association (ADA) accepted fluoride
toothpaste. Clean between teeth daily with floss or an interdental cleaner. For
more information on proper brushing and flossing techniques, see the topic
Basic Dental Care.
Sometimes you may have tooth pain when
you touch a tooth or when you eat or drink foods that are hot, cold, sweet, or
sour (a sensitive tooth). Mild sensitivity can be caused by shrunken (receded)
gums or a worn-down tooth. Moderate to severe sensitivity can mean a tooth has
cracked, a dental
cavity is present, or a
filling has been lost. Seeing a
dentist for treatment can prevent the tooth from
The most common cause of a toothache is
tooth decay, although a toothache may not be present in the early stages of
decay. Other reasons for a toothache might include:
Sometimes a toothache can be caused by a another health
problem, such as:
are pink and firm and do not bleed easily. Occasionally your gums may bleed if
you brush your teeth and gums too hard, use a hard-bristled toothbrush, or snap
dental floss hard against your gums. Be gentle with your teeth—use a
soft-bristled toothbrush and floss carefully to help prevent bleeding gums.
Early-stage gum disease (gingivitis) causes red,
swollen gums that bleed easily when brushed. Because gingivitis usually doesn't
cause pain, many people delay treatment. If not treated, gum disease can cause
more serious problems with the gum tissue.
As gum disease gets
worse, the gums pull away from the teeth, leaving deep pockets where plaque can
hide and cause further damage. This stage of gum disease is called
periodontal disease and is caused by long-term
infection of the gums, bone, and other tissues that surround and support the
teeth. It can progress until the bones that support the teeth are damaged. In
this late stage, teeth may become loose and fall out or need to be removed.
Early treatment of gum disease is important to prevent tooth loss. As gum
disease gets more severe (periodontitis), it becomes harder to treat.
Other causes of gum bleeding, swelling, and pain include:
Smoking and using other tobacco products increases your risk
for gum disease. Smokers have a higher chance of having gum disease throughout
their mouths than nonsmokers. You may not have symptoms of bleeding or swollen
gums because the normal bleeding immune response is affected by tobacco use.
Chewing tobacco or using snuff may push the gums back in the area of the mouth
where the tobacco is inserted. Constant irritation caused by tobacco products
increases your risk of
Check your symptoms to decide if and when you should see a doctor.
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To reduce pain and swelling of a
toothache, use an
ice pack on the outside of your cheek; do not use heat. Avoid very hot,
cold, or sweet foods and drinks if they increase your pain.
To reduce sensitivity to heat,
cold, or brushing, consider using a toothpaste specifically designed for
sensitive teeth. Brush with it regularly or rub a small amount of the paste on
the sensitive area with your finger a 2 to 3 times a day. Floss gently between
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.
If your gums
are mildly swollen and red, use a tartar-control toothpaste that contains
fluoride and an antiseptic mouthwash, such as Listerine, or a mouthwash that
contains fluoride. Make sure you brush after meals and snacks and floss every
day. If you cannot brush after eating, chew sugar-free gum, use a tooth pick,
or rinse your mouth with
warm salt water. You can make your own salt water by
mixing 1 tsp (5 g) of salt in a medium-sized glass [8 fl oz (240 mL)] of warm water.
Tobacco can cause many gum problems, decreases your
ability to fight infection of your gums, and delays healing. Do not smoke or
use other tobacco products. For more information, see the topic
Do not use illegal
drugs, such as methamphetamines, which cause tooth and gum problems.
Call your doctor if any of the following occur during home
Keeping your teeth and gums healthy
requires good nutrition and regular brushing and flossing. To avoid a tooth or
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to
answer the following questions:
July 24, 2012
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & H. Michael O'Connor, MD - Emergency Medicine
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