Dental glossary: toothache, dental and gingival pain
Definitions and causes
While medical diagnostic efforts certainly yield lots of impressive-sounding Greco-Latin words, dentist 'Paul Revere' writes in Dentistry and Its Victims that if one asks 10 dentists for a diagnosis of the same tooth, one will get 10 different diagnoses-an observation the accuracy of which was frankly confirmed by one of my former dentists9. The following discussion attempts to define toothache and its many possible causes & types: why teeth can hurt (sometimes excruciatingly!)
A toothache is any pain or soreness within or around a tooth or the jaw, indicating trauma, inflammation and/or infection.
Toothache or dental and/or gingival pain can be triggered by multiple causes, particularly “tooth decay” & dental cavities where bacteria attack the root and pulp by penetrating the pulp chamber (or coming very close to it) which contains the nerves and tiny blood vessels.1
There also seem to be other (although perhaps related) common causes of toothache such as an abscess, trauma such as a cracked tooth, impacted or erupting teeth, “gum disease”, “tooth root irritation”, "pulp infection," TMJ or "temporo-mandibular joint (jaw joint) disease”, and “bite” [malocclusion] problems. A simple suspect to check oneself for is also a piece of food caught between one's teeth.
Apparently, even trigger points in the (facial) temporalis, masseter, digastric or buccinator muscles can cause toothache2, as can so-called (and not so rare at all) cavitations (see Dental cavitations and cavitation infections [ischemic osteonecrosis]: dangerous hidey-holes in the jawbone). In fact, dentists Drs. Munro-Hall write in their highly recommended book "Toxic Dentistry Exposed", "cavitation infections ... can be painless or just the opposite, causing trigeminal-neuralgia-like pain. This pain is often mistaken for toothache and innocent teeth are extracted one after another in a vain attempt to stop the pain. Even worse, healthy teeth are root-treated causing more focal infections. ... the exact spot where the infection is ...could be some way distant from the actual site of the pain".8
On rarer causes of toothache
Apparently, a tooth or jaw ache can occasionally be triggered by a problem originating elsewhere in the body, such as in the heart (for instance heart attack or angina) or in the sinuses (sinusitis/sinus problem) or ears (e.g. ear infections). I have seen it mentioned that angina patients occasionally only display tooth or jaw pain as sole symptoms of their heart problem. So it seems that not every toothache is what it appears to be but might actually be an indicator of more serious afflictions.3
Interestingly, toothache and discomfort can actually denote a tooth in the process of regenerating itself (see Tooth regeneration achieved via Gerson diet detoxification).
More on bacteria and cavities
Apart from toothache obviously caused by traumatic impacts or misalignment etc., having a toothache caused by a "cavity" to my knowledge means the tooth's nerve is being attacked/irritated by caries and/or other bacteria travelling into the nerve's immediate environs via a "softened" tooth (which has lost its healthy natural hardness4 due to a lack of minerals in its crystalline latticework allowing bacteria to travel through the "gaps" towards deeper-lying tooth areas5). In other words, the pain is caused by bacterial infection settling and spreading in a weakened area.6
To add other interesting perspectives on possible causes of tooth as well as gum pain and for a brilliant explanation just why toothache can and tends to be so excruciating (while simultaneously providing an additional reason why salt and salt water can be so very effective in [often immediately] relieving dental pain), here are some of the definitions offered by dentist "Paul Revere" (a pseudonym) in his 1970 "alternative dentistry" book Dentistry and Its Victims, excerpted from the chapter discussing "Dental Pain and Its Control" (with emphases by Healing Teeth Naturally):
Though the pulp is the most common source of dental pain, it is not a nerve. (But when people say "the nerve", they mean the pulp.) A condition of slight irritation of the pulp is called pulpal hyperemia. A hyperemic pulp usually displays sensitivity to cold, and it may be sensitive to the pressure of biting or the action of food juices, especially sugary or acid juices. Hyperemia may be episodic; the symptoms often disappear entirely for long periods of time, returning for briefer episodes. I have had patients whose hyperemia returned twice a year, at the change of seasons, year after year. Most of us have known days when it was impossible to take something cold into our mouth... without experiencing dental pain.
Pulpal inflammation, or pulpitis, produces more acute pain than that which results from pulpal hyperemia. The inflammation may originate in any of several causes: trauma, as from a blow or dental drilling; irritation, because of decay and, possibly, a resulting invasion by bacteria; toxic effects of poorly insulated filling materials; or changes in temperature. Any tissue, including the pulp, tends to swell when it becomes inflamed. But unlike other tissues, which are usually free to expand, the pulp is confined in inflexible walls of dentin. As the inflamed pulp swells, it builds up terrific pressures inside the tooth. It is these pressures which are the direct cause of the most severe dental pain.7
The gums may be a source of great pain, particularly if there is infection present. Pain in the gums results from infectious lesions, developing wisdom teeth, and irritations such as dentures sores. There are many other causes of mouth pain; the important thing to know is that it is invariably a warning of a real ailment that should be corrected. I have neer seen a cause of what I could honestly call psychosomatic dental pain. Although on occasion dental pain can be very difficult precisely to locate and correct, such pain is very real and rarely, if ever, psychosomatic in origin."
Whatever the cause(s) of your toothache may be, Healing Teeth Naturally is primarily concerned with providing effective help and long-term true pain relief which is based upon addressing and remedying the root causes of both toothache and tooth decay, which in turn can particularly (but not exclusively) be found in the dietary realm.
Note: If after trying many of the remedies found on this (and perhaps other) site(s), starting with my personal best toothache cure, you (unlikely) still suffer from chronic “intractable” dental pain, you may find this e-book very helpful.
Footnotes by Healing Teeth Naturally
1 For an illustrated description of tooth structure, see Dental Glossary: Tooth.
2 For relief techniques for the latter, see "Energetic" toothache remedies: Trigger point therapy.
3 This is not included to scare anyone or to pander to hypochondriacs with too much time on their hands ;-) but a just-in-case addition in order not to risk misleading anyone. Also see Disclaimer.
5 Compare Tooth demineralisation - remineralisation.
6 Incidentally, this is also why salt water can be so effective: The salt water rinse (probably the stronger the brine the better) works in two ways: first via osmosis, pulling out molecules and offending bacteria from the gums surrounding the nerve (and possibly the weakened tooth itself), second by the salt both directly killing these problem-causing bacteria on contact, and them being flushed out by repeated rinsing.
7 And it is here, of course, where the osmotic effect of salt water comes into play, exerting an immediate dehydrating pull on the area concerned, thereby decreasing its internal pressure. It seems clear to me, however, that more than a simple "milking" effect is involved since repeated salt water rinses [if followed up with a tooth-regenerating diet] can possibly initiate a long-term cure for the "decayed" tooth, likely due to making the dental terrain less bacteria-friendly through tooth remineralisation, immune system enhancement and repeated killing off of offending bacteria.
8 The same observation can be found in this interview).
9 For the important details including the frequent lack of honesty in the dental profession see 10 dentists - 10 diagnoses.