It’s a safe bet to say that no one wants a toothache – and the same could be said for having a tooth pulled! Unfortunately, a toothache can occur at the most inconvenient times, and, in some cases, means the tooth needs to be taken out. Although it’s always a good idea to save teeth when possible, there are situations where it’s best to have an extraction and discuss replacement options. Keep reading to learn more about the reasons for a toothache, possible treatment, and when an extraction is necessary.
What Causes a Toothache?
First, it’s helpful to understand some basic tooth anatomy. Teeth have 3 layers: enamel, dentin, and pulp. The enamel is the hard outer layer, dentin is the softer middle layer, and the pulp is the inner layer that contains the nerve.
When a tooth is damaged by a small cavity or fracture, the damage only involves the outer layers and hasn’t reached the nerve. This usually causes relatively mild symptoms such as temperature or chewing sensitivity instead of a full-blown toothache.
However, when a cavity or fracture is larger, it can reach the inner pulp and nerve of the tooth, causing an infection. This is where the pain comes in!
Although no one wants to be in pain, it does serve as a signal from your body that something is wrong and needs to be addressed as soon as possible. If an infection goes untreated, it can spread to other areas and become very dangerous.
How Is a Toothache Treated?
First, a dentist will begin by asking about your symptoms and doing a visual exam. In most cases, they’ll need an X-ray so they can see what’s happening inside the tooth and whether there’s an infection or not.
Then they’ll discuss their findings, provide a diagnosis, and discuss your treatment options. In addition to the possibility of an extraction, here are some other treatments they may recommend:
- Dental filling or crown – These options can work for a mild toothache that hasn’t affected the nerve of the tooth.
- Root canal – If the nerve is infected, a root canal will treat the infection while saving the remaining tooth structure.
When Is an Extraction Necessary?
Extractions may be needed in these situations:
- A severe cavity – If a cavity is so large that it’s destroyed most of the tooth structure, there may be nothing left to support a restoration like a filling or crown.
- A severe fracture – When a tooth has an extensive fracture or one that extends vertically, it typically can’t be saved.
- Gum disease – This common condition damages the gums and underlying bone that support the teeth and keep them in place. Once this happens, the teeth can become loose because they have no support to keep them stable.
Having an extraction isn’t something anyone hopes for. But, when it’s necessary, it will get you out of pain and improve your oral health in the long-run!
About the Author
Dr. John S. Keadle is an award-winning restorative, cosmetic, and implant dentist, and a graduate of the West Virginia University School of Dentistry. He recommends saving teeth whenever possible or restoring missing teeth with a replacement option like dental implants. If you have any questions about toothaches or extractions, he can be reached through his website.