Toothache in medical practice is otherwise called dentalgia. It is a specific reaction to various provoking factors (traumatic injuries, diseases of the teeth and gums, jaw defects and abnormalities in its structure). The most common cause of toothache in patients of all ages is caries. In some cases, the pathological reaction is based on factors not related to oral health. If your teeth hurt only on one side, you may need the help of not only a dentist, but also highly specialized specialists (for example, a neurologist, cardiologist, and even an otolaryngologist).
Characteristic features of unilateral dentalgia
A sharp toothache, for example, on the left side can act as a symptom of a heart attack. If it is aching in nature, there is a high probability of trigeminal neuralgia. In these situations, self-medication is strictly prohibited due to the risk of complications. Therefore, at the first symptoms of dentalgia, you should consult a doctor.
Unilateral toothache usually occurs suddenly. It has a widespread course, when all dental units of both jaws are affected. It is also highly intense.
The pathological process can be provoked by inflammatory tissue pathologies, diseases of the vascular, nervous or cardiac systems. In most cases, patients note the appearance of acute, sometimes throbbing pain. Much less often they go to the doctor with dull pain.
Almost always, discomfort negatively affects people’s quality of life and their psycho-emotional state. They cannot eat or sleep normally, which leads to problems with the digestive tract and central nervous system.
A sleep disorder is diagnosed in almost 90% of patients with widespread dentalgia, since the pain syndrome intensifies at night. During rest, the functional activity of the adrenal cortex decreases. In addition, the natural synthesis of so-called steroid hormones, which have analgesic properties, is reduced.
If the cause of dentalgia is dental disorders, the discomfort intensifies after direct contact with cold or eating excessively spicy or hot foods. It is enough just to open your mouth in frosty or windy weather for the pain syndrome to sharply intensify.
Psychosomatic dentalgia is often a consequence of stressful situations and strong psycho-emotional experiences. To eliminate discomfort, it is often enough to eliminate the provoking factor. Some patients benefit from sessions with a psychotherapist or taking mild sedatives.
Teeth hurt on one side: reasons
Photo 1: When teeth hurt on one side, most likely the body gives a sign of alarm, because we are talking about more serious diseases than damaged enamel and an inflamed dental nerve. Source: flickr (Alisha Sen).
Teeth hurt on the left side, top and bottom
Each tooth has a separate nerve filament. All nerves are collected together in the upper or lower dental plexus.
Important! If several teeth (above and below) become inflamed due to caries or another disease, for example, on the left side, it seems that all the teeth on the left side hurt. This happens because inflammation affects not only the nerve endings directly in the teeth, but also the alveolar branches.
If your teeth hurt on the left side above and below, but the tooth enamel is healthy and no caries is observed , then the cause may be a hilar cyst. In this case, if the cyst has formed on the upper tooth, all the upper teeth hurt .
The eruption of wisdom teeth often causes a lot of discomfort. Sometimes the temperature even rises. There are difficult cases when the wisdom tooth has just begun to grow, and the person is already experiencing pain , and all the teeth on the left side hurt, so it is difficult to determine the cause.
Note! If, in the presence of angina, an unpleasant sensation appears in the shoulder joint, and the teeth on the left side of the lower jaw also hurt, this is a harbinger of a heart attack. You need to call a doctor immediately!
Teeth hurt on the right side, top and bottom
The right side, like the left, can become inflamed even due to caries of one tooth . Violation of the enamel, eating cold or hot food leads at first to simply unpleasant sensations, and then, when an unfavorable temperature environment approaches the nerve endings, all the teeth on the right side hurt .
If your teeth are healthy, but you have a cold or stress , then these two serious reasons can also cause discomfort. Hypothermia or a nervous disorder is quite capable of causing aching pain in the entire jaw or locally .
Another common cause of this condition may be inflammation of the gums, diseases such as gingivitis or periodontitis. In this case, throbbing pain on the right side is felt if the gum is inflamed on the right.
A disease such as inflammation of the trigeminal nerve brings a lot of trouble. In this case, the teeth hurt on the right side, above and below, and on the left side .
Several other diseases not related to tooth decay can cause such unpleasant sensations:
- Frequent inflammation of the middle ear is dangerous due to complications that can lead to meningitis. But it is no less dangerous when, due to a developing infection, for example, in the right ear, the teeth on the right side, above and below, hurt .
- Also dangerous is sinusitis , which causes fever and headaches. In especially difficult cases, teeth hurt on the right side or left .
Dental factors provoking unilateral dentalgia
Regardless of the degree and specific localization of dentalgia, diseases of the oral cavity are its most common cause. Discomfortable sensations may be the result of the carious process. If several adjacent dental units are affected simultaneously, dentalgia will be perceived by the patient as pain spreading throughout the entire jaw and always on one side. However, he will not be able to say exactly where it hurts.
Complicated types of caries
With a complicated version of caries, a pathological cavity does not simply form. It usually contains necrotic tissue, food debris, and bacterial plaque. The so-called peripulpal dentin is also damaged - this is the bone tissue that surrounds the pulp of the dental unit.
If a dentist diagnoses a patient with a superficial or medium caries process, the pathology can quickly transform into a complicated form. Moreover, in almost all cases it spreads to adjacent teeth.
Caries is considered a slow-growing but progressive dental disease. In the absence of timely and high-quality treatment, it can lead to complications. As a rule, no more than 3 years pass from the formation of the so-called chalk stain to severe tissue damage.
Acute pulpitis
Acute pulpitis is considered one of the most painful ailments of dental etiology. It is characterized by the spread of pain. Therefore, if primary symptoms occur, you should consult a doctor to exclude involvement of the pulp and directly periapical tissues in the pathological process.
Pulp is commonly understood as connective tissue, which is localized in the dental canals. It has a loose structure and a large number of blood vessels. Due to the many nerve endings, its defeat is always accompanied by severe discomfort. The pulp provides nutrition to the tooth from the inside.
When the pulp is inflamed, the following symptoms may appear:
- periodic pain syndrome, which increases sharply at night;
- increased sensitivity of enamel;
- after removal of the provoking factor, discomfort persists.
In the case of pulpitis, the pain is usually localized throughout the jaw and intensifies each time after direct contact with food. With the purulent nature of the disease, discomfort increases only when heat is applied to the affected area. The use of cold helps reduce its intensity.
Ignoring the symptoms of pulpitis can lead to the development of complications and complete loss of a dental unit. Treatment is carried out exclusively by surgery. The dentist performs a complete resection of the neurovascular bundles and pulp tissue.
Apical periodontitis
This disease is manifested by inflammation of periodontal tissue. They are localized between the root of the tooth and the immediate alveolar plate.
Periodontitis is characterized by inflammation of the periodontal tissues located between the tooth root and the alveolar plate and holding the tooth in the bony alveolus.
Not only the carious process can provoke a pathological process. Often, the disease is caused by injuries and minor injuries, as well as improper use of medications. Sometimes pain occurs after treatment when the materials or drugs used (for example, arsenic) penetrate the periodontium.
A characteristic symptom of the apical variant of periodontitis is local pain. It appears exclusively in the affected area. As it progresses, the discomfort becomes widespread. The pain can radiate to neighboring teeth, as well as to the temple, ear, or jaw.
The clinical picture of pulpitis and periodontitis is almost identical. However, an important difference between the latter is the appearance of severe pain during tapping of the tooth.
Necrotizing ulcerative gingivitis
Gingivitis is another common oral disease. It is characterized by inflammation of the gum tissue.
Gingivitis on its own rarely provokes pain. Unpleasant sensations are concentrated in the gum tissue. We are talking about itching and severe burning, tingling, and increased dryness of the mucous membranes. The course of certain types of gingivitis can provoke a pain syndrome that spreads to several dental units, but only on one side.
The table below details their main features:
Type of gingivitis | Short description |
Scaly | Gingival epithelial cells are intensively exfoliated. Severe pain and hyperemia of soft tissues are observed in the affected area. |
Ulcerative | The gums bleed heavily and become bright red. Possible appearance of purulent ulcers. In 80% of cases, patients note not only discomfort in the affected area, but also severe burning and itching. |
Hyperplastic | The first distinguishing sign of hyperplastic gingivitis is the external change of the gums. They acquire a purple and sometimes bluish tint. The tissues bleed heavily, and purulent secretion is possible. Another characteristic feature of this variant of the disease is the formation of false gum pockets. It is almost always accompanied by an increase in the size of the periodontal papillae. In particularly serious cases, hyperplasia spreads to the dental crowns. |
Necrotizing | This type of disease got its name due to the formation of necrotic areas on the papillae, which are located between the dental units. |
Other dental causes
Among other common causes of toothache, doctors name:
- traumatic damage to molars and gum tissue;
- inflammation in periodontal tissues;
- tooth abscess, cystic formations;
- perimaxillary phlegmon;
- eruption of so-called wisdom teeth;
- cracks in dental units.
Poorly treated caries can cause severe discomfort. We are talking about those cases when, after visiting the dentist, pieces of necrotic tissue remain in the tooth. They can act as a cause of re-infection.
Why does pain occur in all teeth at once?
If you look at the structure of our jaw, you can easily understand the cause of pain in several units of the dentition at once. The thing is that the teeth are connected to each other by many nerve endings, and the nerves are located both in the lower jaw and in the upper jaw.
Each alveolar nerve has several branches, which allows it to connect different types of teeth. To have a more visual representation, you can visually divide the branches of the nerve into anterior, middle and posterior. In this case, the front one will go to the frontal zone of the smile, the middle one will go to the area where the premolars are located, and the back one will go to the molars.
In addition, there are smaller nerve endings in the oral cavity, on which the sensitivity of the crown of the tooth depends. With the slightest damage to the enamel, gums or nerve of one tooth, unpleasant sensations quickly spread throughout the entire jaw. At the same time, it seems that the entire row is aching at once.
Neurological causes
This category includes causes associated with central nervous system dysfunction. Diseases of this kind are usually diagnosed in patients of the older age category. However, in the presence of a number of unfavorable factors, they can also appear in people 30-40 years old. The cause of the disorder is usually eliminated after taking sedatives or tranquilizers. However, these types of drugs are not recommended for use on a regular basis. Their help should be sought in exceptional cases.
Trigeminal neuralgia
This medical term usually refers to damage to the trigeminal nerve. This is a paired cerebral nerve, which is responsible for sensitivity in the cheek and lips, ensures the functioning of the organs of vision and smell. The main causes of trigeminal neuralgia are mechanical compression, when its processes are compressed by growths or spasmed muscles, and irritation.
Also, the pathological process can progress after recent acute respiratory viral infections, acute respiratory infections or influenza. As a result, after another severe hypothermia, the corresponding symptoms appear.
The pain syndrome in this pathology is localized on one side of the face, but has a wide area of irradiation. Discomfort can manifest itself in the area of the teeth, neck, eye sockets, sides of the nose and temples. Its severity is always high, which affects a person’s quality of life. He cannot eat or sleep properly, move or work. The duration of each pain syndrome varies between 1.5-3 minutes.
Not only degenerative and dystrophic changes in the cervical spine are among the main causes of neuralgia. The pathology also develops against the background of ENT disease, increased nervous excitability and frequent hypothermia. Nerve damage is possible due to compression by a neoplasm, including a malignant one, or changes in the blood vessels.
Cluster syndrome
Cluster headache is a cyclical disorder. In this case, the person experiences severe headaches. They are localized mainly on one side of the face, but can spread to the cheeks, nose, forehead, teeth and jaws. The discomfort is so strong that there are known cases of suicide attempts when people could not cope with it.
The attack always appears suddenly and can last from 10 minutes to 2 hours. Their number per day can vary from 2 to 10. The attack has the following clinical features:
- cutting pain in the eyes, as if they were being pierced with a sharp object;
- lacrimation;
- nasal congestion, mucous secretion;
- swelling of the eyelids;
- increase in heart rate;
- decreased quality of vision;
- subconjunctival hemorrhage.
With cluster syndrome, the duration of toothache is the same as the headache. Upon completion of the next attack, dentalgia goes away on its own. No special correction is required.
After alternating attacks of cluster headaches, a period of calm begins. At this time the person feels well. This period can last from 6 months to 3-4 years.
Homeopathic treatment
Drugs | Symptoms |
| Acute throbbing pain on one side of the face. Used in the treatment of neuralgia. |
| Rheumatic toothache. |
| Pain in teeth and gums during the postoperative period, after an impact, etc. |
| Neuralgic pain. |
| Pain in the lower jaw. |
| Severe toothache caused by caries. |
| Severe inflammation caused by stagnation in carious teeth. |
| Unilateral toothaches, aggravated by contact of teeth with cold or hot. |
| Toothaches in children and pregnant women. |
| Pain in the gums when they are inflamed and bleeding. |
| Toothache and inflamed and swollen gums. |
| Has a quick pain-relieving effect. |
| Toothache from touching cold things. |
| Rheumatic pain in the upper jaw. |
| Acute toothache. |
| Severe toothache caused by caries. |
| With suppuration at the roots of the tooth, cyclical pain. |
| Looseness and inflammation of the gums, toothache. |
| Toothache in pregnant women. |
| Damage to the periosteum. |
| Left-sided toothache. |
| The pain caused by hypothermia is rheumatic in nature. |
| Caries and gum inflammation. |
| Severe toothache. |
| Toothache in pregnant women. |
| Neurological toothaches. |
| Inflammation of the periosteum, severe pain in the right and left side of the jaw. |
Pathologies of ENT organs
Unilateral dentalgia may be a consequence of diseases of the ENT organs, which is due to the structural features of the oropharynx, nasopharynx, and ears. We are talking, first of all, about adenoiditis, otitis media and sinusitis. The help of an otolaryngologist to exclude and differentially diagnose ENT diseases will be required in cases where unilateral dentalgia is combined:
- nasal congestion, when the patient loses the ability to breathe fully;
- headaches;
- the occurrence of discharge from the ears (a clear symptom of purulent otitis media);
- high temperature;
- pain in the ears;
- sore throat;
- copious purulent discharge from the nose.
When the inflammatory process in the paranasal sinuses or middle ear acts as a provoking factor for unilateral dentalgia, the pain goes away on its own after it stops. Broad-spectrum antibiotics (macrolides, cephalosporins, penicillin medications) are used for treatment. Additionally, anti-inflammatory and antibronchoconstrictor drugs (Fenspiride), as well as drugs to stimulate the motor function of the respiratory tract (Sinupret) are prescribed.
Toothache as a sign of a heart attack
A heart attack is a cardiovascular pathology. It is also one of the clinical forms of ischemic disease. The mortality rate for heart attack is more than 60%.
Intact toothache on the left side of the jaw is considered one of the precursors of vascular pathology. It occurs 12-24 hours before an attack. Along with dentalgia, patients complain of headache, shortness of breath, nonproductive cough and changes in the normal heart rhythm.
The main symptom of a heart attack is considered to be angular pain. It appears 10-20 hours after the first manifestations. The duration of the attack itself varies from several minutes to an hour. To stop it, you need to take a Nitroglycerin tablet.
Health care
The occurrence of dentalgia is a signal to seek medical help. If toothache appears above and below, you should not self-medicate. You need to make an appointment with the dentist. If the pain syndrome does not allow you to sleep and do your usual activities, it is better to contact the emergency clinic.
At home and only as an emergency measure, non-narcotic analgesics and non-steroidal anti-inflammatory drugs are allowed. The most popular drugs from these groups, their approximate dosage are presented in the table below.
Drug name | Single dosage | Maximum daily dosage |
Analgin | 500 mg | 3000 mg of active substance |
Citramon | 1 tablet | 3 tablets |
Ketorol | 10 mg of active ingredient | 40 mg of active ingredient |
Paracetamol | 500 mg | 4000 mg of active ingredient |
Mefenamic acid | 500 mg of active substance | no more than 2000 mg of active substance |
Diclofenac | 25 mg of active substance | no more than 150 mg of active substance |
Ibuprofen | up to 800 mg | 2400 mg of active substance |
The dosages presented in the table are advisory in nature and selected for adult patients. For children, these indicators are calculated individually and only according to the instructions included with the drug.
What can you do if all your teeth hurt at once?
It is important to understand that you cannot endure severe pain, especially in all teeth at once. If you experience discomfort, you should visit the nearest dental clinic as soon as possible and undergo an examination. Under no circumstances should you take strong painkillers for a long period of time, especially without a doctor’s prescription.
If you neglect your health, the consequences can be irreversible and very serious. Experts do not recommend applying hot compresses to the sore spot, as increased blood circulation can lead to even more unpleasant sensations.
To alleviate your condition a little before going to the clinic, you can rinse your mouth with a soda solution. It is also allowed to take 1-2 tablets of the most common painkiller, for example, analgin. Before purchasing, you should definitely consult with the seller; most likely, he will be able to suggest the most suitable drug.
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Preventive actions
It is easier to prevent any disease than to subsequently engage in long-term and energy-consuming treatment. This rule also applies to dentalgia. To prevent toothache, experts give the following recommendations:
- Teeth should be brushed twice a day. For this procedure, it is important to choose the right brush and paste. After each meal and whenever possible, you should rinse your mouth. Both ordinary water and special solutions are suitable for these purposes.
- We must not forget about the existence of such assistants as irrigators, dental brushes and floss. These devices allow you to reach hard-to-reach places. As a result, bacteria and plaque will not accumulate, which prevents the risk of caries.
- You need to visit the dentist every six months. This approach allows you to notice the problem at an early stage of development and immediately eliminate it. This helps to prevent complications of the pathological process later.
- You should give up bad habits. Tobacco smoke is considered the most dangerous. It can change the composition of saliva, which only further contributes to the accumulation of plaque.
- It is better to minimize the amount of overly sweet and soft foods in your diet. The thing is that sugar is a favorable environment for the life of pathogenic flora. Soft foods do not allow teeth to naturally cleanse themselves of plaque.
Dentalgia is a very common and at the same time unpleasant phenomenon. It can unbalance any person and significantly worsen the quality of his life. Dentalgia prevents you from eating and sleeping properly, working, and doing household chores. If your teeth hurt on one side, you should not self-medicate. It is necessary to seek help from a dentist as soon as possible. After identifying the cause of the pain, he will prescribe appropriate treatment or refer you for consultation to specialized specialists.