Toothache one of the worst pain we feel. We browse all over the internet to find an amicable solution and resort to all sort of home treatments. Why do we get tooth pain, may be tooth decay, gum infection or both, or Wisdom tooth pain. But, are all the tooth pain the same. Do all have same cause. You visit a Dentist who does all the investigations and let you know that nothing wrong with your teeth. Now you are puzzled that you have toothache dentist says nothing wrong. Do we have pain in the mouth not related to teeth. Is this possible. Let us discuss this to get a firm idea.

Toothache dentist says nothing wrong

Toothache is hurting and many times need emergency dental treatment. But are all toothaches related to teeth problems and are all these are treated by Dentists. No, not all toothaches are from teeth. Some of the toothaches are referred pain. These may be from sinus infections, trigeminal neuralgia, ear infections and TMJ disorders.

Let us explore various pains.


Table of Contents:

1. Referred Pain

2. Causes

3. Sinus infections

4. Trigeminal Neuralgia

5. Ear infections

6. Temporomandibular Joint Disorders

7. summary


Referred Pain

Referred pain – when pain is felt in teeth or mouth, but, the actual source of pain is different other than teeth. So we think its toothache while actual cause or source of pain is different.

Referred pain happens in many parts of our body. Sometimes these pains are fatal. So knowing exact cause of pain is crucial.

 


Causes of Referred tooth Pain

There are several causes for referred pain in teeth region.

Some of the causes are Sinus infections, Trigeminal Neuralgia condition, Ear infections and Temporomandibular Joint disorders. Apart from these, there are also several other causes including pain in jaw may be actually from heart attack.

When you visit a Dentist for tooth pain, they will analyse and diagnose the issue related to Dental or Gums. If  it’s not related to dental they will refer you to General physician or other Medical personnel. In some cases, they will treat the related dental condition and reanalyse the pain. If the pain persists, they will refer you to visit medical personnel.


Sinus infections

Sinus infections or conditions leading to congestion of sinus may lead to pain in the upper jaw teeth. Upper jaw is close to sinus and any infections leading to congestion can ultimately put pressure on upper jaw teeth and nerves supplying the upper jaw teeth. Upper jar teeth pain is one of the symptom in some sinusitis patients. Over the counter Nasal Decongestants may relieve mild congestion and may reduce the teeth pain. But in severe cases visit to ENT is recommended.


Trigeminal neuralgia

Sometimes a painful nerve condition may seem to be a toothache.

Trigeminal nerve branches out on either side of face and innervates face and jaws. This nerve is responsible for face sensation and  chewing function. Trigeminal Neuralgia is a condition of this nerve. Though exact cause is unknown, this may trigger a toothache like pain in some. They will consult a Dentist, thinking some dental abscess. Pain continuous even after related Dental treatment.


Ear infections

In some people, an infected ear may be the cause of toothache. So, an ear congestion may cause toothache. In some case, on the contrary, a back tooth pain (Molar tooth pain) may appear as Ear ache and prompt you to visit an ENT.


Temporomandibular Joint Disorders (TMD)

TMD are disorders of Temporomandibular Joint, facial muscles and ligaments attached to the joint. These disorders may arise due to Trauma, infection or inflammation of these. So, disorder in the joint may mimic a tooth pain. This makes us to visit Dental clinic and complain about the tooth. Even after treating the concern tooth, pain doesn’t subside leaving diagnosis to the other non tooth related disorders.


Summary

Origin of pain and region where pain appears are different. This condition is referred pain. Even toothache is also, sometimes, is referred pain from other places of body.

Visiting dental office clears many of our doubts but some may need more intervention. Sinus infections, Trigeminal neuralgia, ear infections, TMDs are some conditions where pain is originated somewhere else but appears as toothache.

Sinus infections and sinus congestion can sometimes put pressure on the nerve innervating and appear as Tooth pain. Visiting ENT can diagnose the problem.

Trigeminal Neuralgia is a nerve pain of unknown origin. Because of the nerve branches innervating teeth and jaws, any pain on the Trigeminal appear as Toothache. Neurologist or NeuroSurgeon can assess the condition.

Nerves supplying ears and teeth are of the same facial nerves. So, Ear infections and pressure on ears do appear as toothache.

Finally, Temporomandibular joint disorders can also appear as tooth pain. These are conditions related to this joint and its muscles helping chewing and biting. Dentists and OroFacial pain specialists will treat the condition.

To summarise, toothache, all the time, may not relate to dental condition but to another condition.


Renton, Tara. “Tooth-Related Pain or Not?.Headache vol. 60,1 (2020): 235-246. doi:10.1111/head.13689