You expect a decayed tooth, a fracture or a gum infection to be the cause for that toothache causing you grief. Sometimes, though, the answer may be “none of the above”—there's nothing wrong going on in your mouth to cause the pain.

You pain is real—but its source is elsewhere in the body, a situation known as referred pain. It's important to find out the pain's true source to determine what kind of treatment you'll need to alleviate it.

Here are some of the likely candidates for a “toothache” that's not a toothache.

Facial nerves. Tooth pain may be associated with trigeminal neuralgia, a misfiring disorder of the trigeminal nerves that course through either side of the face. The nerve is divided into three branches, two of which are located in the upper face and one in the lower jaw. Because they're interconnected, a problem with one of the branches in other parts of the face could be felt in the branch around the jaw.

Jaw joints. Temporomandibular Joint Disorders (TMD) can cause pain in the pair of joints that connect the lower jaw to the skull. The joints can become inflamed due to stress or trauma and the associated muscles begin spasming, causing severe pain. Because of their proximity to the teeth, the pain from the joints can radiate into the dental area and mimic a toothache.

Ear or sinus infections. Both the ears and the maxillary sinus are subject to infections that can cause severe pain and pressure. With the close proximity of both the ears and the sinus to the upper jaw, it's quite possible for pain originating in these structures to be felt within the mouth.

These are only a few of the possibilities that also include migraines, shingles, fibromyalgia and even vitamin deficiencies. As such, your dentist or physician may need to do a little detective work to locate the true cause. But the effort to locate where your mouth pain is actually coming from will help ensure you get the right treatment to give you lasting relief.

If you would like more information on referred tooth pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Referred Pain: When a Toothache Is Not Really a Toothache.”

If your child has a toothache, there’s good news — and not so good news. The good news is the pain rarely indicates an emergency. On the downside, though, it may definitely be something that needs our attention.

Here, then, are 4 things you should do as a parent when your child tells you their tooth hurts.

Try to find out exactly where the pain is and how long it has hurt. Ask your child which tooth or part of the mouth hurts. You should also find out, as best you can, when the pain started and if it’s constant or intermittent. Anything you learn will be useful information if you bring them to the office for an examination. And, any tooth pain that keeps your child up at night or lasts more than a day should be examined.

Look for signs of recent injury. Your child may have suffered a blow to the mouth that has damaged the teeth and gums. Besides asking if they remember getting hurt in the mouth, be sure to look for chipped teeth, cracks or other signs of trauma. Even if there aren’t any outward signs of injury, the tooth’s interior pulp may have been damaged and should be checked out.

Look for signs of dental disease. Take a close look at the tooth your child’s complaining about: do you see brown spots or obvious cavities? You should also look for swollen gums or sores on the inside of the mouth. If there’s been no apparent injury, these could be signs of infection related to tooth decay.

Try to relieve pain symptoms. If you don’t see anything unusual, there may be a piece of candy or other hard food debris between the teeth causing the pain — gently floss around the tooth to dislodge it. If the pain persists give appropriate doses of ibuprofen or acetaminophen (not aspirin). If there’s swelling, you can also apply an icepack on the outside of the jaw. In any case, you should definitely schedule a visit with us for an examination.

If you would like more information on dental care for your child, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Child’s Toothache.”