Common causes include inflammation of the pulp, usually in response to tooth decay, dental trauma, or other factors, dentin hypersensitivity, apical periodontitis (inflammation of the periodontal ligament and alveolar bone around the root apex), dental abscesses (localized collections of pus, alveolar osteitis ("dry socket", a possible complication of tooth extraction), acute necrotizing ulcerative gingivitis (a gum infection), temporomandibular disorder. Toothache may be caused by dental (odontogenic) conditions (such as those involving the dentin-pulp complex or periodontium), or by non-dental (non-odontogenic) conditions (such as maxillary sinusitis or angina pectoris). There are many possible non-dental causes, but the vast majority of toothache is dental in origin. Pulpitis is reversible when the pain is mild to moderate and lasts for a short time after a stimulus (for instance cold); or irreversible when the pain is severe, spontaneous, and lasts a long time after a stimulus. Left untreated, pulpitis may become irreversible, then progress to pulp necrosis (death of the pulp) and apical periodontitis. Abscesses usually cause throbbing pain. The apical abscess usually occurs after pulp necrosis, the pericoronal abscess is usually associated with acute pericoronitis of a lower wisdom tooth, and periodontal abscesses usually represent a complication of chronic periodontitis (gum disease).
Sensitivity?
Dentin hypersensitivity is a sharp, short-lasting dental pain occurring in about 15% of the population, which is triggered by cold (such as liquids or air), sweet or spicy foods, and beverages. Teeth will normally have some sensation to these triggers, but what separates hypersensitivity from regular tooth sensation is the intensity of the pain.
Sharp and Severe?
Pulpitis (inflammation of the pulp) can be triggered by various stimuli (insults), including mechanical, thermal, chemical, and bacterial irritants, or rarely barometric changes and ionizing radiation. Common causes include tooth decay, dental trauma (such as a crack or fracture), or a filling with an imperfect seal.
Dull Ache?
Apical periodontitis is acute or chronic inflammation around the apex of a tooth caused by an immune response to bacteria within an infected pulp. It does not occur because of pulp necrosis, meaning that a tooth that tests as if it's alive (vital) may cause apical periodontitis, and a pulp which has become non-vital due to a sterile, non-infectious processes (such as trauma) may not cause any apical periodontitis.