A painful toothache — anything from a distressing annoyance to an excruciatingly painful experience — can ruin a business trip or a vacation. To make matters worse, it’s believed toothaches are aggravated by cabin pressure during air travel.

Toothaches can be caused by a dental cavity, a cracked tooth, a dental abscess, a sensitive or irritated nerve root, gum disease, disease of the jaw or spasms of the muscles used for chewing. Toothaches also are caused by trapped food or debris under the gums or between the teeth. Sometimes pain may be caused by a problem not originating from the tooth or jaw. Both oral cancers and non-oral cancers can manifest in the jawbone and mimic dental pain.

Pain around the jaw also can be a sign of heart disease, inner or external ear infection or sinus inflammation or infection. The pain of angina (inadequate supply of oxygenated blood to the heart muscle because of narrowing of the arteries of the heart) is usually located in the chest or the arm. Some angina patients, however, report pain that radiates up to the jaw causing a toothache.

Of course, tooth decay is the primary reason for toothache. Bacteria that lives in our mouths thrive on the sugars and starches in our foods we eat. These bacteria form a sticky plaque that clings to the surface of our teeth. Acids produced by the bacteria in plaque eat right though the hard, white enamel, creating a cavity. The first sign of decay may be sensitivity to hot, cold or sweet foods.

Frequent travelers can take steps to prepare for a dental emergency by packing a dental kit containing your dentist’s phone number, saline solution, a handkerchief, gauze and ibuprofen. Having such a kit prepared and readily available ultimately could prevent the loss of a tooth. If you suffer a toothache while traveling, ask the hotel concierge to recommend a local dentist. Many hotels keep physicians and dentists on retainer to meet the emergency needs of their guests. If you are traveling in the United States, contact the state or local dental society for a referral. The emergency center at the local hospital also may be able to recommend a dentist. If you are traveling abroad, contact the local U.S. Embassy or consulate for assistance.

Common sense can help prevent dental emergencies. Do not chew ice, popcorn kernels or hard candy. Never attempt to rip through tape, open sealed packages, or remove plastic wrapping using your teeth. Always wear a mouth guard when participating in contact sports. If you experience a toothache or dental emergency while traveling, plan to see your dentist as soon as you return home.

Pain Relief

Try these intermediary measures to lessen the pain of a toothache:
Rinse your mouth with warm water to loosen any trapped food.
Use dental floss to remove food particles wedged between your teeth.
Soak a cotton ball with lime juice and place it on the tooth.
Use an over-the-counter pain reliever such as ibuprofen to relieve the pain.
Do not place aspirin or any other painkiller directly against your gums because it may burn your gum tissue.
Apply an over-the-counter antiseptic containing benzocaine directly to the irritated tooth and gum to temporarily relieve pain.

Knock Out

If your tooth is accidentally knocked out, seek immediate emergency care. Act quickly, as it may be possible to successfully re-implant the tooth. If your tooth is knocked out:
Handle the tooth by its top half only. Do not touch the roots.
Do not attempt to remove dirt or debris by rubbing or scraping the tooth.
Gently rinse the tooth in a bowl of tap water. Do not hold it under running water.
Try to replace the tooth in the socket. Then bite down on gauze or a moistened tea bag to keep it in place.
If you cannot place your tooth in the socket, immediately place it in milk, your own saliva or a warm, mild saltwater solution (about a 1/4 teaspoon of salt to a quart of water).