PT Health Watch: Why toothache remains common despite being preventable

Toothache is one of the most common yet preventable health conditions affecting millions globally. However, poor oral hygiene and delayed care continue to fuel its persistence in Nigeria.

According to the World Health Organisation (WHO), it is estimated that oral diseases affect nearly 3.7 billion people globally, with untreated dental caries (tooth decay) in permanent teeth ranking as the most common health condition globally.

Toothache is most often caused by untreated tooth decay, gum disease, or dental infections.

In Nigeria, access to dental care remains limited, particularly in rural areas, while awareness of preventive oral health practices is still low.

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Many people rely on self-medication or only seek help when symptoms become severe, a pattern experts say contributes to avoidable complications.

Speaking with PT Health Watch, Salmon Oladapo, a Senior registrar Oral and maxillofacial surgeon at Lagos State University Teaching Hospital (LASUTH), described toothache as a leading reason patients visit hospitals, noting that pain often forces people to act after ignoring earlier signs.

Mr Oladapo explained that although swelling is also frequent, it is pain that typically drives patients to seek care.

Global burden linked to preventable causes

The WHO also revealed that most oral diseases, including tooth decay and gum disease, are largely preventable and share risk factors with other non-communicable diseases such as unhealthy diet and tobacco use.

The global agency also notes that untreated cavities can lead to pain, infection, and tooth loss if not addressed early.

These findings reflect patterns seen in Nigeria, where poor oral hygiene, high sugar consumption, and low awareness contribute to rising dental problems.

Causes

According to Mr Oladapo, tooth decay, a major cause of toothache, develops gradually due to a combination of factors.

These include the consumption of cariogenic substances such as sweets and chocolate that ferment in the mouth, the susceptibility of certain tooth surfaces where food can easily get trapped, the presence of bacteria that feed on these substances and produce acid, and the gradual destruction of the tooth by this acid over time.

“It is the acid produced by the bacteria that begins to dissolve the tooth. This process does not happen instantly, it occurs gradually over a period of time, weakening the tooth and eventually leading to cavities,” he explained.

Pain not to be ignored

Mr Oladapo warned that toothache can escalate into serious medical emergencies if left untreated, noting that dental emergencies can occur suddenly and without warning.

He explained that infections can spread beyond the tooth, causing severe swelling and complications that can possibly lead to losing the eye.

He said many patients often ignore early symptoms, allowing the condition to worsen.

Common signs include pain while eating, food getting stuck in teeth, bleeding during brushing, gum colour changes and persistent discomfort or bad taste.

He also encouraged regular self-checks.

“I will advise people to check their mouths in front of a mirror. Let’s look at our teeth and gums to see if there are any changes. You will be able to notice any changes and report to your doctor,” he said.

He cautioned against relying on painkillers instead of seeking professional care, noting that while such medications may temporarily relieve the pain, they do not address the underlying cause.

Prevention

The expert says most toothaches can be prevented through simple daily habits and routine dental care.

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He recommended brushing regularly and maintaining good oral hygiene, reducing intake of sugary foods and drinks, visiting a dentist every six months and seeking early care when symptoms appear.

He added that early intervention leads to better results and reduces complications.

“If patients present at the early stage, the outcome will be better, but if they wait until complications develop, they will spend more money and waste more time. Prevention remains the most effective approach, and it is always better, cheaper, and more affordable than cure,” he said.