Toothache

Toothache is pain in or around a tooth. It is a symptom rather than a diagnosis. The pain may come from the tooth itself, the gum, the jaw, or another nearby area.

Brief sensitivity does not always mean there is a serious problem. However, pain that persists, returns, or becomes more intense should be assessed by a dentist. Dental problems often need treatment of the cause rather than pain relief alone.

It can be difficult to tell which tooth hurts. Nerves from several teeth share pathways, so pain may seem to move or spread into the jaw, ear, temple, or face.

Toothache can feel different depending on what is causing it. You may notice:

• A dull ache or pressure
• Sharp pain when biting or chewing
• Sensitivity to hot, cold, sweet, or acidic foods
• Throbbing pain that starts without an obvious trigger
• Pain that lingers after eating or drinking
• A tender, red, or swollen area of gum
• Swelling in the cheek or jaw
• A bad taste or fluid draining near a tooth

Pain caused by cold that stops within seconds may have a different cause from pain that lingers or wakes you at night. These details can help a dentist find the source.

Common causes

Tooth decay can damage the hard outer layers of a tooth and reach the sensitive tissue inside. Early decay may cause no symptoms. Deeper decay can cause sensitivity or ongoing pain.

A cracked, chipped, or worn tooth may hurt when you bite or when the tooth is exposed to temperature changes. Cracks are not always visible.

Gum inflammation can make the area around a tooth sore or tender. Food trapped between teeth or under the gum can also cause local pain.

Recent dental work may cause temporary sensitivity. This should generally settle, although pain that is worsening or affecting your bite needs review.

Less common causes

A loose or damaged filling, an impacted wisdom tooth, teeth grinding, or an uneven bite can cause pain. Gum disease may expose tooth roots, making them sensitive.

Sinus inflammation can sometimes cause aching in the upper back teeth, often with nasal blockage or facial pressure. Jaw-joint or chewing-muscle problems can also feel like tooth pain.

Causes needing prompt attention

An infection around the root of a tooth can form a pocket of pus called an abscess. Possible signs include constant pain, gum or facial swelling, fever, a bad taste, or difficulty opening your mouth.

An injured tooth may need urgent dental treatment, particularly if it is loose, displaced, broken deeply, or knocked out.

Rarely, pain felt in the teeth or jaw can come from the heart. This is more concerning when it begins with activity or occurs with chest pressure, breathlessness, sweating, nausea, or pain in the arm, back, or neck.

Arrange an urgent, same-day dental assessment if you have facial or jaw swelling, fever, spreading redness, pus, or pain that prevents sleep or eating. You should also seek urgent dental advice after a significant tooth injury.

Go to an emergency department or call emergency services if:

• Swelling affects your breathing, swallowing, speech, eye, or neck
• You are becoming confused, faint, or severely unwell
• Jaw or tooth pain occurs with chest pressure, breathlessness, sweating, or nausea

Book a routine dental appointment if pain lasts longer than two days, keeps returning, occurs when biting, or comes with ongoing sensitivity. You should also book if a filling has broken or a tooth has become chipped.

A medical clinician can assess fever, spreading swelling, or symptoms that may not come from a tooth. However, most dental causes need care from a dentist.

A dentist will ask when the pain started, what triggers it, how long it lasts, and whether it spreads. Tell them about swelling, fever, injuries, recent dental treatment, or problems opening your mouth.

They will examine your teeth, gums, bite, face, and jaw. They may gently tap a tooth or test its response to cold. These checks help assess the nerve and tissues supporting the tooth.

Dental X-rays may show decay, bone changes, an infection around a root, or an impacted tooth. Small cracks do not always appear on an X-ray, so the examination and pattern of pain also matter.

Treatment depends on the cause. A dentist may repair a decayed or cracked tooth, replace a damaged filling, clean around the gum, or adjust a bite problem.

If the soft tissue inside a tooth is badly inflamed or infected, root canal treatment may be used to remove the affected tissue and keep the tooth. Sometimes removing the tooth is the most suitable option.

Antibiotics like amoxicillin or doxycycline do not repair a damaged tooth and are not needed for most toothaches. They may be used when there are signs that a bacterial infection is spreading or affecting your general health. Dental treatment is still usually needed to remove the source.

While waiting for care, you can:

• Eat softer foods and chew on the other side
• Avoid very hot, cold, or sugary foods if they trigger pain
• Rinse gently with warm salt water, then spit it out
• Brush carefully with fluoride toothpaste
• Use paracetamol, also called acetaminophen, or ibuprofen if safe for you and taken as directed

A pharmacist can help you choose a pain medicine if you are pregnant, take other medicines, have long-term health conditions, or are unsure what is safe.

Do not place aspirin or crushed pain tablets directly on the tooth or gum. They can burn the tissue. Avoid trying to drain or cut a swollen area yourself.

The course of toothache depends on its cause. Mild sensitivity after dental work may settle over several days. Pain from decay, a crack, or an infected tooth is less likely to resolve fully without dental treatment, even if it temporarily improves.

An abscess may drain and make the pain ease, but the infection can remain. A sudden reduction in pain does not always mean the underlying problem has healed.

After treatment, tenderness may take a few days to settle. Follow the dentist’s instructions and contact them if pain or swelling is worsening rather than improving.

Regular dental checks, fluoride toothpaste, cleaning between the teeth, and limiting frequent sugary foods and drinks can reduce some common causes of future toothache.

Can toothache go away on its own?

Brief sensitivity or minor gum irritation may settle. Pain caused by decay, a deep crack, or infection often returns until the underlying problem is treated.

Does throbbing pain mean an abscess?

Not always. Throbbing can happen with several dental problems. Swelling, fever, pus, or feeling unwell makes infection more concerning and needs prompt assessment.

Can sinus problems cause tooth pain?

Yes. Sinus inflammation can cause aching across several upper back teeth. It often occurs with congestion or facial pressure. A dentist can help rule out a dental cause.

Should I use heat or cold?

A cool pack against the outside of the cheek may ease pain or swelling. Wrap it in cloth and use it for short periods. Avoid applying strong heat to a swollen area.