Toothaches

A toothache is pain in or around a tooth. It may come from the tooth itself, the gum and bone supporting it, or another nearby area. Problems involving the jaw, sinuses, or facial nerves can sometimes feel like tooth pain.

The pain may be mild and brief, or strong enough to disturb sleep and eating. Some toothaches are triggered only by cold drinks or biting. Others throb or continue without a clear trigger.

Pain does not always show how serious the cause is. A tooth can stop hurting if the nerve inside it dies, even though infection may still be present. Ongoing or recurring tooth pain should be assessed by a dental professional.

A toothache can feel different depending on which tissues are affected. You may notice:

• Sharp pain with hot, cold, sweet, or acidic foods
• A dull ache or pressure around one tooth
• Throbbing pain that spreads into the jaw, ear, or face
• Pain when biting or releasing a bite
• Tender, red, or swollen gums
• A bad taste, bad breath, or fluid draining near a tooth
• Sensitivity after dental work

It can be difficult to identify the exact tooth. Pain from one tooth may be felt in a nearby tooth or across the same side of the jaw.

Tooth decay can damage the hard outer layers of a tooth. As decay gets deeper, heat, cold, or sweets may irritate the sensitive tissue inside.

Inflammation inside the tooth may cause lingering sensitivity, spontaneous pain, or throbbing. The inner tissue, called the pulp, contains nerves and blood vessels.

A cracked, chipped, or worn tooth can hurt during biting or when exposed to temperature changes. Some cracks are too small to see without a dental examination.

Gum problems may cause soreness around a tooth. Gum disease can also lead to receding gums, which expose sensitive parts of the tooth roots.

Other possible causes include:

• Food trapped between teeth or under the gum
• Teeth grinding or jaw clenching
• A loose or damaged filling, crown, or other dental repair
• A tooth coming through the gum, including a wisdom tooth
• Recent dental treatment

Less commonly, pressure from a sinus infection can cause aching in several upper back teeth. Jaw joint problems, facial nerve pain, or pain referred from another part of the body can also resemble a toothache.

Arrange a dental appointment if pain lasts longer than a day or two, keeps returning, or interferes with sleep or eating. You should also book an appointment for pain when biting, a cracked tooth, swollen gums, drainage, or a lost filling or crown.

Seek same-day dental or medical care if tooth pain occurs with:

• Swelling of the cheek, jaw, or face
• Fever or feeling generally unwell
• Increasing gum swelling or pus
• Trouble opening your mouth
• Rapidly worsening pain

Call emergency services or go to an emergency department if swelling makes it difficult to breathe or swallow, spreads toward the eye or neck, or causes drooling or a change in voice.

Jaw or tooth-like pain can rarely occur with a heart problem. Seek emergency help for jaw pain accompanied by chest pressure, shortness of breath, sweating, nausea, or pain spreading into an arm or shoulder.

A knocked-out permanent tooth is also time-sensitive. Seek urgent dental care immediately, handle it by the crown rather than the root, and do not scrub it.

A dental professional will ask when the pain began, what triggers it, and how long it lasts after a trigger stops. Mention recent injuries, dental work, swelling, fever, grinding, and any pain elsewhere in your face or body.

They may examine your teeth, gums, bite, jaw, and nearby tissues. Tests may include gently tapping a tooth, checking its response to cold, or asking you to bite on a small instrument. Dental X-rays can help find decay, bone changes, hidden cracks, or infection around a root.

If no dental cause is found, you may be referred for medical assessment of the sinuses, nerves, jaw joint, or another possible source.

Treatment depends on the cause. A cavity may need a filling. A damaged or infected tooth may require repair, root canal treatment, or removal. Gum treatment may be needed if the supporting tissues are affected.

Antibiotics like amoxicillin or doxycycline do not repair decay or remove damaged tissue. They are generally reserved for certain infections, especially when there are signs that infection is spreading or affecting the whole body.

While waiting for care, you can:

• Rinse gently with warm salt water
• Floss carefully if food may be trapped
• Eat soft foods and chew on the other side
• Avoid very hot, cold, sweet, or acidic foods
• Apply a cold pack to the outside of the cheek after an injury
• Use a non-prescription pain reliever according to its label

Ask a pharmacist before using pain medicine if you are pregnant, take blood thinners, or have kidney, liver, stomach, bleeding, or medication-related concerns. Do not place aspirin directly on a tooth or gum because it can damage the tissue.

Do not try to drain a swelling or repair a tooth with household glue.

Brief sensitivity may settle after a minor irritation or recent dental treatment. Pain caused by decay, a crack, or infection usually needs dental treatment rather than waiting alone.

Once the cause is treated, discomfort often improves gradually. Follow-up may be needed to check healing or complete a dental repair. Return sooner if pain or swelling worsens, fever develops, or symptoms come back.

Can a toothache go away on its own?

Some short-lived sensitivity can improve. However, pain may also stop because the nerve inside a damaged tooth no longer works. A toothache that was severe, lasted more than a day or two, or returns still deserves assessment.

Can sinus pressure cause tooth pain?

Yes. Sinus inflammation can cause pressure across several upper back teeth, often with nasal congestion or facial pressure. Pain limited to one tooth, especially with biting or temperature sensitivity, is more likely to need a dental check.

Do I need antibiotics?

Not every toothache is caused by a bacterial infection that benefits from antibiotics. Dental treatment is often needed to remove decay, drain infection, or treat the inside of the tooth.

Why does my tooth hurt after a filling?

Temporary sensitivity can happen after dental work. Contact the dental office if pain is worsening, lasts longer than expected, wakes you at night, or occurs when your teeth meet.

Should children with toothache be assessed?

Yes. Arrange dental care for ongoing pain, swelling, a broken tooth, or difficulty eating. Fever, facial swelling, or trouble swallowing requires prompt medical or dental attention.