What causes a toothache?

Some common toothache causes

While tooth decay is often the primary cause of a toothache, it's important for you to have a complete oral examination to determine the cause. Other causes of a toothache can include the following:

  • Infection
  • Gum disease
  • Grinding teeth (bruxism)
  • Tooth trauma
  • An abnormal bite
  • Tooth eruption (in babies and school-age children)

TMJ/TMD (Temporomandibular Joint Disorder), sinus or ear infections, and tension in the facial muscles can cause discomfort that resembles a toothache, but often these health problems are accompanied by a headache.

Pain around the teeth and the jaws can be symptoms of heart disease such as angina. If your dentist suspects a medical illness could be the cause of your toothache, he or she may refer you to a physician.

If you have a toothache, you may have a cavity or advanced gum disease. The first sign of decay may be the pain you feel when you eat something sweet, very cold or very hot. If the pulp – the inside of the tooth that has tissue and nerves – has become irritated, this can cause pain in your tooth.

What symptoms accompany a toothache?

Because the symptoms of a toothache may resemble other medical conditions or dental problems, it can be difficult to diagnose the cause without a complete evaluation by your dentist. If you notice pus near the source of the pain, your tooth may have become abscessed, causing the surrounding bone to become infected. Or the pus could indicate gum disease, which is usually characterized by inflammation of the soft tissue, bleeding gums and abnormal loss of bone surrounding the teeth.

Contact your dentist immediately if you have any of the following symptoms:

  • Fever
  • Difficulty breathing or swallowing
  • Swelling around the tooth area
  • Pain when you bite
  • A foul-tasting discharge
  • Continuous lasting pain

How do I alleviate the pain if I cannot see my dentist right away?

Anyone with a toothache should see a dentist at once for diagnosis and treatment. If left untreated, a toothache and the condition that is causing it can worsen. However, if you are unable to schedule an emergency appointment, the following self-care treatment can temporarily alleviate pain and inflammation from a toothache:

  • Rinse with warm salt water
  • Gently floss teeth to dislodge any food particles trapped between teeth.
  • Take an over-the-counter pain reliever such as ibuprofen (Advil®) or acetaminophen (Tylenol®) to relieve pain.
  • Never put aspirin or any other painkiller against the gums near the aching tooth, as it may burn the gum tissue.
  • Apply an over-the-counter antiseptic containing benzocaine directly to the irritated tooth and gum to temporarily relieve pain. Direct application of oil of cloves (eugenol) may also help to numb the gums. The oil may be rubbed directly on the sore area, or soak a small piece of cotton and apply it to the sore tooth.
  • If there has been some trauma to the tooth, a cold compress may be applied on the outside cheek to relieve pain or swelling.

How can my dentist help?

Your dentist will conduct a complete oral examination to determine the location and cause of the toothache, looking for signs of swelling, redness and obvious tooth damage. He or she may also take x-rays to look for evidence of tooth decay between teeth, a cracked or impacted tooth or a disorder of the underlying bone.

Your dentist also may prescribe pain medication or antibiotics to speed the healing of your toothache. If by the time you see your dentist your tooth has become infected, then treatment could require removal of the tooth or a root canal procedure, which involves removing the damaged nerve tissue from the middle of a tooth.

Is there a way to prevent a toothache?

The key to preventing toothaches is establishing a regular oral hygiene routine and sticking to it. For example, failure to brush and floss regularly after meals can significantly increase your risk of developing cavities, which can cause toothaches.

Here are a few tips to help reduce your risk for developing a toothache:

  • Brush at least twice a day, preferably after meals and snacks.
  • Floss at least once a day to prevent gum disease.
  • Visit your dentist regularly for oral examinations and a professional cleaning.
Information courtesy of the Academy of General Dentistry
Last updated: June 2010

The oral health information on this website is intended for educational purposes only. You should always consult a licensed dentist or other qualified health care professional for any questions concerning your oral health.

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