Toothache guide

Common causes of a toothache

Cleveland Clinic lists the usual dental causes: cavities, an abscessed tooth, a cracked tooth, a damaged filling or crown, teeth grinding or clenching, and gum disease. A cavity is the most common starting point, and NIDCR notes that decay which reaches deeper layers can cause toothache or sensitivity to sweet, hot or cold foods, with an abscess adding pain, facial swelling and fever.

Each cause needs a different treatment, which is why a dentist's exam matters more than the remedy you try at home.

What helps while you wait to be seen

Cleveland Clinic suggests a warm salt water rinse (half a teaspoon of salt in 8 ounces of warm water), a rinse with equal parts hydrogen peroxide and water that you spit out and never swallow, a wrapped ice pack against the outside of the jaw for about 20 minutes several times a day, and over-the-counter acetaminophen or ibuprofen. It stresses that home remedies give only mild relief and that persistent pain needs dental treatment.

Our guide on how to get rid of tooth pain covers these steps and the warning signs in more detail.

Is it a tooth or a sinus problem?

Healthline explains that the upper teeth sit close to the sinuses, so sinus infection can cause pain in the upper rear teeth, sometimes spreading to the lower teeth. Sinus pain tends to affect several upper molars, comes with congestion or facial pressure, and may feel worse when you bend over. Dental pain more often comes from one tooth, is more intense and focused, and is typically the only symptom.

If the toothache continues after your sinus symptoms clear, see a dentist. If a dentist finds no dental cause, or your sinus symptoms do not improve, see a doctor.

Sensitivity after a filling

Some tooth sensitivity after treatment is normal. Healthline reports soreness and heat or cold sensitivity after a filling typically lasting one to three days, with pain usually peaking around 24 hours and mostly gone within three days to a week. Cleveland Clinic says mild sensitivity and gum soreness typically fade within a week or two.

Sensitivity can persist for months in some cases, and is more likely after deeper fillings. Contact your dentist if it does not improve within a few weeks, if your bite feels uneven, or if you develop a throbbing toothache, which can mean decay has reached the nerve.

Stains, sensitivity and cavities

Persistent sensitivity to hot, cold or sweet foods can be an early sign of a cavity. Healthline says to see a dentist if sensitivity lasts more than 24 to 48 hours, if a toothache will not go away, or if you notice a hole, pit or new staining. Our guide on what cavities look like explains how to recognize each stage.

What a dentist will check

A dentist will ask about the pain, examine the tooth and gums, and usually use X-rays. Treatment depends on the cause, from a filling or a repair to a root canal for infected tooth pulp, gum treatment, or a night guard for grinding. Cleveland Clinic says a toothache lasting more than two days, swelling or pain when opening wide is a reason to call right away.

Emergency signs

Cleveland Clinic's emergency signs include swelling below the eye or a knot on the jaw, unbearable pain that medication does not relieve, bleeding that will not stop with pressure, and a fever above 101°F (38.3°C). It describes unbearable tooth pain with fever and chills as a dental emergency. Trouble breathing or swallowing needs emergency care immediately.

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