Toothache can happen for many reasons. Sometimes the reason is obvious – if you've been hit in the face or bitten into something hard – but other times it can seem like the pain comes out of nowhere.
Toothache isn't always a cause for alarm, but in some cases, it can point to an underlying problem that will get worse without treatment. That's why we recommend making an appointment to see a dentist if you have a sudden or mysterious tooth pain or other unexpected symptoms.
What are the symptoms of a toothache?
Feelings of pain and discomfort are the obvious signs of a toothache, but this can vary from a mild ache that comes and goes to severe pain that's constant or only happens when you bite down. The pain may be localised in one tooth or feel like it's spread across a few teeth.
Toothache may be accompanied by other symptoms, including:
- pain in the jaw, ear, head or face
- sensitivity to hot, cold or sweet food and drink
- swelling around the tooth or in other areas
- bad breath or a bad taste in the mouth
- bleeding from the mouth
- pus or fluid coming out of the gum
If you have any of these symptoms, you should see a dentist or doctor as soon as possible.
When to see dentist
Toothache sometimes goes away on its own, but if it's a symptom of a more serious problem, delaying treatment could extend your suffering and give infections the chance to spread. Some problems that start in the mouth can spread to other parts of the body and affect general health.
It's better to be safe than sorry, so you should always schedule a check-up with your dentist if you're not sure why your tooth is hurting or if you want advice about treatments and home remedies, especially if a toothache lasts longer than 2 days.
- If any of your teeth or dental restorations have broken or come loose, call an emergency dentist for advice or to book a same day appointment.
- If you have swelling, fever, trouble breathing or other possible signs of an infection, go to the emergency room for urgent medical attention.
Toothache causes and treatments
Your dentist will examine your mouth and ask some questions to try to find out why your tooth is aching. This may involve an x-ray so they can see more of your teeth and jaws.
If they think they've identified the cause, your dentist will discuss appropriate treatments with you. They'll make sure you have all the information you need to make an informed decision about what's best for you.
Following are the most common reasons for sudden toothache and how they can be treated.
Tooth decay (dental caries) is the most common reason for toothache. This happens when bacteria on the teeth feed on sugar in food and drink and release acids that wear down the tooth surface. This can weaken teeth or form cavities that expose the sensitive inner layers of the tooth.
If you have tooth decay, your dentist may recommend:
- improving your daily oral hygiene
- professional teeth cleaning to remove plaque
- removing the decayed part of the tooth and restoring it with a tooth filling
- antibiotics if necessary to remove the infection
Chipped or cracked tooth
A damaged tooth can cause throbbing toothache. Dental injuries can happen if you bite something hard, get hit in the mouth, fall over or have other accidents. Even a small crack in a tooth can be painful, which could alert you to tooth damage you didn't know you had.
It's important that a damaged tooth is repaired as soon as possible, or bacteria could enter and cause an infection. Small chips and cracks may be repaired through bonding, but more severe damage could benefit from placing a dental crown or filling to restore the tooth's strength and appearance.
Damaged filling or crown
If you have any fillings, crowns, veneers or other dental restorations protecting your teeth, these can also lead to tooth pain if they break, become dislodged or fall out. Just like natural teeth, dental restorations can be damaged when they're impacted or worn down over time, especially if you grind your teeth.
A damaged or missing crown or filling is considered a dental emergency, as it could leave the tooth vulnerable to infections. Depending on its condition, your dentist may be able to bond it back into place or may have to replace the restoration.
Tooth pulp infection
Severe or throbbing toothache accompanied by sensitivity to temperature could be an indication of a pulp infection or inflammation. The dental pulp is the soft tissue in the centre of the tooth, which contains the nerves and blood vessels. It can be infected if tooth decay or other damage exposes the interior of the tooth to the outside world.
The standard treatment for an infected tooth is root canal therapy. This involves removing the infected tissue and thoroughly cleaning and disinfecting the tooth before filling it with a synthetic material and sealing it with a crown or filling.
If a tooth pulp infection or inflammation isn't treated in time, the bacteria could form a pocket in the tooth known as an abscess. An abscess can be extremely painful and puts your mouth at risk of further infections, so it should be treated as a dental emergency.
A dental abscess may be removed by root canal treatment or antibiotics, but further treatments may be needed to clean the tooth and gums and make sure the bacteria has been removed. If a tooth is too badly damaged by an abscess to save, dentists may extract the tooth as a last resort to protect your other teeth.
Infected, swollen or receding gums can also cause toothache in the surrounding teeth. Gum disease (periodontal disease) can happen if bacteria in plaque reach the gum line.
The early stage of gum disease (gingivitis) is usually reversible by improving your oral hygiene and having hygiene treatments at a dental clinic. Your dentist may also prescribe an antibacterial mouthwash or antibiotics.
The advanced stage (periodontitis) may involve deep cleaning of the gums (root planing) or oral surgery to remove the infected tissue. Advanced gum disease can permanently damage tooth roots and even lead to tooth loss if it's not treated. In fact, it's the leading cause of tooth loss in adults.
A tooth that's stuck partly or completely inside the gum without emerging is impacted. This can happen with wisdom teeth if there isn't enough space for a new tooth in the mouth, which can cause teeth to crowd or go out of shape, as well as causing pain.
Your dentist will take an x-ray to examine the impacted tooth below your gum and discuss treatments. This may involve minor oral surgery to remove gum tissue over the tooth and help it to emerge, orthodontics to move your other teeth and prevent crowding, or wisdom teeth removal if you would prefer to remove the impacted tooth.
Teeth grinding or clenching
If you grind or clench your teeth while you sleep (or when you're awake and feeling stress or anxiety), this can put pressure on the teeth and cause them to ache, especially in the morning after you wake up.
Teeth grinding is called bruxism and it can have many different causes, physical and psychological. Depending on what's causing your bruxism, your dentist may suggest:
- wearing a device called an occlusal splint over your teeth while you sleep
- rebuilding worn or damaged teeth with crowns or fillings
- straightening crooked teeth with orthodontics
- replacing missing teeth with a bridge, denture or implant
- trying relaxation techniques or counselling services
A less common but still possible reason for toothache is an infection of the sinus cavity, especially if the pain is in the upper back teeth (upper molars) and affecting several teeth.
Sinus infections can be treated by a doctor. They may prescribe a decongestant or nasal spray and recommend that you drink plenty of water or use steam to help clear your sinuses.
Home remedies for toothaches
If you think your toothache is likely to go away, or you can't see your dentist today, it's important to know how to relieve pain and discomfort from home. Your dentist can give you personalised advice based on your individual needs, but everyday tooth pain can often be reduced with:
- over-the-counter painkillers
- placing a cold compress or ice pack against your outer cheek
- avoiding overly hot, cold, sweet, hard, crunchy or sticky food and drink
- following good oral hygiene, using a soft toothbrush
- keeping your head upright on a pillow when you sleep
- rinsing your mouth with salt water (not recommended for children)
Toothaches can happen any time and can't always be avoided, but you can lower your risk of tooth pain by following good brushing and flossing habits, watching what you eat and drink and keeping up with your regular dental check-ups.
Do you have a toothache?
Our dentists in Sydney can treat all common causes of toothache or give you advice about how to manage your toothache at home.
Healthdirect. Toothache and swelling [Online] 2017 [Accessed June 2020] Available from: https://www.healthdirect.gov.au/toothache-and-swelling
Healthline. 8 Causes of Throbbing Tooth Pain, and What to Do [Online] 2019 [Accessed June 2020] Available from: https://www.healthline.com/health/dental-and-oral-health/throbbing-tooth-pain