Toothache

Overview

What is a toothache?

A toothache is a pain in or around a tooth. Minor toothaches can come from a temporary gum irritation that you can treat at home. More serious toothaches are caused by dental and mouth problems that won’t get better on their own and will need to be treated by a dentist.

Why is my toothache so painful?

The pulp inside your tooth is soft material filled with nerves, tissues and blood vessels. These pulp nerves are among the most sensitive in your body. When these nerves are irritated or infected by bacteria (abscess), they can cause severe pain.

Symptoms and Causes

What are possible causes of toothache?

Toothaches can be caused by:

  • Tooth decay.
  • Abscessed tooth (a bacterial infection inside the center of the tooth).
  • Tooth fracture (broken tooth).
  • A damaged filling.
  • Repetitive motions, such as chewing gum or grinding or clenching teeth. These motions can wear down your teeth.
  • Infected gums.
  • Eruption (teeth coming out of the gums) or removal of a tooth (for example, wisdom teeth).

What are symptoms of toothache?

  • Tooth pain that may be sharp, throbbing, or constant. In some people, pain results only when pressure is applied to the tooth (biting down on something).
  • Swelling around the tooth.
  • Fever or headache.
  • Foul-tasting drainage from the infected tooth.
  • A bad odor from the mouth.

If you experience trouble breathing and swallowing along with your pain, call a dental professional right away.

Management and Treatment

Can my toothache go away on its own?

Some toothaches that come from pain around (but not inside) your tooth can get better without a trip to the dentist. Pain from a temporary irritation (redness) in the gum can be resolved within a few days. During this time try not to chew around the affected area. Eat soft foods, like eggs and yogurt, and avoid sweets and very hot or very cold foods if teeth are sensitive.

How do I treat a toothache at home?

For temporary relief of a toothache, you can do the following:

  • Rinse with warm saltwater. Saltwater can loosen debris between your teeth, act as a disinfectant and reduce inflammation. Stir a ½ teaspoon of salt into a glass of warm water and rinse your mouth thoroughly.
  • Rinse with hydrogen peroxide. A hydrogen peroxide (3% solution) helps to reduce inflammation and pain. Dilute the hydrogen peroxide with equal parts water and rinse thoroughly. Don’t swallow it.
  • Cold compress. For swelling and pain hold a cold compress of ice wrapped in a towel to the painful area for 20-minute periods. Repeat every few hours.
  • Pain medications. Over-the-counter pain medications can reduce pain and inflammation. NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Motrin®, Advil®) and naproxen (Aleve®) can be used, or take acetaminophen (Tylenol®) if you can’t take NSAIDs. Don’t give a child under the age of 16 aspirin; use Tylenol instead.

Natural or herbal treatments

  • Clove oil. A natural antiseptic that numbs pain and reduces inflammation. Dab a small amount of clove oil on a cotton ball and apply to the painful area. Or add a drop of clove oil to a small glass of water and rinse your mouth thoroughly.
  • Vanilla extract. The alcohol in vanilla extract numbs pain temporarily and its antioxidants help the area heal. Use your fingertips or cotton ball to apply the extract to the tooth and gum a few times a day.
  • Peppermint tea. Peppermint’s soothing properties can be applied to the painful area with a cooled down peppermint tea bag. Hold this warm tea bag against the tooth and gum.
  • Garlic. Make a paste of a crushed garlic clove and apply to the affected area. Garlic can kill bacteria (it contains the antimicrobial allicin) and relieve pain.

What happens when I go to the dentist’s office for my toothache?

Temporary, home-made pain relief won’t be enough if your toothache is progressing. Call your dental professional when it becomes clear that the problem in your mouth is getting worse despite your best efforts.

At the office your dental team will review your medical history. You’ll be asked questions like:

  • Where is the pain located?
  • When did it start?
  • How severe is it?
  • What makes the pain worse and what gives you relief?

The dental team will also do a physical exam. They’ll check your mouth, teeth, gums, jaws, tongue, throat, sinuses, ears, nose and neck. You’ll probably get X-rays of your mouth taken to help show the cause of your toothache.

How will the dentist treat my toothache?

Treatment by a dental professional depends on what is causing your toothache.

  • If a cavity is causing the toothache, your dentist will fill the cavity or take the tooth out, if necessary.
  • A root canal (a procedure to remove and replace infected pulp with sealing material) may be needed if the cause of the toothache is an infection of the tooth's nerve. Bacteria that have worked their way into the inner space of the root of the tooth cause infection.
  • An antibiotic may be prescribed if there is fever or swelling of the jaw. A small piece of food (like a popcorn hull) can get stuck under the gums causing an infection. In this instance, a deep cleaning may be performed or recommended followed by further periodontal (gum) therapy if necessary.

Prevention

How can I prevent a toothache?

Since most toothaches are the result of tooth decay, good oral hygiene practices can prevent toothaches:

  • Brush regularly with a fluoride toothpaste.
  • Floss at least once a day.
  • See your dentist twice a year for professional cleaning.

Also, eat foods low in sugar and ask your dentist about sealants and fluoride applications.

Living With

When should I see a dentist for a toothache?

See your dentist as soon as possible if:

  • You have a toothache that lasts longer than one or two days.
  • Your toothache is severe.
  • You have a fever, earache or pain when you open your mouth wide.
  • You experience swelling in the mouth or face.

The proper diagnosis and treatment of dental infections are important to prevent it from spreading to other parts of the face and skull and possibly even to the bloodstream.

Toothaches can be extremely uncomfortable but the pain isn’t permanent as long as it’s treated. Your dental professional can relieve your pain and prevent any infections in your mouth from spreading in your body.

Can a toothache make me sick, or even be fatal?

A toothache itself isn’t fatal. But an untreated infection in your tooth (or any other part of your body) can spread. You can become sick, and this illness could turn into something serious or even life-threatening. So if you toothache isn’t getting better it’s a good idea to contact your dentist.

Last reviewed by a Cleveland Clinic medical professional on 03/23/2020.

References

  • Academy of General Dentistry. What Causes a Toothache? (http://www.knowyourteeth.com/infobites/abc/article/?abc=T&iid=337&aid=1362) Accessed 11/18/2021.
  • American Dental Association MouthHealthy. Abscesses (Toothache) (http://www.mouthhealthy.org/en/az-topics/a/abscess) Accessed 11/18/2021.
  • American Association of Endodontists. Tooth Pain (http://www.aae.org/patients/symptoms/tooth-pain.aspx) Accessed 11/18/2021.
  • National Institute of Dental and Craniofacial Research. Tooth Decay. (https://www.nidcr.nih.gov/health-info/tooth-decay) Accessed 11/18/2021.
  • National Health Service. Toothaches. (https://www.nhs.uk/conditions/toothache/) Accessed 11/18/2021.

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