Toothache is a symptom, not a diagnosis. The same throbbing can come from a cavity, a dying nerve, a cracked tooth, gum infection, an erupting wisdom tooth or even a sinus problem — and each needs different treatment. What the pain feels like tells you a great deal about which one you have.
What the type of pain tells you
Short, sharp jolt with cold or sweet
Gone in a second or two. Usually sensitivity from exposed dentine or an early cavity. Not urgent, but worth examining before it progresses.
Lingering ache after hot or cold
Pain that continues for minutes after the stimulus is removed suggests the pulp is inflamed or dying. This is the classic signal for root canal treatment. Heat sensitivity in particular is a strong indicator.
Constant throbbing, worse lying down
An infected pulp or abscess. Lying down increases blood pressure in the head, which is why it wakes people at 2am. This needs treating, not enduring.
Sharp pain on biting, then release
Often a cracked tooth. Cracks can be invisible on X-ray, and the pain comes from the segments flexing apart. A crown usually solves it — left alone, the crack propagates until the tooth splits.
Dull ache across several upper back teeth
Frequently sinus pressure rather than a tooth. Roots of upper molars sit close to the sinus floor. If several teeth hurt at once, it worsens when you bend forward, and you have a cold, this is likely the cause.
Pain at the very back of the jaw
Usually an erupting or impacted wisdom tooth, often with a swollen gum flap over it that traps food and gets infected repeatedly.
Soreness of gums with bleeding
Gum disease. Rarely acutely painful until advanced, which is why it does so much damage before people seek treatment.
Relief until you can be seen
- Ordinary painkillers taken as directed on the packet
- Warm salt-water rinses, several times a day
- Cold compress on the outside of the cheek for swelling
- Sleep with your head raised on an extra pillow
- Keep the area clean — brush gently even if it is sore
- Avoid extremes of temperature and very sweet food
What not to do
- Do not put an aspirin against the gum. It burns the tissue and does nothing for the tooth. This old remedy causes real chemical burns.
- Do not apply heat to a swollen face — it can spread infection
- Do not leave antibiotics as the plan. They may settle swelling temporarily, but the infection returns until the tooth is treated. Antibiotics are a bridge, not a cure.
- Do not wait for it to stop hurting. When a pulp finally dies the pain often disappears for weeks — that is not recovery, it is the infection moving into the bone.
See a dentist the same day if
- Your face, cheek or jaw is swollen, particularly with fever
- Pain is severe and painkillers are not touching it
- You have difficulty swallowing, breathing or opening your mouth
- There is a bad taste of pus in your mouth
Facial swelling means the infection has left the tooth and entered the surrounding tissue. In the lower jaw it can spread to spaces that compromise the airway. This is the one category where waiting is genuinely dangerous.
Preventing the next one
Nearly every toothache traces back to decay or gum disease, and both are picked up at a routine six-monthly check-up while they are still small and cheap to treat. Read our guide to the five symptoms of a cavity.
We keep slots free each day for dental pain. Call 8359017239 and say you are in pain — we will fit you in.
