Toothache

What is it?

Toothache is one of the most common pain complaints worldwide and the most frequent dental emergency. Dental caries (cavities) eroding through enamel and dentin cause dull aching to sharp pain with sweets or temperature changes. When caries reaches the pulp, acute pulpitis develops — throbbing, spontaneous, severe pain, worsened by heat and partially relieved by cold. Periapical abscess, from necrotic pulp, produces intense throbbing pain with localized swelling, percussion tenderness, and systemic signs (fever, lymphadenopathy) in severe cases. Cracked tooth syndrome causes sharp pain on biting that disappears quickly. Exposed root surfaces cause hypersensitivity pain with temperature, sweet, and acidic stimuli.

Common causes

When to see a doctor

• 1Toothache with facial swelling, fever, or difficulty swallowing — dental abscess may spread to deep neck spaces
• 2Severe throbbing pain that wakes you from sleep — suggests irreversible pulpitis requiring root canal or extraction
• 3Jaw pain radiating to the chest or left arm with diaphoresis — cardiac referral, seek emergency care
• 4Any toothache lasting more than 1–2 days — dental evaluation is needed regardless of severity
• 5Loose tooth with bone loss or deep pocketing — advanced periodontal disease

What you can do

• ✓Ibuprofen + acetaminophen taken together (if tolerated) provides better analgesia than either alone for dental pain
• ✓Clove oil (eugenol) applied to a cotton ball and placed on the affected tooth provides temporary numbing
• ✓Avoid temperature extremes in food and drinks that trigger or worsen the pain
• ✓Do not place aspirin directly on the gum tissue — causes chemical burns
• ✓Dental care must follow — no home remedy addresses the underlying structural problem

Conditions that cause this symptom

Medications that may help

Treatment depends on the underlying cause. Always consult your provider before starting any medication.

Frequently asked questions