Updated: Dec 7, 2022
A toothache is a sharp constant pain in or around your tooth. It is usually caused by the tooth or the surrounding gum. In some cases, the toothache pain is referred pain, caused by surrounding anatomical structures. You should never ignore toothaches, often if left untreated will get worse. In most cases, they are not life-threatening, but in medical compromised patients, they can become life threatening. If you have a toothache, we recommend to see your dentist as soon as possible.
What does a toothache feel like?
Toothache pain can range from mild to severe, and it may be constant or intermittent. You may feel like:
throbbing pain or swelling in or around your tooth or gum with or without fever
sharp pain when you touch your tooth or bite down
tenderness and achiness in or around your tooth
sharp tooth pain in response to hot or cold drinks
shock-like pain, which is uncommon
What are the common causes of toothaches? The most common cause is tooth decay. If it goes untreated, it will develop into an abscess. This is an infection in the pulp/nerve space inside your tooth. You should see your dentist right away to avoid a dental abcess. Overtime, it can spread in the facial muscle spaces and impair your airway which can be life-threatening.
The second most common cause is an impacted tooth. Usually seen with impacted wisdom teeth which have insufficient space to erupt or grown in, they remain stuck in the gum or in bone. Food constantly remains trapped under the gum, harbouring bacteria and with time causing gum inflammation and exudate (pus). Referred tooth pain from a chronic or acute sinusitis. Since the roots of your upper teeth are close to your sinus, the pressure built in your sinus can cause pain on your upper teeth. Patients often describe a sharp non localized pain when biting on their upper back teeth. Patients also notice pain when they bend down to tie their shoe lace. The pressure in the sinuses presses further on the teeth and patients feel a sharp toothache. Sinusitis is the inflammation of the sinus cavity due to a viral, bacterial, or fungal infection. We recommend to see your doctor.
How to treat a toothache?
Home treatment is a temporary relieve while you wait for your dentist's appointment. Since most toothaches are caused by deep caries, following a thorough oral exam and x-ray of the region, your dentist may recommend a root canal or extraction of the tooth causing the pain. In more severe cases, you may be given pain medication and antibiotics to reduce the infection prior to proceeding with dental treatment.
If the toothache is caused by an impacted tooth, surgical removal is most likely the treatment required. For sinus referred pain, your doctor may treat it with antibiotics or nasal decongestant. For temporary pain relieve use:
over-the-counter (OTC) pain medication ( Tylenol, Advil, Aspirin, Naproxen)
OTC topical dental pain gel (Orajel)
OTC nasal decongestants (if your pain is due to sinus congestion)
clove oil applied to your aching tooth
When is a toothache an emergency? Seek emergency treatment if you have the following symptoms, along with a toothache:
swelling in your jaw or face
trouble breathing and swallowing
How to prevent toothaches? For early detection of a toothache, dentists recommend to brush and floss your teeth at least twice a day and get dental checkups and cleanings twice a year.