What causes a toothache?

Toothaches can leave you miserable. You can’t see its cause, it generally doesn’t go away on its own and you can’t massage it like a muscle knot. It’s also often an indicator of a serious problem that requires immediate attention from a dentist.

Most toothaches are the result of tooth decay, which means you probably have advanced gum disease. The pain you feel — usually when you eat or drink something sweet, very hot or very cold — is an alarm bell telling you that the pulp inside your tooth is irritated. The pulp is where the soft tissue and nerves in your tooth are located, so if something is wrong with the pulp, you’ll feel it in the entire tooth.

Common causes of a toothache

A thorough oral exam is the best way to find out why you’re experiencing a toothache, but generally the reasons fall under one of these causes:

• Infection
• Gum disease
• Grinding teeth (bruxism)
• Tooth trauma
• An abnormal bite
• Sinus pressure
• Tooth eruption (in babies and school-age children)

How can I tell what the cause of my toothache is?

It’s important to pay attention to little things that might seem “off” with your teeth and the inside of your mouth.

For example, you might have an abscess, which means that pus has collected around the tooth root. Pus can be a sign of a bacterial infection, especially if it’s accompanied by tissue inflammation, bleeding gums and bone loss around the tooth. In either case, you should see your dentist as soon as possible.

While an abscess means you should visit your dentist, any of the following symptoms could indicate that you need to visit the emergency room:

• Fever
• Pain when you bite
• A foul-tasting discharge
• Difficulty breathing or swallowing
• Swelling around the tooth area
• Continuous pain that doesn’t end, instead of pain just when you eat or drink something
  
  

One major health issue related to toothaches is the presence of sepsis, which is when an infection that had previously been localized begins to spread throughout your body. If sepsis develops and is left untreated, it can kill you. Nearly 2,000 people a year are hospitalized with it, and it nearly always develops from a treatable bacterial infection. If you have a toothache, you need to get it examined to ensure it doesn’t develop into a life-threatening condition.

My dentist says there's nothing wrong with my jaw or teeth. What's causing my toothache?

The body manifests pain in many ways, and in some cases, what seems to be a simple toothache isn’t one at all. Rather, the pain is a symptom of another problem. Extreme stress, prior trauma, heart conditions and even some forms of cancer can present as pain in the mouth that appears to have no cause.

Do you have a cold or severe allergies? These can cause sinus pressure, which can also put pressure on the roots of your upper molars, leading to tooth pain. Talk with your physician to see if an antihistamine might help relieve the pressure. If the pain doesn’t go away, see your dentist.

Also, if you suffer from chronic pain, migraines, limb movement disorders or similar problems, you should tell your dentist so he or she can better identify the cause of your pain.

The words you use to describe your pain are important, too. The following words often describe types of pain that don’t originate in the mouth, so your dentist will probably ask for more details to help eliminate all known causes:

• Burning
• Tingling
• Electric
• Searing
• Stabbing
• Numb
  
  

Your dentist will probably ask how long you’ve been feeling the pain, so think back. It may even be helpful to keep notes for reference once you begin experiencing a toothache.

The most important thing to remember is that pain in your mouth is not normal. If your tooth hurts and something feels wrong, go to your dentist. Hopefully, it’s something minor that can easily be treated, but it’s not worth taking a risk that could endanger your health.

Last updated January 12, 2022