Note: This article is for general information purposes and does not replace individual dental advice.
Toothache can come on suddenly, be throbbing or dull, and seriously affect everyday life. In this guide, you will learn what can cause toothache, what you can do for immediate relief and when you really should see a dentist.
Common causes of toothache
Tooth decay
The most common cause of toothache is tooth decay (caries). Bacteria produce acids that attack and destroy the tooth enamel. At first, you may notice sensitivity to sweet, hot or cold things. If the decay is not treated, it penetrates deeper into the tooth and can eventually reach the dental nerve – at which point the pain becomes intense and throbbing.
Gum inflammation and periodontitis
Inflammation of the gums (gingivitis) and of the tissues supporting the teeth (periodontitis) can cause dull, diffuse pain, especially when chewing or touching the gums. This is often accompanied by bleeding gums.
Inflammation of the dental pulp (pulpitis)
When bacteria reach the dental nerve, the pulp inside the tooth becomes inflamed. Typical signs are severe, throbbing pain that also occurs at night and can radiate into the jaw, ear or temple. In many cases, root canal treatment can save the tooth.
Tooth fracture or broken tooth
A broken tooth or a crack in the enamel can expose the sensitive dental nerve. The pain occurs particularly when chewing or on contact with hot and cold food.
Erupting wisdom teeth
When wisdom teeth come through, the surrounding gum can swell and become painful. With partially erupted teeth in particular, pockets can form in which bacteria collect.
Teeth grinding (bruxism)
Grinding or clenching your teeth at night puts strain on the teeth, jaw joints and chewing muscles. It can lead to toothache, sensitive tooth necks and headaches. TMD treatment with an occlusal splint can help.
Sensitive tooth necks
Exposed tooth necks – for example due to receding gums – react sensitively to cold, heat, sweet or sour things. The pain is usually brief and sharp.
Toothache – what to do? Immediate relief
Until you can see a dentist, these measures can help:
Cooling
Place a cold pack or a cold flannel on the outside of your cheek (not directly on the skin). The cold constricts the blood vessels and can ease swelling and pain.
Painkillers
Over-the-counter painkillers such as ibuprofen or paracetamol can provide relief, provided there are no contraindications; follow the package leaflet and the maximum daily dose. Acetylsalicylic acid (aspirin, ASA) is not a good choice as a painkiller before dental treatment because it inhibits blood clotting. Prescribed ASA (for example after a heart attack or a stent) must never be stopped on your own.
Mouth rinse
Rinse your mouth gently with lukewarm salt water (half a teaspoon of salt in a glass of water). This can have a disinfecting effect and reduce bacteria.
Clove oil
Clove oil contains the active substance eugenol, which has a mild numbing effect. Dab heavily diluted clove oil onto the painful area with a cotton bud, but not onto open wounds and not in children. This can bring short-term relief.
What you should avoid
- Very hot, cold, sweet or sour food and drinks
- Chewing on the painful side
- Heat on the cheek (can make an inflammation worse)
- Placing medication on the tooth yourself (e.g. aspirin directly on the mucous membrane)
When should you see a dentist?
As a general rule: toothache is always a warning sign. You should see a dentist promptly. A visit is urgently needed in the case of:
- Severe, throbbing or night-time pain: straight away, do not wait
- Swelling of the face or jaw (possible abscess)
- Fever together with toothache
- Swelling with difficulty swallowing, shortness of breath or spreading towards the eye or throat: go to A&E immediately or call the emergency number 112
- Pain after an accident or a blow to the tooth
- Pus or a foul taste in the mouth
- Numbness in the lip or chin
At our dental practice in Düsseldorf, we treat acute problems in our walk-in pain clinic on every practice day from 10.00 to 11.30, also without an appointment; outside consultation hours, the dental emergency service can help. Call us on 0211 – 497 67 69. You will find all the information you need in an emergency on our page Dental Emergency.
How does the dentist treat toothache?
Treatment depends on the cause:
- Tooth decay: removal of the decay and restoration with a dental filling
- Inflamed dental nerve: root canal treatment to preserve the tooth
- Gum inflammation: professional teeth cleaning and periodontitis treatment
- Abscess: incision and drainage, antibiotics if necessary
- Tooth fracture: depending on the extent, a filling, a crown or, if the tooth cannot be saved, extraction and an implant
- Wisdom tooth: wisdom tooth removal if necessary
Preventing toothache
The most effective measure against toothache is prevention:
- Brush your teeth thoroughly twice a day with fluoride toothpaste
- Use dental floss or interdental brushes every day
- Regular professional teeth cleaning (once or twice a year)
- Check-ups at the dentist every six months
- Limit sugar consumption, especially between meals
- If you grind your teeth: wear an occlusal splint
This article is for general information purposes and does not replace professional dental advice. If you have symptoms, please contact your dentist.
