Toothache is pain in and around the teeth and jaws that is most often caused by tooth decay.
The pain usually starts suddenly and it can vary from mild discomfort to a severe throbbing, which is often worse at night. The area of your jaw close to the infected tooth may also be sore and tender to the touch.
Toothache can either come and go or be constant. Eating or drinking can make the pain worse, particularly if the food or drink is hot or cold.
When to see your dentist
If you have toothache for longer than one or two days, you should visit your dentist as soon as possible to have it treated. The longer you leave it, the worse it will get.
If your toothache is not treated, the pulp inside your tooth will eventually become infected. This usually leads to a dental abscess forming, which can cause severe and continuous pain.
Painkillers such as paracetamol and ibuprofen may help reduce pain and discomfort while you are waiting for an appointment. Children under 16 years of age should not be given aspirin.
Why it happens
Toothache happens when the innermost layer of the tooth – called dental pulp – becomes inflamed. Dental pulp is made up of soft, delicate tissue that contains sensitive nerves and blood vessels.
Dental pulp can become inflamed because of:
tooth decay that leads to cavities (holes) forming in the hard surface of the tooth
a cracked tooth – the crack is often so small that it can’t be seen with the naked eye
loose or broken fillings
receding gums – where the gums contract (shrink) to expose softer, more sensitive parts of the tooth root
periapical abscess – a collection of pus at the end of the tooth caused by a bacterial infection
There are a number of other conditions that can cause pain similar to toothache, even though the pulp is not affected. These include:
periodontal abscess – a collection of pus in the gums caused by a bacterial infection
ulcers on your gums
sore or swollen gums around a tooth that is breaking through, such as when your wisdom teeth start to come through
sinusitis (inflammation of the sinuses) – this sometimes causes pain around the upper jaw
an injury to the joint that attaches the jaw to the skull (temporomandibular joint)
Babies can also experience discomfort when their teeth start to develop. This is known as teething.
The type of treatment you have for toothache depends on the cause of the pain, so your dentist will examine your mouth and may carry out an X-ray to try to identify the problem.
If your toothache is caused by tooth decay, your dentist will remove the decayed area and replace it with a filling.
If your toothache is caused by a loose or broken filling, the filling will be removed, any decay will be cleaned out and a new filling put in place.
If the pulp of your tooth is infected, you may need to have root canal treatment. This is where your dentist removes the infected pulp, fills the space with a paste and may cover the remaining tooth with a crown to protect and seal it.
If your toothache cannot be treated using these methods or your tooth is impacted (wedged between another tooth and your jaw), your tooth may need to be removed.
The best way to avoid getting toothache and other dental problems is to keep your teeth and gums as healthy as possible. To do this, you should:
brush your teeth twice a day using a toothpaste that contains fluoride; gently brush your gums and tongue as well
clean between your teeth using dental floss and, if necessary, use a mouthwash
limit your intake of sugary foods and drinks; you should have them as an occasional treat and only at mealtimes
don’t smoke as it can make some dental problems worse
Visit your dentist once a year for a dental check-up. Children should have a dental check-up every six months so that tooth decay can be spotted and treated early.