Toothache: Causes, Relief and When to See a Dentist

This page is general information and does not replace an examination.

What can cause toothache?

Toothache is a symptom, not a diagnosis. The same throbbing or sharp pain can come from the tooth itself, from the gum around it, or from the jaw joint and muscles nearby. The NHS lists these possible causes^[1]; the two marked [4] and [5] are added from the NHS wisdom-tooth page and Cleveland Clinic:

• Tooth decay, where acid has made a hole that can reach the sensitive inner part of the tooth.
• A dental abscess, a build-up of pus caused by an infection, which will not go away on its own^[2].
• A cracked or damaged tooth, which often hurts when you bite.
• A loose or broken filling.
• An infection around a tooth that has only partly come through, often a wisdom tooth without enough room^[5].
• Problems with braces.
• Gum disease.
• Teeth grinding, which can also make the jaw muscles ache^[1][6].
• Sensitive teeth, where worn enamel or receding gums expose the inner layer of the tooth^[1][4].

Pain is not always felt where the problem is. Pain from the jaw joint can be felt around the jaw, ear and temple^[6], and it can be hard to tell which tooth hurts. That is why the cause needs an examination, not a guess.

Possible causes of toothache at a glance

The table lists common causes and the features people often notice. It is a guide for talking to your dentist, not a way to diagnose yourself: the same feeling can have different causes.

Sources: NHS [1][2][5][6], Cleveland Clinic [4]. You may cite this table with a link to this page.

When to see a dentist, and when it is an emergency

The NHS advises seeing a dentist if you have toothache^[1]:

• that lasts more than 2 days;
• that does not go away when you take painkillers;
• with a high temperature, pain when you bite, red gums, or a bad taste in your mouth;
• with a swollen cheek or jaw.

A family doctor (GP) usually cannot treat the tooth itself; the NHS advises seeing a dentist rather than a GP surgery for toothache^[1].

Relief while you wait for an appointment

These steps can ease the pain until a dentist treats the cause. They do not treat the cause itself^[1].

• Over-the-counter pain relief, such as ibuprofen or paracetamol, taken as directed on the package, if your physician or pharmacist has not told you otherwise. A pharmacist can advise you. Children under 16 should not take aspirin^[1].
• A pain-relieving mouth gel from a pharmacy^[1].
• Rinsing with warm salt water: half a teaspoon of salt in a glass of warm water, rinse and spit. Children should not try this in case they swallow it^[1].
• Soft food such as yoghurt or scrambled eggs, and chewing on the other side^[1].
• A soft toothbrush, and no flossing right around the sore tooth for now^[1].
• Avoid sweet, very hot or very cold food and drink, and do not smoke^[1].

For dental pain, an evidence-based guideline from the American Dental Association concluded that non-opioid medicines are first-line: non-steroidal anti-inflammatory drugs (NSAIDs) alone or combined with paracetamol (acetaminophen) likely give better pain relief, with a more favourable safety profile, than opioids^[3]. Not everyone can take NSAIDs, for example because of other illnesses or medicines^[3], so check with a pharmacist or your doctor.

Toothache at night

Many people notice toothache most when they lie down at night, when there is nothing else to take their attention. Pain that wakes you up, starts on its own without a trigger, or keeps throbbing long after a hot or cold drink should be checked by a dentist rather than waited out. It does not tell you the cause by itself; a dentist will test the tooth and take an X-ray to find out.

• Take any pain relief early in the evening as directed on the package, rather than waiting until the pain is severe.
• Avoid very hot, cold or sweet food and drinks before bed^[1].
• If you grind or clench at night, jaw and tooth pain may be worse in the morning; tell your dentist about it^[6].
• If swelling spreads, or breathing or swallowing becomes difficult during the night, call the emergency number (112 in Türkiye).

How a dentist finds the cause

A dentist asks when the pain started, what sets it off (biting, cold, heat, sweet) and how long it lasts. They look at the teeth and gums, test the suspected tooth with cold, gentle tapping or a bite test, and take X-rays to see decay under fillings, between teeth and around the root tip. At our clinic every patient has a panoramic X-ray as the basis of diagnosis, and we take periapical X-rays of a single tooth in the clinic when needed. When a case needs a 3D view, our dentists evaluate a cone-beam CT (CBCT) scan.

If you are in pain, bring a list of your medicines and any allergies. If you have taken painkillers, say what and when: it helps the dentist judge the pain and plan anaesthesia.

Treatment depends on the cause

Painkillers and home care only bridge the time until treatment. The pain usually stops for good only when the cause is treated^[1][3]:

• Decay: a filling, or root canal treatment if the inner part of the tooth (the pulp) is inflamed or infected.
• Abscess: treating the source of the infection, by drainage, root canal treatment or removing the tooth^[2]. Antibiotics are used when the infection has spread or there are signs such as fever or malaise, alongside dental treatment, not instead of it^[7]. See our guide to tooth abscess.
• Cracked tooth or broken filling: a new filling, an onlay or a crown, depending on how deep the crack goes.
• Wisdom tooth: cleaning the gum flap, or removing the tooth if it keeps causing problems^[5]. See our wisdom teeth guide.
• Sensitivity: desensitising products, fluoride varnish or bonding over exposed areas^[4].
• Jaw joint or grinding: self-care first, a night guard if grinding is involved, jaw exercises and physiotherapy for persistent cases^[6].

Prices for fillings, root canal treatment, extractions and crowns are on our dental treatment prices page; you receive a written quote after the examination and X-rays.

How to prevent toothache

The NHS’s advice is to keep teeth and gums as healthy as possible^[1]:

• Brush twice a day for about 2 minutes with a fluoride toothpaste.
• Clean between your teeth every day with floss or an interdental brush.
• Have sugary food and drinks only occasionally, at mealtimes.
• Keep regular dental check-ups, so problems are found before they hurt.

If you grind your teeth, a night guard protects the teeth and any crowns or veneers. Our crown and bridge guarantees exclude fracture due to bruxism (teeth grinding), and patients who grind their teeth must wear the night guard we provide; see our written dental guarantee.

How we handle toothache at our clinic

Both of our dentists, Dr. Ali Cem Ulubey and Dr. Surur Ulubey, examine and treat patients themselves; there are no rotating dentists.

• Diagnosis first: examination, a panoramic X-ray for every patient and periapical X-rays in the clinic when needed, before any treatment is decided.
• Treated in the clinic: fillings, root canal treatment, extractions including surgical and impacted teeth, crowns and onlays, gum treatment and night guards. We treat children too, generally from about 5–6 years of age if the child cooperates; Dr. Surur Ulubey treats our child patients.
• Referred: white or red patches or other lesions in the mouth are referred to a university faculty of dentistry; impacted wisdom teeth with a high risk to the nerve are preferably referred to a university faculty of dentistry; persistent jaw-joint problems may be referred to physiotherapy.
• Pain relief after treatment: when we prescribe pain relief, it is usually an anti-inflammatory (NSAID) such as diclofenac, naproxen or dexketoprofen, chosen for the individual patient. Follow the prescription and the package leaflet; we do not give doses on this page.
• Antibiotics: only when the examination shows they are needed, never as a replacement for treating the tooth.

Messages on WhatsApp are usually answered within 4 hours, also on Sundays, when the clinic itself is closed. Sending a clear photo or a recent X-ray helps us judge how soon you should be seen.

Frequently asked questions