What causes a toothache?

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Unlike bones, teeth don’t have to break in order to cause you pain.

In fact, several things may lead to you experiencing tooth pain, and some of the causes of your toothache can become serious if you don’t see a dentist. Learn about some common toothache causes, how to know if you have a toothache, and what to do about it.

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Signs you have a toothache

There may be many reasons why your teeth hurt. Many people encounter fleeting tooth or jaw discomfort, so it can be difficult to know whether you’re experiencing a toothache or if the sudden pain is temporary. In general, toothaches reveal themselves¹ with the following symptoms:

  • Pain: When it comes to teeth, pain can be intense, throbbing, or persistent. Some people also have tooth pain that only surfaces when applying pressure to the tooth.

  • Swelling: This generally occurs in the gums that surround the affected tooth. Inflamed gums can put pressure on the teeth, leading to pain. Swelling can happen for a number of reasons, including infection. 

  • Headache: Since the teeth and mouth are connected to the rest of the bodily systems, it’s not unusual for head pain and even fever to happen as a result of a toothache.

  • Taste: An infected tooth can cause bad-tasting drainage to leak into the mouth. This is a sure sign that you should see a dentist, as they will have the proper equipment and experience you need to diagnose and treat your tooth pain.

Reasons for a toothache

Toothaches usually happen when the pulp, or central part of the tooth, becomes inflamed. The most common causes of toothaches include the following:²

  • Damaged Filling: Dental fillings can become damaged when you bite down on a hard object or sustain an injury. Fillings can also wear down over time from the normal wear and tear from chewing, biting, and grinding that occurs when eating. This may cause them to loosen or fall out entirely. When a filling becomes damaged, the affected tooth is no longer properly protected and may be prone to infection and general discomfort.

  • Grinding Teeth: Many people grind their teeth from time to time, such as during sleep. However, when tooth grinding happens regularly, you can cause serious damage to your teeth. Grinding your teeth can even cause fractures or cracks in your teeth. If enough damage is done and the grinding is not addressed, you could potentially even lose one or more teeth.

  • Cracked Tooth: Enamel and dentin protect teeth, but these hard surfaces can crack or chip as a result of injury, age, or chewing on hard objects. When cracked, the hard surfaces of teeth can shift while you chew, thereby causing pain in the pulp. Over time, a cracked tooth can also cause temperature sensitivity and even infection.

  • Tooth Decay: Bacteria from food you’ve eaten can turn into acid that wears away at your enamel, which contributes to tooth decay. Over time, tooth decay can cause cavities and painful toothaches, among other dental issues.

  • Abscessed Tooth: When left untreated, tooth decay can lead to an abscessed tooth, which refers to an infection at the tooth’s root. A tooth abscess can compromise the enamel, leaving the pulp exposed to possible infection and tooth pain if not treated effectively.

  • Infected Gums: Also known as gingivitis, infected gums start with bacterial growth, plaque buildup, and inflammation. Gingivitis can be uncomfortable, but the effects are treatable. If left untreated, though, gingivitis can quickly escalate to periodontitis and tooth loss.

How to diagnose a toothache

While it may be tempting to diagnose your toothache on your own, the reality is you are unlikely to have the experience and wherewithal to determine the exact cause of your toothache. Only a professional like a dentist can properly pinpoint the cause of toothaches and give a recommendation on next steps.

You may experience several symptoms when you have a toothache, and a dentist considers them during your appointment to determine a diagnosis for the cause of the problem as well as treatment options. 

Your dentist will likely perform a visual examination of your teeth and as you questions about your daily habits, when the pain began, what type of tooth pain you are experiencing, and any other questions that might help inform them as they hone in on the cause of your problem., If necessary, they may take X-rays or ask for a specialist, such as an endodontist³, to provide additional support. 

How to treat a toothache

Not all toothaches require you to rush to the dentist. If your symptoms haven’t escalated beyond moderate pain or you can’t see your dentist right away, your dentist may suggest you perform basic treatment yourself to alleviate pain before your appointment. 

First, try flossing between teeth gently and rinsing your mouth with saltwater. A pain reliever or use an over-the-counter solution that you can apply directly to the tooth, such as an oral topical gel could also help. Medications like acetaminophen are also helpful to manage the pain.

However, even though you may be able to keep toothache symptoms at bay with these methods, you shouldn’t skip the dentist visit altogether. For one thing, your body is trying to tell you that something is wrong when it signals the pain receptors. Moreover, the pain may be a sign of a larger problem that, without treatment, could worsen over time, costing you even more in dental bills than if you had treated the problem quickly.

Contact a dentist to help with your toothache

Dentists are here to help and can locate the root of the problem during your visit. They may fill a cavity after diagnosing your issue, or they may take other measures such as prescribing an antibiotic. In more extreme circumstances, you may need a root canal to fix your toothache. However, the only way you can know for sure is to schedule an appointment with your dentist.

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Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice. It is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office. Guardian Direct plans are underwritten and issued by The Guardian Life Insurance Company of America New York, N.Y. or its subsidiaries. Products are not available in all states.


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  1. https://www.webmd.com/oral-health/guide/toothaches (Last accessed December 2019)

  2. https://www.colgate.com/en-us/oral-health/basics/mouth-and-teeth-anatomy/tooth-anatomy (Last accessed December 2019)

  3. https://www.aae.org/patients/dental-symptoms/tooth-pain/ (Last accessed December 2019)