Why a tooth hurts
A tooth is not a solid block. Inside it sits living pulp, containing nerves and blood vessels. When decay, a crack or inflammation reaches that pulp — or when the gum recedes and exposes the root — pain appears. The character of the pain says a great deal about its cause.
- Brief pain with cold or sweet things — usually sensitivity, or decay approaching the nerve.
- Throbbing, constant pain that worsens at night — inflammation of the pulp. This does not wait.
- Pain only when biting — possibly a cracked tooth, a filling sitting too high, or inflammation at the root tip.
- Pain with facial swelling — most likely an abscess. This is urgent.
- Upper back teeth aching with facial pressure — sometimes the sinuses are the source, not the tooth.
What helps while you wait
These measures ease the pain. They do not treat it — the cause remains until it is addressed.
- Rinse with warm salty water — cleans the area and calms the gum.
- Cold compress on the cheek, from outside — reduces swelling and pain. Never place ice directly on skin.
- Sleep with your head raised — lying flat increases pressure in the tooth, which is why toothache is so often worse at night.
- Clean the area gently — trapped food between teeth is sometimes the whole problem.
For pain relief, ask your pharmacist or doctor what suits your medical history and current medication. We will not name products or doses here.
When it becomes urgent
Some signs should not wait until tomorrow.
- Swelling of the face or neck, particularly if it spreads towards the eye or under the jaw.
- Difficulty swallowing, breathing, or opening the mouth — go to an emergency department immediately.
- Fever alongside the toothache.
- Severe pain that will not settle despite usual painkillers.
- A tooth broken or knocked out after an injury.
Outside those situations, pain lasting more than a day or two deserves an early appointment. Waiting rarely improves matters, and often turns simple treatment into heavier treatment.
How toothache is actually treated
Treatment follows the cause, which is why an examination — and X-rays where justified — comes first.
- Surface decay — a simple filling.
- Decay reaching the pulp — root canal treatment, which removes the inflamed tissue and keeps the tooth.
- Abscess — drainage, then treatment of the underlying cause.
- Gum problem — scaling and root surface cleaning.
- Impacted wisdom tooth — extraction may be needed.
- Teeth grinding — a custom-made night guard.
Avoiding the next one
Most toothache is the end of a problem that built up silently. Prevention is far easier than treatment.
- Brush twice daily for two minutes with a fluoride toothpaste (1450 ppm).
- Clean between the teeth every day with floss or interdental brushes — a brush cannot reach there, and that is exactly where decay often starts.
- Reduce how often you have sugar rather than how much. Ten small servings across a day are worse than one larger one.
- Have regular check-ups, at an interval your dentist sets according to your own risk.