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Tooth Pain Causes and Treatment
Why your tooth may be aching and what to do about it By Lora Dodge Lora Dodge She was certified by the Dental Assisting National Board in 2001. Her career in dentistry first began in orthodontics and continued to expand into general dentistry, pediatrics, and oral surgery.
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Learn about our editorial process Updated on September 01, 2022 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates.
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Learn more. by Sumaya Ibraheem, DDS Medically reviewed by
Sumaya Ibraheem, DDS Sumaya Ibraheem, DDS, is a general dentist practicing in New York, and a member of the American Dental Association and New York State Dental Association.
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Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Causes When to See a Dentist Diagnosis Treatment Prevention Frequently Asked Questions Tooth pain may occur because of tooth sensitivity, a mouth injury, decay, an infection, or other issues. How bad your tooth pain is isn't necessarily a reflection of the severity of the problem, either. And a toothache can be significant even if it is caused by a relatively minor problem.
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That can make it hard to tell when tooth pain is serious and you need to get to the dentist. This article explores the possible causes of tooth pain and the signs you need to get checked out. It also covers how tooth pain is diagnosed and treated, and how it can be prevented.
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Verywell / Alexandra Gordon
What Causes Tooth Pain Common causes of a toothache that relate to your oral health include: Gum disease
Tooth decay
Sensitive teeth
Bruxism (grinding teeth while awake and/or asleep)
A cracked tooth due to mouth trauma
A tooth abscess (infection in the center of the tooth)
An impacted tooth (a tooth that doesn't fully break through the gums)
Tooth pulp inflammation (called pulpitis), which causes pain in the center of the tooth
Ludwig's angina (a serious but rare mouth infection) Is There a Link Between Your Headache and Your Toothache? Gum Disease Gum disease, or periodontitis, is characterized by an infection of the gums.
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More specifically, with gingivitis, which is the early stage of gum disease, the gums become inflamed and hot, red, and swollen. Both gingivitis and periodontitis can cause mild or intense pain. Typically, the worse the pain, the more advanced the infection is.
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DermNet / CC BY-NC-ND
Tooth Decay Tooth decay refers to the gradual destruction and cavity formation in the outer surface, or enamel, of the tooth. Plaque, a sticky layer of bacteria that forms on the tooth enamel, feeds on the sugars and starches from food particles in your mouth. This produces an acid that eats away at the enamel, causing weak areas and holes.
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Over time, the enamel breaks down and a cavity forms. As the decay spreads inward toward the middle layer of the tooth, known as the dentin, it can cause pain and sensitivity. Sensitive Teeth Teeth sensitivity develops from exposed dentin.
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This can happen as a result of cavities, worn fillings, receding gums, or cracked teeth. Teeth sensitivity is associated with quick, sharp pain when exposed to a triggering situation, such as teeth brushing or cold air exposure. Bruxism Bruxism, which is characterized by clenching and teeth grinding, can occur while sleeping or while awake.
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Over time, it may cause: Tooth sensitivityCracked teethTooth or facial painTemporomandibular joint disorder (TMJ)
Cracked Tooth A cracked tooth may be caused by trauma to the mouth, severe teeth grinding, or biting down on something hard. Symptoms of a cracked tooth may include a sharp pain when biting or chewing, as well as temperature and food sensitivity.
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The five types of cracks in teeth include: Craze lines: Shallow, tiny cracks on the outer enamelFractured cusp: A piece of the tooth's chewing surface breaks off, usually around a fillingCracked tooth: A crack goes from the chewing surface of your tooth to the root of the toothSplit tooth: The tooth splits into two partsVertical root fracture: A crack forms in the root of the tooth and may go unnoticed until an infection develops
Abscess A dental abscess, which may result from an untreated cavity or pulpitis, is caused by the buildup of bacteria inside the pulp chamber. The infected pulp chamber tries to drain itself out of the very tip of the tooth root, which is located beneath the pulp. This can cause intense pain and swelling.
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DermNet / CC BY-NC-ND
Impacted Tooth Teeth can become impacted when something stops them from moving into their proper position in the mouth. Wisdom teeth commonly get impacted because they are usually the last to break through and you may not have room for them in your mouth. Impaction can cause: PressurePainSwelling
Inflammation of the Tooth Pulp Pulpitis is a condition that occurs when the tissue in the center of the tooth, also known as the pulp, becomes inflamed and irritated.
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This can lead to pain and an intense sensitivity to various things, such as temperature. Conditions that may trigger pulpitis include: Tooth decayTrauma to a toothMultiple procedures done on a tooth Pulpitis may or may not be reversible. If it is, the pain or sensitivity stops within a couple seconds of the trigger being removed.
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If pulpitis is irreversible, the pain can linger for minutes after the trigger is taken away. Ludwig' s Angina Ludwig's angina (also called submandibular space infection) is a rare bacterial infection under the tongue.
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It can be life-threatening and requires emergency treatment. Ludwig's angina can be caused by mouth trauma or a tooth abscess.
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This condition may cause: New or increased tooth painFeverA swollen tongue that may stick out of your mouthDifficulty swallowing or speakingDroolingNeck pain, swelling, and rednessWeakness and fatigueConfusionEarache This infection is very serious and can spread fast. If it gets into your airway, it can make breathing difficult. It can also lead to bodywide infection (sepsis) and septic shock.
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Call 911 or get to an amergency room right away if you notice changes in breathing. When to See a Dentist for Tooth Pain Make an appointment with your dentist if: Your tooth pain is intenseYou have a feverYour face and/or mouth are swollenYour toothache won't go away
How Is Tooth Pain Diagnosed To determine the cause of your tooth pain, your dentist may take a medical history, give you a physical exam, and have you undergo an imaging test, such as an X-ray.
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Medical History Your dentist will ask you questions about your symptoms, including: Where it hurtsWhat makes it better or worseHow long you've had painIf you have other symptoms such as swelling or fever
Physical Examination Your dentist will likely check your mouth and face for swelling. During the oral (mouth) exam, they'll look for inflammation and signs of an infection.
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For potentially worrisome symptoms, like a fever or neck pain, your dentist may perform a cranial nerve exam, which focuses on the head. What You Can Expect From Your Dental Exam
Imaging and Other Tests Your dentis may want to take a dental X-ray to check for abscesses, cavities, or any other problems. A computed tomography (CT) scan or magnetic resonance imaging (MRI) test may be more helpful for diagnosing rare conditions like Ludwig's angina.
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ENT Evaluation Sometimes, tooth pain or sensitivity has nothing to do with your teeth. Other conditions that can cause a toothache include: A sinus infection, which can radiate pain through to your mouth or make your teeth feel sensitive
TMJ (dysfunction of the jaw joint), which may cause pain or tenderness that worsens with jaw movement and chewing You may be referred to an ear, nose, and throat specialist (ENT) for an evaluation if your dentist suspects that your tooth pain is unrelated to your oral health. Tooth Pain Treatment Treatments for tooth pain depend on the underlying cause.
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They may include: Medication
Oral rinses
Oral devices
Medical procedures Most conditions that cause tooth pain can get worse or cause additional problems if they're not taken care of early on. It's always best to get checked and start treatment as soon as possible. Medication Your dentist may recommend or prescribe various medications: Pain relief: Tylenol (acetaminophen) or a nonsteroidal anti-inflammatory (NSAID) such as Advil (ibuprofen) or Aleve (naproxen)
Severe pain: Opioid pain relievers such as Vicodin (hydrocodone/acetaminophen) or OxyContin (oxycodone)
Antibiotics (for abscess, pulpitis, or other infections): Amoxicillin, clindamycin
Oral Rinses and Topical Fluoride Oral rinses include: Chlorhexidine: Reduces mouth bacteria; may be used to treat gingivitisFluoride rinses: Can help prevent or treat tooth decay and gum disease For sensitivity and pain, your dentist may apply fluoride to your teeth and recommend a fluoride toothpaste designed for sensitive teeth.
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Oral Devices If you have sleep-related bruxism, your dentist may recommend wearing an oral device, like a mouth guard, at night. Over-the-counter options that mold to your teeth are the most affordable, but custom guards made from molds of your teeth are typically more comfortable and durable. While a mouth guard will protect your teeth from damage, it won't decrease the number of bruxism episodes.
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With this in mind, you may want to also work to address your underlying bruxism triggers, which can include stress, anxiety, and anger. Dental Procedures For certain conditions, you may need one of several dental procedures. Tooth decay and cavities: Drilling to remove the decay and replacing lost materials with a filling
Irreversible pulpitis: A root canal to remove the infected pulp
Abscess: The infected pocket is cut open and drained
Cracked tooth: A filling, a root canal, or removal and replacement, depending on the extent of the damage
How Do I Prevent Tooth Pain To prevent cavities, gum disease, and tooth sensitivity, practice good oral hygiene: Brush your teeth gently twice a day
Use a fluoride toothpaste
Floss daily
Drink fluoridated water when possible
Get your teeth cleaned regularly
Don't smoke
Avoid habits like chewing pencils or biting down on a fork
Summary Tooth pain may be caused by an infection or disease, mouth trauma, general sensitivity, or inflammation.
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Call your dentist if you have intense tooth pain, a fever, or swelling in the face or mouth. Tooth pain treatment varies with the cause.
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Whether you need medication, an oral device, or something else, the sooner you're treated, the better. Frequently Asked Questions What are common causes of tooth pain?
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Common causes of tooth pain include:Gum diseaseTooth decayTeeth clenching and grinding (bruxism) Why are my teeth sensitive? Teeth can become sensitive due to cavities, cracks, worn fillings, gum disease, or overly forceful brushing. Sensitivity can also increase when the dentin (middle layer of the tooth) is exposed.
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Learn More: Remedies for Sensitive Teeth What are the symptoms of infected wisdom teeth? Symptoms of infected wisdom teeth can include sharp pain, fever, gum inflammation, and trouble swallowing. Learn More: Wisdom Teeth Removal How can I relieve pain from an abscessed tooth?
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While you wait to see your dentist, you may find relief by:Applying a cold compress to help with pain and inflammationRinsing your mouth with warm salt water a few times a dayTaking over-the-counter pain medications like Tylenol (acetaminophen) or Advil (ibuprofen) Learn More: How To Make a Saltwater Rinse 37 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Take these steps immediately if your tooth is infected. By Lora Dodge
She was certified by the Dental Assisting National Board in 2001. Her career in dentistry first began in orthodontics and continued to expand into general dentistry, pediatrics, and oral surgery.
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Other Helpful Report an Error Submit Related Articles Rotting Teeth: Signs, Symptoms, and Treatment Here's What You Need to Know About Abfraction Why Root Canals Are Performed and How They Work What to Do When You Have an Abscessed Tooth How to Relieve Pain From a Cracked or Broken Tooth Antibiotics for Tooth Infection: What You Should Know Cavity Between Teeth: What You Should Know Sensitive Teeth: Causes and Treatment Tooth Decay: Stages, Complications, and Treatment Here Are the Basics of Calculus Bridges, Including How They're Treated 9 Home Remedies for Tooth Pain Treating a Chipped Tooth Should You Get a Dental Bridge? Tooth Pulp Inflammation May Result in a Root Canal Dentin and the Layers of Your Teeth The 7 Best Toothpastes of 2022 for Whitening and Gum Health Cookies Settings, which can also be found in the footer of the site.
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