Mouth
Toothache
Pain in or around a tooth — aching, throbbing or sharp — most often caused by decay, gum problems or a dental infection, but occasionally referred from the sinuses, nerves or, rarely, the heart, and which can become a serious spreading infection.
Education and reference only. This explains the common causes of toothache and the warning signs that need urgent help, in plain language — it is not a diagnosis or a substitute for advice from a clinician. If you feel very unwell or are worried, seek medical help.
Quick answer
What is toothache?
Toothache is pain felt in or around a tooth, ranging from a dull ache to a sharp twinge on biting or a relentless throbbing that disturbs sleep. The great majority comes from the teeth and gums themselves: decay reaching the sensitive inner part of the tooth, a cracked tooth, gum disease, an exposed root, or an abscess where infection has built up at the root.
- Get urgent help: Seek urgent or emergency help for toothache with spreading facial or neck swelling, a high fever, or difficulty swallowing or breathing — this is a spreading dental infection that can become dangerous. Call 999 for tooth or jaw pain that comes on with exertion or with chest tightness, breathlessness or sweating, which can be a sign of a heart problem.
- Self-care: While arranging to see a dentist, you can ease toothache with simple measures.
About toothache
Toothache is pain felt in or around a tooth, ranging from a dull ache to a sharp twinge on biting or a relentless throbbing that disturbs sleep. The great majority comes from the teeth and gums themselves: decay reaching the sensitive inner part of the tooth, a cracked tooth, gum disease, an exposed root, or an abscess where infection has built up at the root. Sensitivity to hot, cold or sweet things often points to early decay or a worn tooth, while constant, throbbing pain with swelling suggests infection. Not all pain felt in the teeth comes from them, however: inflamed sinuses can ache in the upper back teeth, nerve conditions such as trigeminal neuralgia cause electric-shock-like facial pains, and very occasionally pain in the jaw or teeth brought on by exertion can be referred from the heart. A dental infection that is spreading — with facial swelling, fever or difficulty swallowing or breathing — is a serious, urgent problem.
When to get help
Call 999 or go to A&E if toothache comes with any of these warning signs:
- Seek urgent or emergency help for toothache with spreading facial or neck swelling, a high fever, or difficulty swallowing or breathing — this is a spreading dental infection that can become dangerous.
- Call 999 for tooth or jaw pain that comes on with exertion or with chest tightness, breathlessness or sweating, which can be a sign of a heart problem.
- Seek urgent dental help for a knocked-out, broken or dislodged tooth following an injury, or for uncontrolled bleeding from the mouth.
- Seek prompt review for severe, throbbing toothache with a swollen face or gum, which suggests a dental abscess.
- Seek review for toothache with a non-healing mouth ulcer, a lump, or numbness of the lip or jaw lasting more than three weeks.
When to see a doctor
See a dentist promptly for toothache, as most causes — decay, gum problems, a cracked tooth or an abscess — need dental treatment that home measures cannot replace. Seek urgent or emergency help if toothache comes with spreading facial or neck swelling, a high fever, or any difficulty swallowing or breathing, as a dental infection can spread and become dangerous. Treat tooth or jaw pain brought on by exertion or with chest tightness, breathlessness or sweating as a possible heart problem and call 999. Seek dental help quickly after any injury to a tooth, and review any non-healing mouth ulcer or lump.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
What can cause it
Common causes of toothache
Toothache has many possible causes. Each links to a full, plain-language guide to that condition — what it is, how it's treated and when to seek help.
What helps
Self-care and what you can do
While arranging to see a dentist, you can ease toothache with simple measures. Rinsing gently with warm salty water can soothe sore gums and help keep the area clean, and keeping your head propped up rather than lying flat may reduce throbbing. Avoid very hot, cold, sweet or hard foods that set the pain off, and chew on the other side of your mouth. Keep brushing and cleaning between your teeth gently, even if the area is tender, to keep it clean. A cold compress held against the cheek can help if there is swelling. These measures only relieve symptoms and do not treat the cause, so see a dentist as soon as you can, and seek urgent help if there is spreading facial swelling, fever, or difficulty swallowing or breathing.
Answers
Toothache: frequently asked questions
What usually causes toothache?
Most toothache comes from the teeth and gums — decay reaching the inner tooth, a cracked tooth, gum disease, an exposed root or an abscess. Sensitivity to hot, cold or sweet often means early decay, while constant throbbing with swelling suggests infection. A dentist can identify and treat the cause.
When is toothache an emergency?
Seek urgent help if toothache comes with spreading facial or neck swelling, a high fever, or difficulty swallowing or breathing, as the infection may be spreading. Call 999 if tooth or jaw pain comes on with exertion or with chest tightness, as this can signal a heart problem.
Can toothache come from something other than my teeth?
Yes. Pain felt in the teeth can be referred from inflamed sinuses (especially the upper back teeth), from an ear infection, from nerve conditions like trigeminal neuralgia, or rarely from the heart. A dentist or doctor can help work out where the pain is truly coming from.
What can I do for toothache before I see a dentist?
Rinse gently with warm salty water, avoid very hot, cold, sweet or hard foods, chew on the other side, keep the area clean, and use a cold compress on the cheek if there is swelling. These ease symptoms only, so see a dentist as soon as possible and seek urgent help for spreading swelling or fever.
Sources
Where this is drawn from
- NICE CKS: Dental abscess.
- Oral Health Foundation: toothache and dental pain.
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