Toothache is usually caused by decay reaching the nerve, a cracked tooth, an infection, or gum problems. Over-the-counter pain relief taken as directed and a cold compress can help in the short term, but toothache does not resolve on its own - the cause needs treating. Pain that keeps you awake, or comes with swelling or fever, needs to be seen urgently.
What causes toothache
Toothache is a symptom, not a diagnosis, and several different problems produce it. The character of the pain is often a clue.
- Decay reaching the nerve - a deep ache, often worse at night or lying down
- A cracked or fractured tooth - sharp pain on biting, and often on release
- An abscess - constant throbbing, often with swelling and a tooth tender to touch
- Exposed dentine or a receded gum - short, sharp pain with cold or sweet things
- A lost or leaking filling - sensitivity, sometimes a sharp edge you can feel
- Gum inflammation or something wedged between teeth - sore, tender gums
- Wisdom teeth pushing through - pressure and soreness at the back of the jaw
- Sinus pressure - an ache across several upper back teeth at once, worse leaning forward
What helps until you can be seen
These manage the pain. None of them treat the cause, and the cause is what makes it stop.
- Over-the-counter pain relief, taken as directed on the packet
- A cold compress against the outside of the cheek, not directly on the tooth
- Sleeping propped up - lying flat increases pressure and pain
- A warm salt-water rinse if the gum is sore
- Avoiding very hot, very cold, sweet or hard foods on that side
- Keeping the area clean, gently, even if it is tender
Two things not to do
Do not hold aspirin against the gum. It is an acid and it burns the soft tissue, leaving a chemical burn on top of the toothache.
Do not assume pain stopping means the problem is gone. Toothache that disappears suddenly can mean the nerve inside the tooth has died - the pain source is gone but the infection is not, and it can go on quietly and form an abscess.
See a dentist if
- The pain is keeping you awake or is not controlled by over-the-counter pain relief
- There is swelling in your face, jaw or neck
- You have a fever alongside the tooth pain
- The pain has lasted more than a day or two
- The tooth is loose, or painful to touch
- Swallowing or breathing is affected - this is a 111 call, not a dental appointment
We're in central Queenstown and keep room for emergencies. Call 03 441 8248.
This page is general information, not a diagnosis. Reviewed by Dr Adrian Paul, BDS (Otago), principal dentist at Lakeside Dental Practice. If you're worried about a specific problem, see a dentist.
