Toothache: Symptoms, Causes, Diagnosis, Treatment, Prevention and Outlook

A woman with a toothache‬‏


The teeth are important parts of the body. They are there to chew on food and to provide a beautiful smile. Aside from these, many studies have shown that having healthy teeth may have an important effect on the diet, health and overall sense of well-being.

One of the problems associated with the teeth is a toothache and it can be caused by a wide array of factors. One of the most common causes of a toothache is tooth decay/dental cavities. The condition of the teeth deteriorates over time due to the presence of plaque and tartar. These are the sticky substances produced by the breakdown of food.

Moreover, bacteria can thrive on the teeth and can eat away its protective covering called the enamel. Eating sugary foods and drinking sugary drinks may lead to an increased number of bacteria in the oral cavity. When the teeth break down, it may expose the nerve inside the tooth, leading to a toothache.

A toothache pertains to the pain in the teeth that is typically caused by dental cavities. People may feel a toothache in numerous ways and it could be constant, intermittent, mild and severe. The pain may start abruptly or may feel a sharp pain.

The primary cause of a toothache in both children and adults is tooth decay. The bacteria living inside the mouth survive because of the sugars and starches people consume.
These bacteria form a sticky plaque that attaches to the tooth surface.

The bacteria produce acids and these can dissolve the enamel, creating a cavity.
The first sign of tooth decay may be a sensation of pain when you consume foods that are very hot, very cold, and sweet. Tooth decay may cause pain, swelling, and tooth sensitivity. Visiting the dentist regularly can reduce the risk of tooth loss and progression of the tooth decay.


The pain of a toothache is not always constant or severe. There are many ways to feel the symptoms of a toothache. It can vary from a minor discomfort to a severe pain and sensation. Severe bouts of pain may be accompanied by minor discomforts that appear days before the attack. You may feel discomfort when biting on a tooth or you may have increased tooth sensitivity.

The common signs and symptoms of a toothache include:

  • A toothache or tooth pain that can be sharp, constant or throbbing.
  • Fever or a headache
  • Inflammation around the tooth
  • Foul-tasting secretion or drainage from an infected tooth

When to see a dentist:

Call or visit a dentist immediately if you have any of the following symptoms along with a toothache:

  • Persistent pain for more than two days
  • Signs and symptoms of an acute infection such as pain when biting, red gums, inflammation, swelling, and a foul-tasting discharge
  • Fever
  • Difficulty breathing or swallowing


A toothache can occur when the innermost layer of the tooth, which is called the dental pulp, becomes swollen and exposed. The pulp contains sensitive nerves and blood vessels. The inflammation of the dental pulp could be caused by the following:

  • Tooth decay or oral cavities
  • Cracked tooth
  • Loose or broken fillings
  • Periapical abscess
  • Receding Gums
  • Accumulation of food and debris between teeth
  • Trauma to the tooth, such as teeth grinding
  • Sudden fracture to the tooth or root of the tooth
  • Infection at the root or in the gums
  • Tooth eruption (teething)
  • Split in the tooth that occurs in time
  • Sinus infection that can be felt like a toothache
  • Ulcers on the gums
  • Swollen gums or sore gums around teeth that are erupting (wisdom teeth)


It is very easy to detect a toothache. The dentist will rely the diagnosis on the symptoms you are feeling. Pain in the mouth can legitimately be considered a toothache if it has the following criteria:

  • The pain is constant, sharp, throbbing
  • There is swelling on the face and the gums around the affected tooth
  • There is a foul-tasting drainage
  • There is fever or marked elevated temperature

The doctor will also conduct a check-up of the oral cavity. He will check on the affected tooth and its surrounding gums. Aside from that, he will also conduct an assessment of the procedures needed to address the problem.


Self-care tips

Until you can visit a dentist, here are self-care tips you may perform to reduce pain and swelling:

  • Use dental floss to remove trapped particles or plaque between the teeth
  • Take over-the-counter pain relievers to reduce the pain. Make sure you consult with your dentist or doctor on the drugs that are safe to take.
  • Rinse the mouth with warm water. You can also use saline water.
  • If trauma or injury causes the pain, apply cold compress on the area.

Treatment options

The type of treatment on the affected tooth depends on the underlying cause of the pain. The dentist will assess the mouth and may request for an X-ray to determine the problem. If an oral cavity causes the tooth decay, the dentist may need to remove the decayed area and replace it with a dental filling.

In worse cases, a root canal can be done to reduce the pain and swelling. This is also advised for those who have the pulp inside the tooth infected. The procedure entails the removal of the infected pulp and replacing it with a filling to seal the tooth and reduce the risk of reinfection.

If there is no more to be saved, the tooth can be removed through extraction. In some cases, if the tooth is impacted, an oral surgery is recommended.

For early stages of tooth decay – The dentist will apply a fluoride gel to protect the teeth against decay by making the enamel strong. This will protect the enamel from the acids the bacteria emit.

Dental fillings and crown – This procedure involves the removal of the decayed part of the tooth and filling in the hole.

Root canal treatment – If the infection and decay have already reached the pulp, it can be removed through a procedure called root canal treatment. This is the process wherein the pulp is removed and replaced with a filling.

Extraction – If the tooth is damaged and it cannot be restored anymore, the dentist will remove the affected tooth. It can be replaced with a denture, an implant or a bridge.


Since most toothaches are caused by tooth decay or oral cavities, practicing good oral hygiene can help prevent a toothache. Good oral hygiene includes brushing the teeth regularly, flossing once a day, and seeing the dentist regularly.

In taking care of your teeth, you need to:

  • Limit the intake of sugary drinks and food
  • Brush the teeth at least twice a day with a toothpaste containing fluoride.
    Gently brush the gums and tongue as well.
  • Do not smoke because it can worsen the tooth decay
  • Clean between the teeth using a dental floss and do not forget to use mouthwash.
  • Rinse the mouth with warm water. You can also use saline water.
  • If trauma or injury causes the pain, apply cold compress on the area.
  • Visit the dentist regularly for consultations and regular dental check-ups
  • Cut down on sugary and starchy food and drinks.
  • Some medicines contain sugar, choose alternatives that are sugar-free.
  • Look after your gums by brushing them and flossing regularly
  • Avoid drinking excessive amounts of alcohol because it can contribute to the erosion of the tooth enamel.

Protecting your child’s teeth:

Brush your baby’s teeth as soon as the teeth erupt. Establish good eating habits by limiting sugary drinks and snacks can help the child avoid oral cavities. Also, assist your child during dental visits so he or she would not feel scared to visit the dentist. Encourage brushing the teeth twice daily and teach them on how to clean the teeth properly. Avoid letting your baby sleep drinking milk from the bottle because this can cause oral cavities.


A toothache will disappear as soon as the underlying cause is addressed. However, there are complications associated with a toothache. The main serious complication is the spread of the infection from an area to the next tooth or nearby gums or tissues.

The infection can also spread to the other parts of the oral cavity. Worse, when the infection affects the gums, it may lead to a condition called gingivitis. Infection can cause inflammation of the tongue, in a condition called Ludwig angina. This is severe and could cause swelling to close the airways. This is a life-threatening condition so immediate treatment is needed.

The warning signs of people with a toothache and has an infection spread include:

  • Headache
  • Confusion
  • Double vision or problems with vision
  • Inflammation and tenderness on the floor of the mouth
  • Fever

People with the warning signs should seek medical attention right away because this may lead to serious complications. If there are no warning signs but the jaw is inflamed, there is severe pain and there is a drainage of pus in the tooth, seeking medical attention is advised too. These are classic signs that there is an acute infection.