What are the most common causes of toothache?
Toothache is not a diagnosis but a sign of very different problems. According to the NHS, the causes include tooth decay, a dental abscess, a cracked or damaged tooth, a loose or broken filling, infection around a partly erupted wisdom tooth, problems with braces, gum disease and teeth grinding; sensitive teeth can also cause pain. The NHS and Cleveland Clinic describe the causes in more detail:
- Decay: as decay approaches the dentine and the nerve (pulp), pain with hot, cold and sweet food begins.
- Cracked tooth, broken or lost filling: sudden, sharp pain when biting or chewing.
- Inflammation of the nerve (pulpitis): throbbing pain that can get worse at night.
- Abscess: a collection of pus at the root tip or in the gum, often with swelling, a bad taste and fever.
- Gum disease: inflamed or receded gums can make teeth painful.
- Wisdom tooth: according to the NHS, the gum around a partly erupted tooth can become infected. See our guide on wisdom tooth removal.
- Sinusitis: the NHS counts toothache among the symptoms of sinusitis, alongside pain around the cheeks, eyes and forehead and a blocked nose.
- Teeth grinding: the strain can cause a dull, persistent ache in the teeth and jaw; see our guide on teeth grinding.
- Sensitive teeth: worn enamel or exposed tooth necks react briefly to cold and heat; see our guide on sensitive teeth.
What does the type of pain tell you?
According to Cleveland Clinic, the character of the pain gives clues, but the cause is only established after an examination. The table is for orientation only; the diagnosis is made at the practice with an examination and, where needed, an X-ray.
| Pain | Possible causes |
|---|---|
| Short pain with cold or heat that stops straight away | Worn enamel, exposed dentine |
| Pain that lingers after cold or heat | Inflamed nerve |
| Sharp pain when biting or chewing | Decay, cracked tooth, faulty filling or crown |
| Severe, throbbing pain | Infection of the nerve, abscess |
| Dull, persistent ache | Infected tooth, night-time clenching |
| Pain in the upper teeth after a cold, with a blocked nose and pressure in the cheek | Sinusitis |
When a filling is enough and when the nerve has to be treated is explained in our guide filling or root canal.
What helps until your appointment?
Home measures do not remove the cause; the aim is relief without making anything worse. Call the practice early and mention the pain, so that an early appointment can be found. The advice of the NHS, the ADA, Cleveland Clinic and Mayo Clinic can be summarised as follows:
- Rinse: rinse with warm water or salt water and spit it out, do not swallow. The NHS advises not using salt-water rinses for children.
- Keep the area clean: use a soft toothbrush. If food is stuck between the teeth, the ADA recommends removing it gently with floss; the NHS advises not forcing floss around the sore tooth.
- Do not chew on the painful side: choose soft food and avoid very hot, cold and sweet food.
- Cool any swelling: Cleveland Clinic recommends holding ice wrapped in a clean towel against the outside of the jaw for about 20 minutes, several times a day. Never put ice directly on skin or gums.
- Painkillers as directed: according to the NHS, over-the-counter painkillers can help until your appointment, and a pharmacist can advise you; children under 16 should not take aspirin. The Royal Devon NHS Trust advises avoiding aspirin as a painkiller if there is bleeding. Do not exceed the dose on the packet. If you take other medicines regularly, are pregnant or have a medical condition, ask your doctor or pharmacist which painkiller is suitable for you.
- Do not smoke: according to the NHS, smoking can make some dental problems worse.
- Do not put off the appointment: even if the pain eases, the cause has to be found.
Which home remedies can harm?
Some tips from friends or the internet give brief relief but can damage the tissues:
- Putting a tablet on the gum: according to the ADA and Mayo Clinic, aspirin or other painkillers must not be placed against the tooth or gum, because they can burn the gum tissue.
- Garlic: a case report in Special Care in Dentistry (2021) describes earlier reports of burns to the lining of the mouth from crushed raw garlic used against toothache; the authors warn against self-treatment.
- Cloves and clove oil: a case report in BMJ Case Reports (2013) describes irritation, ulcers and allergic reactions from products containing eugenol, the active substance in cloves. We therefore do not recommend putting undiluted clove oil on the gum.
- Numbing gels: Mayo Clinic warns that benzocaine, found in some numbing gels, has been linked to a rare but serious blood condition; ask a dentist or pharmacist before using it, never exceed the dose, and do not use it in children under two.
- Antibiotics without a prescription: do not take leftover or someone else’s antibiotics. According to the ADA guideline of 2019 (Lockhart and colleagues), the benefit of antibiotics is negligible for most toothache arising from the nerve and root tip and for most swelling inside the mouth; dental treatment of the cause takes priority. Antibiotics are recommended mainly when fever, malaise or swollen lymph nodes point to spreading infection; unnecessary use promotes resistance and side effects. Whether you need an antibiotic is decided by the dentist.
When does toothache belong in an emergency department?
An infection from a tooth can spread, rarely but dangerously. The NHS advises going to an emergency department if toothache is joined by:
- swelling around the eye or in the neck
- swelling that makes breathing, swallowing or speaking difficult
Cleveland Clinic adds swelling below the eye, unbearable pain that does not respond to medication, bleeding that cannot be stopped by pressure, and a fever above 38.3 °C.
Not an emergency department, but a prompt appointment is needed according to the NHS for:
- toothache that lasts longer than two days
- pain that does not ease with painkillers
- fever, pain when biting, red gums or a bad taste
- a swollen cheek or jaw
Outside practice hours, your local emergency dental service is the right place; in the UK, NHS 111 advises on urgent dental care.
What applies to toothache before, during and after treatment in Türkiye?
Before travelling: acute toothache belongs with a dentist or emergency dental service near you, not on a plane. The initial treatment should take place at home; the definitive treatment can then be planned, for example root canal treatment with a crown, or an implant after an extraction. For this, send us the findings and X-ray on WhatsApp at +90 532 363 49 54 for a preliminary assessment.
During your stay: if pain occurs during treatment at our clinic in Serdivan, tell us straight away; your dentist will look for the cause. If inflammation at the root tip, a crack or a root fracture needs to be clarified, a cone-beam CT (CBCT) is available. Before treatment starts, you receive a written treatment and cost plan, and you know from the beginning who will treat you. Plan a buffer day before your return flight so that any complaints can be checked while you are still here. What to expect during and after root canal treatment is described in our guide does root canal treatment hurt.
After your return: mild complaints in the first days are normal after many procedures. Send us a description and a photo on WhatsApp; during opening hours we reply to messages in English within 15 minutes. If pain or swelling increases after a few days instead of easing, or fever, heavy bleeding or pus appear, see a dentist or your local emergency dental service promptly without waiting for our reply, and let us know afterwards. With swelling and difficulty breathing or swallowing, go to an emergency department. The copies of your treatment summary and X-rays that you receive when you leave help the local dentist. How follow-up is organised is described on our page on aftercare and follow-up.