Toothache is something most people associate with bad news. But it’s actually a valuable signal that something is wrong with your teeth. In many cases, that signal is what gives you the chance to act before things get worse and save the tooth from extraction. Let’s look at the different types of toothache and what causes them.
Types and causes of toothache
Toothache is a broad term that covers a wide range of sensations. Throbbing, sudden, sharp, dull, pain when biting, pain on contact with cold liquid, pain accompanied by a fever or a swollen face, there are many variations. Specialists point out that teeth can hurt in dozens of different ways. Most people immediately think of tooth decay, and decay is indeed the most common cause, but it’s worth knowing what else can trigger toothache.
Sudden, sharp toothache
A sudden, sharp, piercing, short-lived pain is often a sign of tooth sensitivity. This kind of pain can appear when:
- eating or drinking something cold or hot,
- eating sweets,
- eating highly acidic foods, such as citrus fruits or fizzy drinks,
- breathing in cold air through your mouth.
The most common cause of tooth sensitivity is enamel erosion, which exposes the underlying dentine. Dentine contains thousands of tiny tubules that lead directly to the nerve, which is why exposed dentine is so sensitive to temperature and acidity. Enamel erosion can be caused by consuming too many acidic or sugary foods and drinks, brushing too hard, or teeth grinding.
Sensitivity can also be linked to other conditions, including gum disease, a cracked tooth, or a filling or crown that’s worn down. A short, sharp pain when you bite down on something is also commonly associated with a cracked tooth.
Throbbing toothache
A throbbing toothache that persists for a long time, especially after eating hot or cold food, may be a sign of pulpitis. This is an inflammation of the dental pulp, which is the soft tissue inside the tooth containing nerves and blood vessels. If untreated, pulpitis can develop into a periapical abscess, which causes the gum and surrounding tissue to swell. Pulpitis is most commonly caused by deep decay, a cracked tooth, or a large filling.
Dull, lingering toothache
A dull, constant ache that lingers for a long time after contact with a hot or cold substance may suggest that the pulp is dying or already dead. In this case the tooth needs root canal treatment. Dull aches can also occur in teeth that have already been root-canal treated, particularly if the treatment wasn’t fully successful and bacteria have re-entered the canal.
Toothache with fever and facial swelling
Toothache accompanied by fever, facial swelling, or swollen lymph nodes is a sign of a dental abscess, which is a serious infection. This type of situation needs urgent dental attention. An untreated abscess can spread to surrounding tissues, and in severe cases even to the jaw, neck, or further into the body.
Pain when biting
Pain that appears when you bite down can have several causes. It may indicate a cracked tooth, a loose filling, or periodontitis. It can also occur in teeth that have recently been treated. After a filling, for example, it’s quite normal to experience some sensitivity when biting for a short period while the tooth settles.
Pain from pressure or touching the tooth
If a tooth hurts when you press on it or touch the surrounding gum, this could point to a periapical abscess or periodontitis. Pain that radiates from a single tooth to a larger area of the jaw is sometimes linked to a cracked tooth or a problem with the temporomandibular joint.
Toothache after a filling
It’s quite common to experience some discomfort after a dental filling, particularly sensitivity to hot and cold. This usually settles within a few days. If the pain persists or gets worse, go back to your dentist, as the filling may need adjusting.
When should you see a dentist?
Any toothache that lasts more than a day or two should be checked out. Don’t try to manage ongoing dental pain with painkillers alone. The sooner you get it looked at, the more likely you are to save the tooth and avoid a more complicated procedure. If you have pain accompanied by fever, significant swelling, or difficulty swallowing or breathing, seek urgent care straight away.
