An Overview on Tooth Pain and Management – By a Dentist

Tooth pain is one of the most common complaints of a patient that is encountered in daily dental practice. Tooth pain is a physical nerve stimulation that is caused when the vital nerves in the tooth root are irritated. Some of the primary causes of tooth pain include tooth decay, pulp infection, a traumatic injury that may affect the sensory nerves and loss of the tooth.

Sometimes, tooth pain can develop as a referred pain from other areas of the mouth – for example, temporomandibular joint disorder, sinusitis, and ear pain. It is essential to understand the severity of tooth pain and the amount of discomfort it causes to the individual. Several treatment modalities can help to manage tooth pain. However, the type of procedure depends on the underlying cause.


Preventative measures to maintain healthy teeth and gums can take you a long way in avoiding painful dental problems. Today’s article will highlight the different causes and management of tooth pain. Moreover, we will look at some of the conventional home treatments that can manage tooth pain.

What do you mean by tooth pain?

Tooth pain is typically described as pain in the teeth or surrounding tooth structure. Usually, tooth pain is caused by a dental disease that affects the tooth or referred pain from non-dental diseases. It is essential to address the tooth pain immediately and get appropriate treatment.

Tooth pain is not a life-threatening disorder, but it can often be a sign of an underlying adverse health condition. Untreated cause of tooth pain can increase the severity of pain and discomfort, which may often impact sleep, chewing, and daily activities. Moreover, tooth pain deteriorates the quality of life. (1)

Tooth pain can be constant or intermittent, depending on the underlying cause. Furthermore, tooth pain can typically be characterized into the following types –

  • Dull throbbing pain associated with swelling around the tooth or the gums
  • Sharp shooting pain that may impact the sleep (2)
  • Acute pain on touching the affected tooth or biting
  • Tenderness and intermittent pinching type of pain around the affected tooth
  • Tooth sensitivity in response to hot or cold food and drinks
  • Burning sensation and discomfort
  • Shock-like pain

What causes tooth pain?

There is a wide range of causes that can lead to tooth pain and discomfort. Some of the common causes of tooth pain can be categorized as follows –

Dental diseases that cause tooth pain

This category consists of the most common reasons that typically cause tooth pain and are encountered daily during routine dental examinations. The dental causes of tooth pain are listed as below –

  • tooth decay
  • extensive tooth cavity
  • untreated tooth decay can further produce tooth abscess which increases the severity of tooth pain
  • pulp infection
  • fractured tooth (3)
  • traumatic injury to the tooth
  • damaged tooth filling
  • a habit of tooth grinding
  • wisdom tooth pain

Referred tooth pain from non-dental diseases

Referred pain is described as a pain perceived at a location other than the actual site of stimulus or origin. This pain is usually caused by a network of interconnected sensory nerves that transmit the pain sensation to other areas. Some of the typical types of referred pain that can cause toothache are listed below-

  • Sinusitis caused by inflammation of the sinuses around the face. This can happen due to viral, bacterial, or fungal infection of the sinus cavity. Usually, the tooth roots of upper teeth are closer to the sinuses. An untreated sinus infection can transmit pain to the surrounding tooth.
  • Temporomandibular disorder or joint pain
  • An underlying heart or lung disease can transmit pain to the tooth through the vagus nerve. Such type of referred pain often proves to be the first clinical sign of heart disease.
  • Trigeminal neuralgia – a painful neurologic disorder which develops due to inflammation or irritation of the trigeminal nerve.

What are the signs and symptoms of tooth pain?

Tooth pain can range from mild to severe, depending on the type of cause. Usually, mild tooth pain persists for dew minutes and subsides as the stimulus is removed. Severe tooth pain may radiate to the surrounding cheek, ear, and jaw. The typical signs and symptoms of tooth pain include the following –

  • Pain on biting or chewing
  • Fever and headache
  • Presence of swelling or abscess around the affected tooth and gums
  • Bleeding or pus discharge may be associated with the swelling
  • Sensitivity to hot or cold food and drinks
  • Tooth fracture
  • Disturbed sleep
  • Constant discomfort throughout the day

It is usually challenging to identify the signs and symptoms of referred tooth pain. At this time, a dental professional can help to examine all the oral and extra-oral structures to determine the specific cause of referred pain.

When should you see a dentist?

Sometimes, untreated tooth pain can get so severe that you may need to seek immediate dental care. (4) Such situations are listed below –

  • Pain does not subside after taking pain relievers.
  • Tooth abscess that may progress to cause massive swelling of the face associated with severe pain. Such conditions are also accompanied by a fever that does not subside quickly.
  • A traumatic dental injury that leads to broken or knocked-out teeth.
  • Sometimes, patients who undergo tooth extraction may experience pain in the extraction site after a few days. Often this happens due to dislodgement of the blood clot from the socket. Such condition is called as ‘Dry Socket.’
  • Wisdom tooth pain associated with pericoronitis can be a painful condition that required immediate dental care. (5)

How is tooth pain diagnosed?

Usually, a dentist takes a thorough medical and dental history of the patient to eliminated conditions like chest pain, heart disease, rash, and trauma, which may cause tooth pain. Moreover, a history of current medications may also be taken to rule out the presence of diabetes or hypertension. The dentist will also ask a few questions related to the character, type, location, and frequency of the pain.

The step mentioned above is followed by a complete physical examination of the oral and dental tissues especially the area of concern. The dentist will check for tenderness, bleeding and pus discharge from or around the affected tooth. (6)

A series of pulp sensitivity tests may also be performed to check the vitality of the tooth. Tooth fracture can be assessed by asking the patient to bite on a tooth slooth. Dental x-rays may be required for extensive tooth infections to determine the type of treatment necessary. Moreover, dental x-rays can help to predict the prognosis of the dental condition. Sometimes, if there are no clinical signs of dental disease, an ECG or lab evaluation may be performed to rule out an underlying health condition like the heart disease or lung disease.

What are the treatment modalities to manage tooth pain?

Professional dental treatments usually depend on the underlying cause of tooth pain. Once the dentist has identified the cause and diagnosed the disease, the following treatment modalities can be used to manage tooth pain –

  • Small tooth decay or tooth abrasions that often cause tooth sensitivity may be treated with tooth-colored fillings. Composite is commonly used as it can bond quickly to the tooth structure and is aesthetically pleasing.
  • Extensive dental diseases like pulp infection, tooth abscess, and fractured tooth are often treated with root canal treatment. During this procedure, the dentist drills the tooth to find access to the root canals. Specialized endodontic files are used to extirpate the pulp and clean the root canals. (7)

Followed by this step, the tooth root canals are filled with a therapeutic rubber material called gutta-percha. The cavity is filled with a tooth filling, and a dental crown is placed on strengthening the tooth.

  • Tooth extraction is often considered as the last resort for badly broken teeth, infected tooth with bad prognosis and wisdom tooth problems. Antibiotic coverage is determined before starting the procedure. During this procedure, the dentist numbs the area using local anesthetics. The tooth is luxated with elevator and removed using dental forceps.
  • Non-dental diseases may be referred to a physician or medical professional for an evaluation. Often a series of medications and long-term medical care is necessary for conditions like heart and lung disease.
  • Preventative dental therapy for children can be the placement of dental sealants. Dental sealants help to improve the cleanability of newly erupted back teeth. Moreover, it prevents future development of tooth decay or cavity formation.

It is necessary to do a treatment follow-up to ensure proper dental healing of the tooth. Moreover, proper dental care during routine check-ups can help to relieve the pain faster.

What can you do to manage tooth pain at home?

Before taking appropriate steps to treat the tooth pain at home, it is essential to understand the origin of the pain. Usually, over-the-counter pain relievers like ibuprofen or acetaminophen can be used. However, follow the dosage instructions as written on the pack.

It is better to follow a healthy diet and avoid cold or hot food or drinks that can cause tooth sensitivity. Over-the-counter clove oil can be used by soaking a piece of cotton in the oil and placing it in the tooth cavity or decay.

Preventative measures

Regular dental care is always the key to avoid situations that may cause tooth pain. Some of the preventative measures that can take you a long way in maintaining healthy teeth are as follows –

  • Establish an excellent routine dental cleaning habit – this includes brushing the teeth two times a day. Always use a soft-bristled toothbrush with a small head to easily access the back teeth. Fluoride toothpaste is considered best for remineralizing the teeth and preventing tooth decay.

Flossing once a day after tooth brushing helps to clean the area between the teeth. This ensures the complete removal of plaque and bacteria from the tooth surface. People who do not prefer flossing can use a water flosser which uses a pulsatile high-pressure water stream to clean the interdental areas.

  • Fluoride supplements in the form of fluoridated water can help significantly to reduce the incidence of tooth decay and cavity formation. Moreover, it makes the tooth enamel acid-resistant. Children are benefited considerably from fluoride. School fluoride programs are a great initiative to provide fluoride supplements to children.
  • Maintain a healthy dietary habit – Avoid eating acidic food that may weaken the tooth enamel. Bacteria in the mouth thrive on sugary food and food rich in carbohydrates. They ferment these food substances and initiate the process of tooth decay and cavity formation. Switch to a balanced diet that consists of fresh fruits and vegetables, nuts and dairy products like milk and yogurt.
  • Routine dental check-ups are the key to a healthy oral environment. Do not miss out on professional tooth cleaning. Your dentist will examine your teeth, gums and oral tissues to ensure there are no signs of dental decay. Moreover, he can detect such conditions at an early stage and treat them appropriately.
  • If you use a dental appliance such as removable dentures or retainers, make sure to clean them regularly. Often dental appliances attract more amount of dental plaque and bacteria as compared to other oral tissues. Special denture cleaning brush and solutions are available in the market. Use it regularly to clean the appliance and remove the plaque and bacteria.
  • Athletic people and children who play contact sport such as football, cricket, baseball, and hockey should use protective dental appliances such as a mouthguard.

FAQs for tooth pain

How to stop tooth pain fast?

Although some over-the-counter pain medications such as acetaminophen and ibuprofen have proved to be useful in relieving tooth pain effectively, there are some home remedies that you can try to relieve tooth pain quickly –

  • Apply cold compress using an ice pack or ice wrapped in a clean cloth. Place the pack on the area of concern for a few minutes and repeat it several times. Usually, it also helps to reduce the inflammation around the tooth.
  • Warm saline mouth rinse is useful in cleaning the mouth and getting rid of the infectious bacteria on the tooth surface. Moreover, it promotes gum health.
  • Hot compressions are also useful to bring down the inflammation. You can place a cloth dipped in warm water. Or you can also take a rice-filled sock and heat it in the microwave for a couple of minutes.
  • Acupressure is a natural remedy that usually promotes the release of endorphins in the body, which in turn reduces the tooth pain. However, if you decide to choose acupressure, make sure you do it from a reputed acupressure trainer or online website.
  • Peppermint tea bags have a numbing effect when placed on the tooth and gums. However, the effect only lasts for a short time. Take the tea bag and dip it in warm water. Apply the pack when it is still warm.
  • Clove oil is another and one of the most trusted home remedies for relieving tooth pain. You can use over-the-counter clove oil or bite on a clove and let the juice seep into the tooth.

How long does the pain last after tooth extraction?

Usually, the patient may experience pain or even swelling in surgical tooth extraction for a few days after the procedure. However, the dentist will prescribe specific antibiotics and anti-inflammatory drugs to ease the pain and make the healing process comfortable. If you still have pain after a week of tooth extraction, visit your dentist for a check-up.

How long does pain after wisdom tooth extraction last?

For the first three to four days, the patient usually experiences an increase in the swelling post-extraction. However, after the fifth day, the healing process reduces pain, discomfort, and swelling. During this time, the patient can open the mouth fully ad resume to a healthy diet. However, it may take one to two weeks for the extraction site to heal completely.

How long does wisdom tooth pain last?

The intensity and duration of wisdom tooth pain usually depend on the type of dental condition, oral health, and hygiene of the patient. Patients who have wisdom teeth close to the mandibular nerve may experience continuous pain for several weeks and months until they get the tooth removed.

Patients with pericoronitis or impacted wisdom tooth experience pain when there is poor oral hygiene.


Why does tooth pain come and go?

The frequency of tooth pain depends on the cause of the pain. Usually, tooth sensitivity is short-lasting, and it occurs only when there is a trigger such as hot and cold food or drinks. Fractured tooth or filling may cause pain only on biting or chewing food. Continuous tooth pain may occur when the pulp tissue is infected.

Take away message

Tooth pain is one of the most disturbed and uncomfortable perceptions that anyone can experience in their life. Most commonly tooth pain is caused by dental diseases like tooth decay, cavity formation, pulp infection, tooth abscess, traumatic injury to the tooth and fracture of the tooth filling.

Dental treatments aiming to repair the underlying cause can help to manage the tooth pain. However, preventative measures like maintaining good oral hygiene and following routine dental check-ups can help to avoid future consequences. For most common causes of tooth pain, the prognosis is good under proper dental care. However, tooth pain caused by non-dental diseases such as heart and lung disease or neurological disorders may require appropriate diagnosis and prompt treatment to improve the long-term outcome.


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