An aching tooth can make it hard to go about your day. Some causes of tooth pain are more serious than others. Figuring out what’s causing your teeth to hurt is the first step toward alleviating pain and getting back to enjoying day-to-day life. Here are symptoms and potential causes of tooth pain, plus what you need to do to make it go away.

Tooth pain can sometimes be difficult to pinpoint. You may experience a radiating ache or nagging pain in your teeth, jaw, ear, forehead, face, or neck. You may also have trouble determining where exactly it’s coming from. Your symptoms may help provide clues. These could include:

  • sudden, sharp pain in one or more teeth while running or upon exertion
  • sensitivity to temperature changes, such as hot and cold
  • persistent, dull ache, ranging from mild to severe (this can be centralized in one tooth or may radiate to or from the ear or nose)
  • pulsating, intense pain, which may be accompanied by swelling (this pain may radiate to the ear, jaw, or neck on one side of the head)

Some causes of tooth pain include:

Tooth decay

Cavities(dental caries) are holes in the teeth that are caused by decay. Not all cavities hurt at first, and only your dentist can tell if you have one. If pain occurs in just one tooth, you may have a cavity that is becoming large or deep, or is affecting the inside of the tooth. Tooth decay can be caused by poor dental hygiene and by eating sugary foods. It can also be caused by medications that cause dry mouth, such as antacids, antihistamines, and blood pressure medication.

Abscess

A pocket of pus, called a tooth abscess, can occur in various parts of the tooth. Abscesses are caused by bacterial infections. They can also originate from periodontal disease or cavities that have been left untreated. There are two types of abscesses: periodontal abscesses, which occur alongside a tooth near the gum tissue, and periapical abscesses, which are usually caused by decay or injury and are located at the root of the tooth.

Pulpitis

Pulpitis is inflammation of a tooth’s pulp — the tissue within a tooth where the nerves and blood vessels are located. Pulpitis can be caused by untreated cavities or, less commonly, periodontal abscesses. If left untreated, cavities and pulpitis can eventually cause a tooth to die, which would also cause intense pain.

Thinning tooth enamel

Your teeth are protected by enamel — a hard layer designed to shield the nerve endings within. When this layer wears awayyour teeth become sensitive to hot and cold foods, and cold air. Acidic, sweet, and sticky foods can also cause teeth to hurt. Brushing your teeth with too much pressure or with a hard-bristled toothbrush can also wear down tooth enamel over time.

Old dental work or cracked teeth

Very old fillings, cracked fillings, or cracks within the toothcan expose the inner layers of teeth, increasing sensitivity.

Gingival recession (receding gums)

This occurs when gum tissue rises up, pulling away from the tooth. Receding gums expose the tooth’s root, causing sensitivity and pain. It can be caused by overly vigorous brushing, trauma to the mouth, poor oral hygiene, or genetics.

Gum disease (periodontal disease)

Gingivitis is a mild form of periodontitis, a type of gum disease. If left untreated gum disease can escalate breaking down the tissue and bone supporting teeth, causing pain. Inflammation and irritation can also occur.

TMJ disorders

A type of temporomandibular joint (TMJ) disorder, TMJ disorders cause pain in the jaw joint and surrounding muscles. It can also cause pain in the ear. TMJ pain can radiate to teeth and may be accompanied by facial pain or headache. TMJ has a range of causes including grinding teeth (bruxism) and clenching the jaw during sleep. People with this condition may feel more sensitivity when they wake up as a result.

Sinus congestion and infection

Your upper rear teeth may hurt when you have a sinus infection (rhinosinusitis) or your nasal cavities are swollen and feel stuffed. This may feel like dull pressure. You may also have pain around your eyes or forehead. Anything that causes sinus congestion, such as allergies or colds, can cause this effect.

Impacted tooth

Impacted teethare teeth that don’t break through the gumline but stay lodged in gum tissue or bone. Wisdom teeth are the ones most likely to be impacted. Impacted teeth sometimes cause no pain, but may crowd the other teeth in the mouth, if left untreated. They can also cause pain that ranges from a dull, unending ache, to sharp, long-lasting pain. This pain may radiate up to the ear or to one side of the nose.

Diabetes

Frequently high blood sugar can affect the saliva in your mouth, increasing bacteria and plaque. Gum disease, cavities, and tooth pain can all result.

Find more information about type 2 diabetes and oral health.

Heart disease

Because it’s not always easy to identify the origin of the pain in teeth, it makes sense to see a dentist or doctor. Especially for symptoms that are severe or have lasted longer than a day or two.

Jaw pain can be mistaken for tooth pain but may represent a serious condition, such as anginaor a heart attack.

Go to an emergency room or call 911 immediately if you experience any of these symptoms in addition to pain in your teeth and jaw:

  • shortness of breath
  • sweating
  • nausea
  • chest pain

Jaw pain may occur when you physically exert yourself or experience mental stress. Even if the pain comes and goes, a doctor’s immediate attention is required.

Tooth pain has a wide range of treatments based on the underlying cause.

  • Some sinus infectionsrequire antibiotics, but others resolve on their own. Your doctor may recommend decongestants, saline solution, nasal corticosteroids, or antihistamines.
  • If you have thin tooth enamel, you may get relief by using a sensitivity toothpaste.
  • Sipping more water may also help reduce dry mouth.
  • Reducing your intake of acidic or sugary foods can also help preserve the tooth enamel you have left.
  • Make sure to brush regularly to remove plaque. This will help reduce your risk of cavities and gum disease. Don’t brush too vigorously, as this may adversely affect tooth enamel.
  • Have regular dental checkups so a dentist can assess the overall condition of your mouth, including old dental work.
  • If you have cavities, filling them will eliminate tooth pain.
  • If you have old or cracked fillings, replacing them will also eliminate pain.
  • TMJ disorders are sometimes temporary and resolve on their own. If you have chronic tooth pain and jaw pain, your dentist may recommend a mouth guard you can wear at nightto reduce teeth grinding. You may also benefit from lifestyle changes that reduce anxiety and activities such as meditation, walks, and yoga.
  • Gum infections and abscesses may require antibiotics or antibacterial rinses. Your dentist may also need to clean out the area around the affected tooth. You can also try these 10 home remedies for tooth abscessesuntil you’re able to see a dentist.

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If you have diabetes or heart disease your doctor will determine the best course of action for your condition as well as an appropriate treatment for symptoms like tooth pain.

There are several dental procedures that can address the underlying cause:

  • If you have advanced periodontal disease, your dentist or a specialist known as a periodontist may do deep cleaning procedures designed to remove tartar and plaque from below the gumline. Other procedures, such as deep cleaning or dental surgery, may be required.
  • Impacted teeth are typically removed by an oral surgeon.
  • A tooth that is cracked or damaged may require a root canal if the nerve has died or been damaged beyond repair. Pulpitis and dental abscesses may also be treated this way. In some instances, a tooth extraction may be used to completely remove the tooth.

Maintaining good dental habitsis your best way to avoid many causes of tooth pain. Brush and floss daily, but not too hard or with a brush with stiff bristles.

Tooth pain has a wide range of causes. If your pain is constant or doesn’t resolve quickly, see a dentist or doctor. They can help you become pain free more quickly. Some causes of tooth pain are more serious than others. Seeing a professional is your best bet for determining the right fix.

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