Toothache or dental pain is caused when the nerve in or around the tooth is irritated.

Dental infection, gum disease, plaque, dental decay, injury, or loss of a tooth (including tooth extractions) are the most common causes of dental pain. Patient information can be found here.

There are instances, however, where pain originating outside the dental area radiates to the mouth, thus giving the impression of tooth pain. This often happens when there is a problem with the jaw joint (temporomandibular joint or TMJ - more here) or ears. Occasionally, heart problems can give the sensation of tooth pain.

One can prevent the majority of dental problems through flossing, brushing gums and teeth properly with fluoride toothpaste, and having teeth professionally cleaned on a regular schedule. The dentist may apply sealants and fluoride, which are especially important in children.

The mechanism of toothache to date is still not fully understood.

Causes of Toothaches

Toothaches occur from inflammation of the central portion of the tooth called pulp. The pulp contains nerve endings that are very sensitive to pain. Inflammation to the pulp or pulpitis may be caused by dental cavities, trauma, and infection.

Toothache Symptoms and Signs

Toothache and jaw pain are common complaints. It is not unusual for one to feel mild pain from pressure, and hot or cold exposure to the tooth. However, if the pain is severe and persists for longer than 15 seconds after the pressure or temperature exposure, then this could be an indication of a more serious problem. If there is severe inflammation of the tooth, the pain can radiate to the cheek, the ear, or the jaw. The signs and symptoms that might lead one to seek care include the following:

  • Pain with chewing
  • Hot or cold sensitivity
  • Bleeding or discharge from around a tooth or gums
  • Swelling around a tooth or swelling of the jaw or cheek
  • Injury or trauma to the area

These signs and symptoms may sometimes be associated with dental decay or gum disease (periodontal disease). Dental decay or an area of redness around the tooth's gum line may point to the source of pain. If one taps an infected tooth, it may make the pain more intense. This sign may point to the problem tooth even if the tooth appears normal.

A toothache needs to be differentiated from other sources of pain in the face. Sinusitis, ear or throat pain, or an injury to the temporomandibular joint (TMJ) that attaches the jaw to the skull may be confused with toothache. Pain from a deeper structure (called referred pain) may be passed along the nerve and be felt in the jaw or tooth. In order to pinpoint the source of the pain and get relief, call the dentist or doctor.