Toothache Triage: What to Expect and What to Do

[updated August 2019]

Few feelings are more unwelcome than that of a toothache. No matter what is causing it, a toothache is always an unwelcome sensation.

Fortunately, your dentist can provide you with the capable treatment and relief you need. If you’re suffering from a severe toothache, you will want to call your dental office  to schedule an appointment as soon as possible. Read on for a quick guide to diagnosing your toothache—and what you should do when you have one.

What Causes a Toothache?

Toothache can have any number of causes, and not all of them are obvious. While tooth decay is by far the most common cause of toothache, there are other reasons for it. If you grind your teeth, have erupting teeth, or have a sinus infection, it may manifest as a dull feeling of pain in your teeth. Tooth injury can also lead to sudden and severe toothache. Other factors include chips or fractures which may not always be clearly visible. Underlying decay, caries, and periodontitis (gum disease) can also cause tooth pain.

Toothache can happen for a number of reasons. These are some of the most frequent causes of toothache:

  • Cavities. Contrary to popular belief, tooth decay doesn’t always cause pain. If you do experience sharp and noticeable pain as a result of a cavity, it is likely because the decay has reached the pulp inside your tooth. If any of your teeth seem unusually sensitive to touch, it could be an indication that the enamel on the tooth has been eroded by decay.
  • Gum disease. If the plaque on your teeth allows a bacterial infection to develop, it can lead to gum disease. When gum disease goes untreated and worsens, it can cause your teeth to be unusually sensitive to changes in temperature. Regular checkups and cleanings at your dentist’s office can help to keep you safe from gum disease.
  • Teeth grinding. If you’re experiencing a dull toothache that nags at you all day long, it could be caused by grinding or clenching your teeth. In many cases, people do not even realize they are grinding their teeth because they’re doing it while they’re sleeping. If you suspect you may have bruxism—the technical term for teeth grinding and clenching—you should be evaluated by your dentist as soon as possible.
  • Impacted wisdom teeth. Impacted wisdom teeth are molars that have not completely emerged from your gums. If you have impacted wisdom teeth, it’s important to inform your dentist as soon as you experience any pain or discomfort in the back of your mouth. If your wisdom teeth have become inflamed or infected, your dentist may recommend removal.

How Can I Relieve the Pain of a Toothache?

The best way to treat a toothache is to treat the cause, and for that, you’ll need to see your dentist. Until then, however, there are some methods that you can use to reduce the pain. Remove any bits of food that may be wedged between your teeth using floss—stuck particles can be one of the reasons for a toothache. Using warm water to rinse may help to relieve your toothache. You can also try holding a cold compress to your cheek for short periods.

In some cases, you may be able to tackle the causes of the pain through increased attention to your dental hygiene. Regular, conscientious brushing and flossing may reverse painful conditions such as gingivitis (inflammation of the gums). If the pain is the result of a more stubborn underlying condition, your dentist will be able to suggest an appropriate treatment.

At-Home Remedies for a Toothache

If you have a toothache, the best course of treatment is making an appointment with your dentist. But until you can get in with your dentist you can try these at-home remedies for a toothache.

  • Cold compress or ice pack. Place an ice pack or even a bag of frozen peas against the outside of the cheek above the painful tooth for a few minutes at a time. This helps constrict the blood vessels which slows the flow of blood to the affected area resulting in the reduction of swelling and inflammation.
  • Saltwater rinse. For most people, a saltwater rinse is an effective first-line treatment. Saltwater is a natural disinfectant and it can help loosen food particles and debris that may be stuck in between your teeth. It also helps reduce inflammation and heal any oral wounds. Use 1 teaspoon of salt in a glass of warm water and swish around in the mouth for 30 seconds before spitting out.
  • Over the Counter Painkillers. Over the counter painkillers such as acetaminophen and ibuprofen can provide temporary pain relief for a toothache. Do not use Aspirin for anyone under 16.
  • Peppermint tea bags. Peppermint has numbing properties that can soothe a toothache. Menthol which gives peppermint its minty flavor and smell is also known to be antibacterial. One teaspoon of dried peppermint leaves can be put in a cup of boiling water and steeped for 20 minutes. After allowing to cool, it can be swished around in the mouth then spat out or swallowed.

When Should I See my Dentist?

Having a toothache is nothing to be ashamed of. Sometimes, teeth can become sensitive or painful for no obvious reason. However, if you are suffering from persistent or lasting dental pain, you should consult your dentist as soon as possible.

In fact, it’s generally a good idea to set up an appointment with your dentist as soon as you notice a toothache, even if the pain isn’t severe. It’s important, however, to know when you need treatment right away. You should call for an immediate appointment if you are in extreme pain, if you experience other symptoms such as fever or pain throughout your entire jaw, or if your toothache lasts for more than two days.

If you experience the following symptoms schedule an appointment with your dentist immediately.

  • fever
  • trouble breathing or swallowing
  • foul-tasting discharge or pus
  • pain when you bite
  • swelling
  • abnormally red gums
  • general pain that lasts more than 1-2 days

If you’re experiencing a nagging ache or sharp pain in your teeth, it’s time to schedule an appointment with your dentist. If the pain is severe, you may need to make an emergency visit to a dental practice in Renton, WA.


About the Author – Dr. Thuy Nguyen, DDS

Dr. Thuy Nguyen DDS in Tukwila, WA holds a Bachelor of Science in Microbiology and received a Doctorate of Dental Surgery from the University of Washington. In 2011, she also completed the Progressive Orthodontic Program. She is known for her fine work and a friendly and caring attitude. Her enthusiasm for dentistry is contagious, as she designs and improves smile after smile. Dr. Nguyen is bilingual in English and Vietnamese. She maintains memberships to the Seattle King County Dental Association, The Washington State Dental Association, and The American Dental Association.

References

Ponsford, Soccy. How to treat a toothache at home. Medical News Today, December 2017.  https://www.medicalnewstoday.com/articles/320315.php

Sawyers, Tessa. How to get rid of a toothache at night. Healthline, October 23, 2018.   https://www.healthline.com/health/how-to-get-rid-of-toothache-at-night

Home remedies for toothache. WedMD.com  https://www.webmd.com/oral-health/home-remedies-toothache

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