Main Line Pediatrics

Are You Sick?


Is this your symptom?

  • Pain or discomfort in a tooth

Some Basics...

  • The main cause of toothache is tooth decay (cavities). Problems from tooth decay can also cause pain. For example, a pus pocket can grow around a tooth with a cavity.
  • Pain from other parts of the body can sometimes cause toothaches. For example, some earaches can cause people to feel tooth pain.
  • A toothache that lasts longer than 24 hours means that something is wrong. Often it is a cavity, a cracked tooth, or an infected tooth.

Dental Causes of Toothache

  • Dental cavity (tooth decay): pulpitis, periapical abscess
  • Food stuck between teeth
  • Lost crown
  • Lost filling
  • Gum disease: gingivitis, periodontal abscess, pericoronitis
  • Tooth fracture: broken or cracked tooth

Other Causes of Toothache

  • Canker sore (aphthous ulcer)
  • Heart attack
  • Ludwig's angina
  • Sinusitis
  • TMJ Syndrome
  • Trigeminal Neuralgia

Pain Scale

  • None: no pain. Pain score is 0 on a scale of 0 to 10.
  • Mild: the pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
  • Moderate: the pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
  • Severe: the pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

Complications of Tooth Decay

  • Cellulitis of the cheek
  • Periapical dental abscess
  • Ludwig's Angina: this is an infection of the floor of the mouth. It is serious. It is most often a complication from a dental abscess or tooth extraction. Symptoms are fever, a swollen/tender tongue, and trouble swallowing.
  • Submandibular lymphadenitis

Caution: people may have a toothache or jaw pain as the only symptom of a heart attack. Most often, there will be other symptoms of a heart problem. These include chest pain, shortness of breath, nausea, and sweating.

When to Call for Toothache

Call 911 Now

  • Very weak (can't stand)
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Self Care at Home

  • Mild toothache present less than 24 hours

Care Advice for Mild Toothache

  1. What You Should Know:
    • Most toothaches are due to a sensitive tooth.
    • The pain will go away after a short time. If your pain gets worse or does not get better in 24 hours, it could be from a small cavity.
    • You can treat mild toothaches at home.
    • Here is some care advice that should help.
  2. Floss: Floss on either side of the painful tooth to remove any wedged food.
  3. Pain Medicine:
    • You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
    • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
    • Use the lowest amount of a drug that makes your pain feel better.
    • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
    • Read the instructions and warnings on the package insert for all medicines you take.
  4. Cold: Put an ice pack on the painful jaw for 20 minutes.
  5. What to Expect: Most minor causes of toothache get better in less than a day.
  6. Call Your Dentist If:
    • Toothache lasts more than 24 hours
    • The toothache gets worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 5/23/2019 1:00:25 AM
Last Updated: 3/14/2019 1:00:29 AM

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