Toothache: Symptoms, Causes, and Treatment

A toothache is when pain occurs in or around a tooth. Toothaches are usually a result of decay, cavities, infection, or poor dental hygiene. However, toothaches can occur because of other health issues.

This article covers the symptoms, causes, risks, and complications of toothache and when and where to get help.

Symptoms of Toothache

Toothaches can range from short bursts of pain to long-lasting pain that doesn't seem to respond to pain medications. The symptoms of a toothache can appear in both children and adults, whether a tooth is growing or already in place. Symptoms of toothache include:

• Feeling short (seconds) or long-term (minutes and longer) pain in a tooth after eating hot, cold, sugary, or acidic foods for seconds or minutes
• Pain around the tooth or in the jaw area
• Jaw swelling (note: swelling that reaches the neck can put breathing at risk and requires urgent care)
• Redness, bleeding, and swelling in the gums (also called inflammation of the gums)

Causes of Toothache

The most common causes of toothache are:

• Tooth decay or dental cavities: Tooth decay is when acids in plaque, a combination of bacteria and old food and saliva, wear teeth down. Tooth decay can cause dental cavities, or holes in the teeth.
• Dental abscess: This is when bacteria infect the tooth, creating pus and swelling.
• Gingivitis: Inflammation from plaque and tartar buildup can eventually destroy gums and other tissues.

Other causes of toothache include:

• Having a broken tooth or filling
• Issues with braces
• Sinus infections
• Earache
• Jaw or mouth injury
• Neurological or "referred" pain, in which pain in one part of the body results from injury to another

What Medications Cause Toothache?

Medications that speed up tooth decay can cause toothache because tooth decay is a common cause of toothaches. These include medications that cause dry mouth because lack of saliva can increase the chances that bacteria and food particles will remain in the mouth.

Medications that may cause dry mouth include:

• Antidepressants
• Diuretics
• Antihistamines and decongestants
• Opioids
• Chemotherapy medications
  

Other medications that can cause toothache include:

• Antibiotics: Some antibiotics taken for chronic disease can speed up tooth decay and cause tooth deformities, especially for children.
• Aspirin: Aspirin should only be swallowed with water because it is highly acidic and can harm teeth if chewed.
• Syrups: Cough syrups and other syrupy medications can leave sugar on the teeth, which can also cause tooth decay.
• Osteoporosis medications: Medications for bone issues can affect the jawbones.
• Immunosuppressive drugs: These are drugs that prevent the immune system from overreacting and can increase the chance of mouth infections.

Treatment for toothache caused by medication can include speaking to a healthcare provider about modifying medications or dental treatments like fillings or dentures.

How to Treat Toothache

Treating a toothache might include:

• Antibiotics to treat bacteria
• Over-the-counter pain medications
• A root canal, a procedure that entails cleaning the tooth at the root
• Draining an abscess
• Tooth removal
• Severe cases, such as those that involve swelling of the neck, may necessitate emergency care

Complications and Risk Factors Associated With Toothache

An untreated toothache is more than a cosmetic issue, and leaving tooth decay untreated can result in serious complications. These include:

• Losing a tooth or other dental shifts
• Halitosis (bad breath)
• Bleeding gums or holes in the gum tissue
• Difficulty chewing and swallowing
• Infection in the mouth tissues, jaw, and the rest of the body, including the brain and heart

Risk factors that can increase the chances of toothache include:

• Poor dental hygiene, including leaving food (especially sugar) on the teeth, not flossing
• Lack of regular dental checkups
• Medications like antihistamines, antibiotics for chronic conditions, and antidepressants

Are There Tests to Diagnose the Cause of Toothache?

In most cases, a dentist will determine the cause of a toothache by:

• Examining the teeth and surrounding areas, including the neck and jaw
• Requesting dental X-rays
• Asking questions about the pain's timeline, when the pain occurs, medications, and dental history

When to See a Healthcare Provider

It's important to see a dentist as soon as possible if your toothache:

• Lasts longer than two days
• Includes other symptoms like fever, earache, or mouth pain
• Is causing severe pain
• Includes swelling
• Is the result of injuries, like a broken jaw (though this likely requires emergency care)

Summary

Symptoms of toothache can include pain, swelling, and bleeding gums. Causes of toothache include fractures, broken fillings, tooth decay, issues with braces, earache, sinus infection, and heart attack.

Several medications can cause toothache, especially medications that cause dry mouth. These medications include antihistamines, decongestants, chemotherapy, antibiotics, and medications for Parkinson's disease.

Treatment for toothache can include pain medications, draining a tooth abscess, antibiotics for bacteria, and removing a tooth. If a toothache lasts longer than two days or is severe, seeing a dentist is advisable. A toothache that results from an injury may necessitate emergency care.