- Physical Examination
- Surgical Examination
- Ophthalmology
- Clinical Skills
- Orthopedics
- Surgery Videos
- Laparoscopy
- Pediatrics
- Funny Videos
- Cardiothoracic Surgery
- Nursing Videos
- Plastic Surgery
- Otorhinolaryngology
- Histology and Histopathology
- Neurosurgery
- Dermatology
- Pediatric Surgery
- Urology
- Dentistry
- Oncology and Cancers
- Anatomy Videos
- Health and Fitness
- Radiology
- Anaesthesia
- Physical Therapy
- Pharmacology
- Interventional Radiology
- Cardiology
- Endocrinology
- Gynecology
- Emergency Medicine
- Psychiatry and Psychology
- Childbirth Videos
- General Medical Videos
- Nephrology
- Physiology
- Diet and Food Health
- Diabetes Mellitus
- Neurology
- Women Health
- Osteoporosis
- Gastroenterology
- Pulmonology
- Hematology
- Rheumatology
- Toxicology
- Nuclear Medicine
- Infectious Diseases
- Vascular Disease
- Reproductive Health
- Burns and Wound Healing
- Kidney Zone Podcast
- Other
Toothache
Category: Head, Eyes, Ears, Nose & Throat · All head & senses symptoms
What it can feel like
Toothache is pain in or around a tooth — throbbing, sharp on biting, or triggered by hot, cold or sweet foods. It usually means the tooth's nerve is inflamed or infected, from decay, a cracked tooth, a failing filling or gum disease, and it needs a dentist rather than a doctor in the first instance.
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
Toothache can be associated with tooth decay reaching the nerve, a lost or damaged filling, a cracked tooth, receding gums exposing sensitive roots, teeth grinding, and sinusitis referring pain to the upper back teeth.
Other possible causes
Severe or spreading toothache can be associated with a dental abscess — a collection of pus at the tooth root or in the gum — which can spread to the face, floor of the mouth and, rarely, threaten the airway or cause serious infection.
Red flags — when to seek help promptly
- Toothache with facial or neck swelling, or difficulty opening the mouth
- Dental pain with fever, feeling unwell or difficulty swallowing — urgent
- Swelling of the floor of the mouth or tongue — emergency
- Toothache after a tooth injury, with the tooth loose, displaced or knocked out
What a clinician may do
A dentist will examine and X-ray the tooth, test its response to cold and tapping, and treat the cause — filling, root treatment or extraction — draining any abscess. Doctors manage spreading infection and pain control when a dentist is not immediately available, but definitive treatment is dental.
Frequently asked questions
Why does toothache pulse and worsen at night?
The inflamed nerve sits in a rigid box of enamel and dentine, so swelling has nowhere to go and pressure throbs with each heartbeat. Lying flat raises pressure in the head further, which is why nights are worst.
Will antibiotics fix my toothache?
Antibiotics alone cannot fix a dead nerve or a walled-off abscess — the infected tissue must be treated directly by a dentist. Antibiotics are added when infection is spreading, there is facial swelling or fever, or the person is medically vulnerable.
Related symptoms — Head, Eyes, Ears, Nose & Throat
Browse the T section of the A–Z list or return to the Symptoms A–Z hub.