A lot of tooth pain is caused by inflammation in the pulp or inside part of the tooth. The pulp of each tooth contains lots of nerve endings that are highly sensitive to pain. This can cause the often constant throbbing pain that makes toothache especially unbearable.


Toothache is any pain, soreness, or ache felt in or around a tooth. It’s not just one type of pain. That means it’s sometimes hard to even describe what you’re experiencing to your dentist. The pain can be sharp, dull, throbbing or constant.

In some cases, the pain is only felt when you put pressure on the tooth. Your tooth might also be particularly sensitive to hot or cold temperatures. Pain with chewing is also fairly common.

Other symptoms could include a swollen gum around the tooth or deeper in your jaw, headaches and high fevers. You might also have bleeding from your tooth or bleeding gums. In the case of infection, you might have foul-tasting fluid leaking from around the tooth.



Toothache is caused by both dental and medical factors. Dental causes of toothache may be related to your teeth, gums or jaw. Of all the toothaches that our dentists see each day, the most common causes are:

  • Dental cavities as a result of tooth decay
  • A fractured or broken tooth
  • An impacted tooth

Sometimes, the pain is caused by a damaged filling or by sensitive teeth. Periodontitis or an abscess or infection in the tooth are also common. Gingivitis, or gum disease, can cause toothache, yet these can also be painless in some people. Toothache can also be caused by pain in other areas that radiate to the jaw. This is called referred pain. One common area is the temporomandibular or jaw joint, known as TMJ. Other less common medical causes of toothache include ear pain, sinus infections, shingles and sometimes even heart problems.

Get prepared

Generally, your dentist will ask you about your medical history and then thoroughly examine your mouth, teeth, gums, jaw, tongue, throat, sinuses, ears, nose and neck. You may also need an x-ray, depending on what your dentist suspects might be the cause of your toothache.

At Inspire Dental Group, our dentist in Vancouver asks these questions about the pain, such as:

  • When did your toothache start?
  • How severe is the pain?
  • Where do you feel the pain?
  • What makes it worse?
  • What makes it better?


The nerves in your teeth don’t feel heat, cold or touch. When they’re stimulated, their only response is pain. On top of that, teeth have a lot of neural connections that lead directly to your brain’s pain centre.

A toothache stimulates your dental nerves to an intense degree, and this contributes to why it can be more severe at night. This nerve stimulation activates your brain and can keep you awake.

In some cases, what you eat for dinner might aggravate a painful tooth. Food that is very hot, cold, sugary, acidic or starchy can quickly make an underlying toothache issue worse.

Sometimes, toothache gets worse when you lie down because blood rushes to your head, which then puts extra pressure on the already sensitive areas in your mouth.

Yes. You can greatly reduce your chances of getting toothache by taking good care of your oral health. That means a combination of at-home dental care and building a great relationship with your dentist.

We recommend daily healthy habits and regular visits to the dentist. For optimum oral health:

  • Practice good oral hygiene habits at home, including brushing your teeth twice a day and flossing once a day
  • Book hygiene visits with your dental hygienist at least twice each year
  • Book routine exams and x-ray visits with your dentist once each year

The short answer is yes. In some situations, a toothache or tooth sensitivity can come and go. If this happens, it’s probably a reversible inflammatory response by your tooth. Your relief may be short-lived, though.

Only after a dentist has made a proper diagnosis about the cause of your pain can you potentially avoid further damage and find a permanent pain solution.

If your pain is minor, there are a few things you can try before you see your dentist. Apply an ice pack to the area and take painkillers for short-term relief. Some people recommend cloves or clove oil applied directly to the tooth or a topical anesthetic like the gels used for teething babies. You can also try rinsing your mouth with warm salt water. You may find the pain soon gets worse if there is an underlying issue. That’s why it’s important to get checked out by a dentist, even if you manage to get some temporary relief from the pain.