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A Look at the Most Common Underlying Causes of Painful Toothaches

When sharp pain sears through your tooth, it’s not only a painful experience, but it’s also a stressful and frustrating one as you rack your brain trying to figure out what is causing this sudden pain.

To give you an idea of the potential causes of your toothaches, here’s a look at the most common toothache symptoms, causes, and remedies, including when you should see a dentist for relief.

Symptoms of A Toothache

A toothache is a pain felt inside or around a tooth. This pain may be constant or intermittent—e.g. the pain only occurs when eating cold or hot foods. And it can be sharp, dull, or throbbing.

Along with pain, a toothache may be accompanied by swelling around the tooth, a bad taste, a fever, or a headache, depending on what’s causing the pain.

Causes of Tooth Pain

There are many causes of tooth pain; some are avoidable with proper oral health care and others are out of your control.

The most common causes of tooth pain include:

Sensitive Teeth

When tooth enamel wears down, it exposes the middle layer of a tooth (the dentin) and no longer fully protects the nerves inside. This means that anything you eat or drink can reach the nerve endings, causing pain whenever you eat something hot, cold, sweet, or acidic.

Gum disease can also cause sensitive teeth since the gums eventually shrink away from the teeth and expose the roots.

Orthodontic Alignment

Braces, retainers, and other types of orthodontic alignment devices can often cause toothaches, pains, and oral discomfort. Pain is usually most noticeable after an adjustment that tightens or moves the teeth.

Impacted Wisdom Teeth

Wisdom tooth pain can occur when the tooth fails to push through the gum line and is pushing against the adjacent tooth instead. You may also experience pain if food gets stuck under the gum of a partially erupted tooth and causes tooth decay and infection.

Teeth Grinding

Repetitive teeth grinding can cause myofascial pain as the result of excessive pressure on jaw muscles and inflammation of the temporomandibular joints, known as TMJ syndrome. Those with TMJ syndrome may experience TMJ tooth pain, which occurs when a patient experiences pain in specific teeth that are actually healthy.

Teeth grinding can also wear down the tooth enamel, cause tooth fractures, and lead to headaches and dull aches in the teeth and jaw.

Fractured Tooth

Pressure on teeth, such as hard blows to the mouth, chewing on hard foods, teeth grinding, and clenching teeth can cause tooth fractures. A fractured tooth will cause pain until the injured piece is removed and replaced with a crown. But if left untreated, it may eventually become a split tooth which is harder to save.

Damaged Filling

Damaged fillings can lead to tooth pain when they expose sensitive parts of a tooth to food particles, bacteria, and extreme temperatures. Amalgam (silver) fillings are known to expand and contract with temperature fluctuations, eventually breaking down and causing toothaches.

Gum Disease

Without regular flossing, brushing, and professional dental cleanings, plaque bacteria are left to grow at and below the gum line, resulting in gum irritation and causing tooth, bone, and gum pain, inflammation, bleeding gums, and gum disease.

If left untreated, gum disease can progress to become periodontal disease or periodontitis. Periodontitis causes damage to the supportive structures in the gums, breaking them down and possibly causing tooth loss. This infection can also reach the jawbone if left untreated.

Tooth Abscess

A dental abscess is a buildup of pus caused by an infection inside the tooth or in the gums around the root of the tooth. This infection can cause constant, severe, and throbbing pain when the soft tissue (dental pulp) inside the root canal becomes inflamed and also when the tissue dies.

Tooth abscesses are often caused by tooth decay that’s left untreated and eventually reaches deep inside the tooth. Bacteria entering through a cracked or broken tooth can also cause an abscess infection.

Tooth Decay

Tooth decay is the leading cause of toothaches. Tooth decay occurs when plaque bacteria break down sugar from food particles left on teeth and create acid that wears down the tooth enamel.

When worn-down enamel is left untreated, a hole (cavity) can appear in the tooth and damage the dentin, causing pain and sensitivity. Bacteria can then enter through the cavity and infect the pulp of the tooth, causing sharper tooth pain.

Common Non-Dental Causes of Tooth Pain

Tooth pain can also be caused by an issue elsewhere in the body, which is known as referred pain. Causes of this referred pain can include:

Sinus Infection

Infected sinuses can cause tooth pain when the fluid-filled sinuses place pressure on the upper back corners of the mouth.

Heart Attack

In rare cases, a heart attack can cause tooth pain when the pain from the heart attack radiates into the lower jaw.

Vitamin Deficiency

People who are vitamin B12 deficient may experience tooth pain.


Uncontrolled blood sugar can increase the risk of tooth decay for those with diabetes, which in turn, increases the risk of tooth pain as well.


Viral infections, such as shingles, can also cause tooth pain.

When to See A Dentist

If you are experiencing any type of tooth pain, see your dentist as soon as possible. Many causes of tooth pain can get worse over time, leading to more severe pain and a potentially more serious issue. And if there is an infection, you will need to take antibiotics to prevent the infection from spreading.

Your dentist will be able to find the cause of the pain, treat it, and help alleviate your pain, so you won’t have to suffer any longer.