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Tooth pain - What's the Cause? What should You do?


If you have tooth pain, you can use the chart below to give you some idea as to what the source of the pain might be. Bear in mind, though, that the intention of this chart is not to diagnose your pain; only your dentist can do that.

When you contact your dentist regarding your tooth pain, it's important that you be as thorough as you can in your explanation of the pain; i.e., how severe it is, when you feel it, where it's located, and whether any conditions make it better or worse. That way, your dentist will have a sense as to the urgency of your problem.

Symptom What Could This Be? Possible Solutions
You feel a sharp pain when you bite down. Decay, a cracked tooth, or a loose filling can cause sharp pain in your tooth when you bite. You could also have an infection inside the pulp layer of your tooth; this is where the nerve exists. A dentist should evaluate the tooth that's causing your discomfort to determine the source of the pain. If you have an infection within the pulp of your tooth, you will need root canal therapy to remove the infected tissue and seal off the space to prevent further infection.
You have severe pain, pressure and swelling in your mouth that does not go away. It is possible that you have an abscess, which is an infection in the tooth and/or gum and bone tissue. Take an over-the-counter pain reliever until you can see a dentist or endodontist (a specialist who treats injuries, diseases and infections of the tooth pulp) to evaluate and treat the infection.
Your upper teeth and jaw ache, but the pain is not sharp or severe. You may have a sinus headache or a sinus infection. Sinus pain can "travel" to the upper jaw because of its proximity to the sinus cavity.

Also, grinding your teeth (a condition called bruxism) can also cause a dull ache in the upper jaw, due to pressure on the temporomandibular joint (the TMJ).
Your physician can determine if the pain you are feeling is from a sinus infection, and can prescribe medication, if necessary. Over-the-counter pain relievers and sinus medications often are very effective in reducing sinus pain.

If your pain is due to bruxism, see your dentist for treatment recommendations.
You have pain in your head, neck or ear that does not go away. Damaged or infected pulp tissue in your teeth can cause pain elsewhere in your head. However, there may be other medical or dental causes for the pain.

Problems in your temporomandibular joint (the TMJ) can also cause this type of pain.
See your dentist, who can tell you if the problem is tooth-related, or if it would be more appropriately treated by a physician. Your dentist can also diagnose any dysfunction that may be occurring in your TMJ, and identify your treatment options for correcting it.
After you receive dental treatment, your teeth are sensitive to heat or cold. Temporary tooth sensitivity is normal after dental treatment, as it often disturbs the nerves within the pulp layer. The pain should subside within four to six weeks. If it doesn't, or if it worsens, be sure to contact your dentist.
You suddenly feel some discomfort in your teeth when they're exposed to heat or cold, but then it goes away. Slight sensitivity that only lasts a few moments usually means you have a loose filling, or a portion of your gums is pulling away slightly from your tooth, exposing a bit of the root surface. An exposed root surface usually results in tooth sensitivity. You can try a toothpaste that is created especially for use on sensitive teeth; allow a week or two for it to begin easing the sensitivity. Also, be sure to use a soft toothbrush, and brush up and down in little circles, to avoid damaging your gums. If you make these changes in your oral hygiene routine, and the sensitivity persists, contact your dentist for an appointment.
After you eat something hot or cold, you have lingering pain in one or more teeth. Your tooth is likely damaged by either deep decay or a fracture to the tooth. See your dentist as soon as possible. It is likely that you will need a crown or root canal therapy to save your tooth.

Source: Your Health Encyclopedia, 4-rd Edition, 2002
Last Revised at December 4, 2007 by Harutyun Medina, M.D.

Select a way to Improve Your Smile


Bonding is an excellent way to repair or change the shape or color of teeth, particularly front teeth. Bonding is usually a one-appointment procedure that starts with a careful matching of the color of the bonding materials to your tooth color.

Next your teeth are lightly roughened and a gel is applied to ensure that the bonding materials will adhere. Then the bonding material is applied, sculpted and hardened with a high-intensity light. The final step is a careful polishing of your new teeth.

Porcelain Veneers

Porcelain veneers are custom-crafted, fingernail-thin porcelain shells that are bonded to natural teeth. Because of their subtle color and near transparency, porcelain veneers can make a dramatic and very natural-looking improvement to your smile.


If you prefer not to have a partial denture or bridge attached to adjacent teeth, you might consider an implant, which is a metal cylinder surgically inserted into the bone of the upper or lower jaw. A crown or modified denture may be attached to the implant.

An additional benefit: implants may stop or slow down the bone loss that occurs once teeth have been lost.

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