What to do if you have a toothache

Toothache can appear suddenly and vary in intensity. It may feel dull, sharp, or throbbing, be triggered by hot or cold foods, or be accompanied by swelling. It is important not to panic, but also not to delay seeing a dentist unnecessarily.

Pain usually indicates that there is a problem in or around the tooth that is unlikely to resolve without professional treatment. Painkillers may provide temporary relief, but they do not treat the underlying cause.

The most common causes of toothache

Toothache may be caused by:

• tooth decay;
• inflammation of the dental pulp, commonly referred to as the tooth nerve;
• a cracked or broken tooth;
• inflammation of the gums or the tissues supporting the tooth;
• erupting wisdom teeth;
• tooth sensitivity;
• an infection or dental abscess;
• excessive pressure on a tooth or an incorrect bite;
• complications following recent dental treatment.

The type of pain may help the dentist identify its cause. A brief response to cold may be linked to sensitivity or early tooth decay, while persistent or throbbing pain may indicate inflammation of the dental pulp.

However, the exact cause can only be determined through a professional examination.

What can you do at home?

Until you are able to see a dentist, you can take several basic steps:

• rinse your mouth with lukewarm salt water;
• gently clean the area around the painful tooth;
• carefully use dental floss or an interdental brush if food is trapped between the teeth;
• take an over-the-counter painkiller according to the package instructions and with regard to your medical condition;
• apply a cold compress to the outside of your cheek;
• avoid very hot, cold, sweet, or hard foods;
• keep your head slightly elevated when resting.

Always wrap a cold compress in a cloth and apply it only for short periods. Warm compresses are not recommended when swelling or infection is suspected, as they may make the problem worse.

Never place aspirin or any other medication directly on the tooth or gum. This may irritate or burn the soft tissue.

When should you see a dentist urgently?

You should arrange an urgent dental examination if you experience:

• severe, throbbing, or worsening pain;
• pain lasting longer than one or two days;
• swelling of the gum or face;
• fever or general illness;
• pain when biting;
• discharge of pus or an unpleasant taste in the mouth;
• a cracked or broken tooth;
• pain following an injury;
• bleeding that does not stop;
• complications following recent dental treatment.

If the swelling is spreading rapidly, extends towards the neck or eye, or is accompanied by difficulty swallowing or breathing, seek emergency medical care immediately.

What happens during the examination and treatment?

The dentist will first ask about the nature and duration of your symptoms. This is followed by a clinical examination and, where necessary, an X-ray, sensitivity testing, or an assessment of your bite.

The treatment will depend on the cause of the pain and may include:

• removing tooth decay and placing a filling;
• adjusting an unsuitable filling or bite;
• root canal treatment;
• gum treatment;
• treatment of an infection;
• a surgical procedure;
• extraction if the tooth can no longer be saved.

The aim is not only to relieve the pain, but also to remove its cause and preserve the natural tooth whenever possible.

Do not ignore toothache

The earlier the cause of the pain is identified, the simpler and less invasive the treatment usually is. A small cavity that could initially be treated with a filling may develop into an infection requiring root canal treatment or extraction if left untreated.

Modern dentistry allows most procedures to be carried out gently and under local anaesthesia. You should therefore not postpone seeing a dentist, even if the pain temporarily improves after taking medication.