Does this describe your symptoms?
- Pain or discomfort in a tooth
The main cause of toothache is tooth decay (cavities). Complications of tooth decay can also cause pain. For example, a periapical abscess (pus pocket) can develop around the base of tooth with a cavity.
Dental Causes of Toothache
- Dental caries (tooth decay): pulpitis, periapical abscess
- Food stuck between teeth
- Periodontal disease (gum disease): gingivitis, periodontal abscess, pericoronitis
- Tooth fracture (broken or cracked tooth)
Other Causes of Toothache
- Canker sore (aphthous ulcer)
- Heart attack
- Ludwig's angina
- TMJ Syndrome
- Trigeminal Neuralgia
Complications of Tooth Decay
- Cellulitis of the cheek
- Periapical dental abscess
- Ludwig's Angina: This serious infection is a rapidly progressive cellulitis of the floor of the mouth that usually is a complication of a dental abscess or tooth extraction. The presenting symptoms are fever, a swollen/tender tongue and difficulty swallowing.
- Submandibular lymphadenitis
Caution: Rarely individuals may have a toothache or jaw pain as the sole symptom of a heart attack. Usually there will be other accompanying symptoms of a heart problem, such as: chest pain, shortness of breath, nausea and/or sweating.
If not, see these topics
|Call 911 Now (you may need an ambulance) If|
|Call Your Dentist or Doctor Now (night or day) If|
- You feel weak or very sick
- Severe pain and not improved after taking pain medication
- Fever is present
- Face is swollen
- Tongue is very swollen and tender
|Call Your Dentist Within 24 Hours (between 9 am and 4 pm) If|
- You think you need to be seen
- Toothache present longer than 24 hours
- Brown cavity visible in the painful tooth
- Red or yellow lump (pus pocket) present at the gum line of the painful tooth
|Call Your Dentist During Weekday Office Hours If|
- You have other questions or concerns
|Self Care at Home If|
- Mild toothache present less than 24 hours and you don't think you need to be seen
HOME CARE ADVICE FOR MILD TOOTHACHE
And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.
- Reassurance: Most toothaches are temporary and due to a sensitive tooth. If the pain becomes worse or does not resolve in 24 hours, it could be due to a small cavity.
- Floss: Floss on either side of the painful tooth to remove any wedged food.
- Pain Medication:
- For pain relief, take acetaminophen or ibuprofen.
- Acetaminophen (e.g., Tylenol): The dose is 650 mg by mouth every 4 hours or 1000 mg by mouth every 6 hours. Maximum dose per day = 4000 mg.
- Ibuprofen (e.g., Motrin, Advil): The dose is 400 mg by mouth every 6 hours or 600 mg by mouth every 8 hours.
- People who are over 65 Years of age: Acetaminophen is generally considered safer than ibuprofen. Acetaminophen dosing interval should be increased to every 8 hours because of reduced liver metabolism. Maximum dose per day = 3000 mg.
- CAUTION: Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
- CAUTION: Do not take acetaminophen if you have liver disease.
- Read the package instructions thoroughly on all medications that you take.
- Local Cold: Apply an ice pack to the painful jaw for 20 minutes.
- Expected Course: Most minor causes of toothache resolve in less than a day.
- Call Your Dentist If:
- Toothache persists longer than 24 hours
- The toothache becomes worse
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: David A. Thompson, M.D.
Last Reviewed: 1/19/2009
Last Revised: 4/5/2008
Content Set: Adult HouseCalls Online
Portions Copyright 2000-2009 Self Care Decisions LLC; Copyright LMS, Inc.