What is toothache?

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Toothaches and gum problems: Overview

Toothaches and gum problems are common. But you can usually prevent them by taking good care of your teeth and gums. Keeping your teeth, gums, and the bones around your teeth healthy requires regular brushing, flossing, and good nutrition. Brush your teeth twice a day with a fluoride toothpaste that's approved by the American Dental Association (ADA). Clean between teeth daily with floss or an interdental cleaner.


Sometimes you may have tooth pain when you touch a tooth or when you eat or drink foods that are hot, cold, sweet, or sour (a sensitive tooth). Mild sensitivity can be caused by shrunken (receded) gums or a worn-down tooth. Moderate to severe sensitivity can mean that you have a cracked tooth, a dental cavity, or a lost filling. Seeing a dentist for treatment can prevent the tooth from dying.

The most common cause of a toothache is tooth decay. But you might not have a toothache in the early stages of decay. Other reasons for a toothache might include:

  • An infection of or around the tooth (abscess). A red, swollen, painful bump may be found near or on the side of the sore tooth. The tooth may hurt more when you bite down.
  • A tooth that has not broken through the gum (impacted tooth). Gums may be red, swollen, and sore. The area around this tooth can ache, throb, and be quite painful.
  • Problems with or injury to the nerves in the center of the tooth (pulp). These can be caused by an injury to the face or from grinding or gnashing the teeth.

Sometimes a toothache can be caused by another health problem, such as:

  • A heart attack, a cluster headache, or a sinus infection. These can cause referred pain into the teeth or jaw.
  • Viral infections, such as shingles.
  • Diseases, such as diabetes.
  • Nerve-related disease, such as trigeminal neuralgia.
  • Alcohol or drug abuse, especially methamphetamines.
  • Vitamin deficiencies, such as too little vitamin B12.

Gum problems

Healthy gums are pink and firm and don't bleed easily. Now and then, your gums may bleed if you brush your teeth and gums too hard, use a hard-bristled toothbrush, or snap dental floss hard against your gums. Be gentle with your teeth. Use a soft-bristled toothbrush and floss carefully to help prevent bleeding gums.

Gingivitis is a gum disease that causes red, swollen gums that bleed easily when brushed. Because gingivitis usually doesn't cause pain, many people delay treatment. If not treated, gum disease can cause more serious problems with the gum tissue.

Periodontitis is severe gum disease. It's caused by long-term infection of the gums, bone, and other tissues that surround and support the teeth. It can progress until the bones that support the teeth are damaged. In this late stage, teeth may become loose and fall out or need to be removed. Early treatment of gum disease is important to prevent tooth loss.

Other causes of gum bleeding, swelling, and pain include:

  • Pregnancy, blood-thinning medicines, and bleeding disorders. Each of these can cause gums to bleed easily.
  • Lack of vitamins, such as vitamin K or vitamin C, or medical problems, such as anemia, that interfere with how well the body can absorb certain vitamins.
  • Teething in babies and young children.
  • Medicines such as Dilantin or calcium channel blockers.
  • Dentures or a dental appliance that irritates the gums.
  • An infection around the root of the tooth. Swelling and redness, sometimes with pus, may appear at the base of a tooth.

Smoking and using other tobacco products increases your risk for gum disease. Smokers have a higher chance of having gum disease throughout their mouths than nonsmokers. But you might not have symptoms of bleeding or swollen gums. That's because the normal bleeding immune response is affected by tobacco use. Chewing tobacco or using snuff may push back the gums in the area of the mouth where the tobacco is inserted. Constant irritation caused by tobacco products increases your risk of oral cancer.


A toothache is pain that is felt in the mouth or jaw from a problem with one or more teeth or the gums. Sensitivity or pain typically moves along the nerves in the center of the tooth, known as the pulp.

A toothache may be caused by:

  • Dental decay. Bacteria and other organisms, often present in plaque that forms on the teeth, can result in tooth decay. Pain from decay may not develop until the late stages.
  • Infection around the tooth.
  • An impacted tooth. A tooth that does not break through the skin can cause pain and gum inflammation.
  • Gum disease. Receding gums or unhealthy gums can lead to pain in and around the teeth.
  • An injury to the pulp. Extreme sensitivity to temperatures or sweet or sour tastes can occur when the pulp has been injured or exposed by wear or the loss of a filling.

Although it is not as common, a toothache can be caused by a problem not related to the teeth, such as a sinus infection, shingles, or cluster headaches.

A toothache should be evaluated by a dentist right away to determine the cause of the problem and prevent the tooth from dying.

Caring for toothaches and gum problems

Try these tips to help treat a sensitive tooth, toothache, or gum problem.

  • Treat tooth sensitivity.

    You can reduce sensitivity to heat, cold, or brushing.

    • Use a toothpaste specifically designed for sensitive teeth.
    • Brush with it regularly, or rub a small amount of the paste on the sensitive area with your finger 2 or 3 times a day.
    • Floss gently between your teeth.
  • Ease a toothache.
    • Use an ice pack on the outside of your cheek to reduce pain and swelling. Don't use heat.
    • Avoid very hot, cold, or sweet foods and drinks if they make your pain worse.
    • Adults can apply an over-the-counter benzocaine gel to the tooth for short–term relief. Do not use teething gels for children younger than age 2. Ask your doctor before using mouth-numbing medicine for children older than age 2. The U.S. Food and Drug Administration (FDA) warns that some of these can be dangerous. Be safe with medicine. Read and follow all instructions on the label. If your pain lasts longer than a few days or it gets worse, call a doctor.
  • Treat gum problems.
    • Use a tartar-control toothpaste that contains fluoride. And use a mouthwash that contains fluoride if your gums are mildly swollen and red.
    • Make sure to brush after meals and snacks and floss every day.
    • Chew sugar-free gum, use a toothpick, or rinse your mouth with warm salt water if you can't brush after eating. You can make your own salt water by mixing 1 tsp (5 mL) of salt in a medium-sized glass [ 8 fl oz (240 mL) ] of warm water.
    • Don't smoke or use other tobacco products. Tobacco can cause many gum problems, decrease your ability to fight infection of your gums, and delay healing.
    • Don't use illegal drugs, such as methamphetamines, that cause tooth and gum problems.

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.

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