Intermittent Tooth Pain: Types, Causes & What To Do 2024

You bite into something, or you sip something cold, and OUCH! Maybe you seem to have done nothing at all to cause it, but it is there all the same. Tooth pain can be very bothersome, and it may not always be immediately apparent what is causing it. This distressing pain can be a sharp pain, throbbing, or may be more of a dull ache.

Pain is the way your body tells you something is wrong. Even when the pain seems to come and go in waves it should not be ignored. The problems associated with toothaches can range from mild to very serious. So, what should you do about it? We will discuss the common causes of tooth pain, when to seek professional help, and some ways to manage the pain.

What Is a Toothache?

A toothache refers to any pain in your teeth or the areas around your teeth. Sometimes this pain can be relatively minor, and you may be able to treat some of this irritation at home. This can be the case particularly if there is inflammation of the gums, (gingivitis). In other instances, the pain can be much more severe.

Symptoms Of A Toothache

Symptoms of a toothache can vary depending on the cause. Some common symptoms include:

• Dull ache
• Sharp tooth pain, sometimes described as “jabbing”
• Sensitivity pain
• Throbbing pain 
• Swelling
• Bad taste in your mouth, or bad breath
• Fever
• Chills
• Headache

If you have a fever or chills associated with a toothache (especially if the pain is severe) it is best to contact a dentist immediately or consider a visit to an emergency room. These are signs of an infection. If left untreated, a bacterial infection can potentially spread^[1] into your bloodstream and affect other areas of your body. The use of antibiotics helps prevent the risk of an infection spreading to your bones, brain, lungs, and many other areas of your body.

Types Of Tooth Pain

Generally speaking, the types of tooth pain experienced can be described as a dull ache, a sharp pain, neuropathic pain, or temperature sensitivity. It is helpful to consider the causes of these types of pain. 

Common Dental Causes Of Tooth Pain

Cavities / Tooth Decay (Dental Caries)

It has been estimated that over 20% of people in the United States have untreated cavities^[2], and 75% of people have had at least one dental restoration in their lifetime. Tooth fractures and the development of cavities are made more likely by the breakdown of tooth enamel. Plaque formation allows bacteria to thrive on the sugars in your diet. These bacteria produce acid which leads to damaged enamel. A cavity that affects the nerve can cause sensitivity and significant pain.

Maintaining oral health by brushing your teeth twice daily, flossing, and using a mouth rinse significantly reduces the likelihood of developing cavities. A healthy diet minimizing sugar and monitoring the acidity of food and beverages are helpful as well. Soda provides both sugars and acidity, making it an excellent thing to limit or avoid to reduce the likelihood of cavities. This also lends support to the conventional parental wisdom of avoiding things like orange juice after brushing your teeth before bed.

Grinding Teeth (Bruxism) 

Teeth grinding, gnashing, or clenching is referred to as bruxism. The severity varies and this may not require treatment in and of itself. Regular appointments with a dental professional can help ensure the risks of tooth damage, jaw pain or weakness, and associated headaches will be less likely through monitoring and appropriate intervention when necessary.

Bruxism is most commonly associated with stress, alcohol consumption, and smoking. It has also been tied to genetics and the use of certain medications.^[3] If you are using meds to treat seizures, depression, or attention deficit hyperactivity disorder (ADHD) and notice you are  grinding your teeth it may be helpful to discuss this with your doctor or pharmacist.

Abscessed Tooth (Infection)

An abscess is a pocket of pus, or a site housing infection. It is important to seek treatment for this before an infection spreads. There are several potential locations for infections, such as gingival (gums), periapical (at the root tip), or periodontal (in the surrounding bone or tissue). You cannot distinguish these from the pain alone, and this pain may radiate to your jaw, ear, or neck. Other symptoms may include sensitivity to temperature, fever, swollen lymph nodes, or swelling in your cheeks.

Care provided by a dental professional or a trip to an emergency room is recommended to ensure appropriate treatment. This will help manage the risks of more severe cases^[4] developing in which the infection spreads to other parts of the body.

Root fracture

A fractured tooth root can occur for several reasons, ranging from bruxism, chewing on hard food, or can even occur naturally with aging. These fractures are sometimes not visible above the gum line so they may require professional intervention to detect. A cracked tooth may go unnoticed for some time for these reasons.

Pain or tooth sensitivity may not occur until an infection develops in some cases. Severity varies along with suggested treatment – in some instances the tooth may need to be removed, or root canal treatment may be recommended.

Wisdom teeth “cutting” / impaction

Impaction refers to a tooth failing to “erupt” above the gum line, potentially because there is not enough space along the jawline. Sometimes this is not painful and will only be detectable using an X-ray. In other cases, it can cause jaw pain, swelling, or even difficulty opening your mouth. It may be recommended to remove the impacted teeth, and the benefits and risks of a procedure will be discussed.

Common Non-Dental Causes Of Tooth Pain

Gum Disease

Gum disease or gingivitis is typically not a cause of more severe pain but it does lead to some potential symptoms.

• Tooth sensitivity
• Bad breath or bad taste in your mouth
• Bleeding or swollen gums

It is a good idea to visit the dentist twice a year for monitoring. This can help catch or prevent any potential issues before they become more concerning. Brushing and flossing your teeth twice a day, particularly immediately before bed is recommended.

Sinus Infection or Allergies

A sinus infection can be associated with tooth pain, particularly in the upper rear teeth as these are closest to the sinuses. Allergies can cause inflammation in this area as well. Treating the inflammation in the sinuses will manage these symptoms. If your toothache is persistent it is a good idea to schedule an appointment with your dentist.

When To See A Dentist

It is recommended to call your dentist or seek more immediate care if you have any of the following:

• Fever.
• Swelling of jaw, gums, or cheek.
• Foul tasting discharge.
• Pain that has lasted longer than 24-48 hrs.

Some tooth pain can be temporarily treated at home or will need additional care after visiting a dentist. There are many ways to approach this. Care should be taken to ensure these are used appropriately.

• Acetaminophen (Tylenol) or NSAIDs (ibuprofen, naproxen) 
  • Do not take more than the recommended dose on the package without consulting a healthcare provider.
  • Do not place aspirin or any other over-the-counter pain reliever directly on your gum. This can cause tissue damage. Swallow the tablets or capsules whole.

• Over-the-counter local anesthetics (benzocaine,  Orajel, etc.)
  • Never use benzocaine in children under 2 years old.
  • Discuss use with a healthcare professional before use due to the rare but serious risk of methemoglobinemia^[5] (affects oxygen delivery in your blood).

The use of CBD is becoming more popular and does show some benefits^[6] for pain relief. These products are not routinely inspected by the FDA which makes finding a reputable supplier crucial. There are many products available, so finding the best CBD for tooth pain may feel like a daunting task. Joy Organics reviews are generally positive and the brand submits to independent lab testing which is very important for establishing trustworthiness in OTC products. For patients with sensitivity to flavors due to nausea or other concerns, there are also resources for those who may be wondering “what does CBD oil taste like?”

General support for tooth pain is also very helpful. Taking steps such as finding soft foods to eat and using a cold compress can make a big difference in relief.

Conclusion

There are many different potential causes of tooth pain. These can often be difficult to distinguish from one another without an exam. If your pain is stubborn and keeps coming back (even for just a few days!) it is best to schedule an appointment for a dental exam to make sure you receive appropriate care!

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