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Causes of Upper Toothache

author image Dr. Steve Tuggle
Dr. Steve Tuggle has been writing dental, health, fitness and wellness articles since 2007. He has been published in the “Journal of Endodontics” and is the author of “The Relaxed Root Canal” ebook. He completed his dental degree and endodontic residency at the Medical College of Georgia School of Dentistry.
Causes of Upper Toothache
A young woman holding her cheek with a toothache. Photo Credit diego_cervo/iStock/Getty Images


The upper teeth lie in close proximity to the maxillary sinus, eyes, ears and temperomandibular joint. These can make it challenging to differentiate between pain that originates in the teeth or in some other source. Trained medical and dental professionals often work together because of the complex causes of upper toothache.

Abscessed Tooth

Dental decay, multiple dental restorations, cracks and trauma can cause an upper tooth infection. Each of these is able to cause irreversible damage to the dental pulp or nerve of the tooth. An infected pulp causes inflammation and infection at the tip of the root known as apical periodontitis. This condition results in pain while chewing, spontaneous pain or a prolonged ache after hot or cold foods or beverages contact the tooth. The treatment for an abscessed tooth is root canal treatment. This removes the diseased tissue and seals the root from future infection. Root canal treatment saves most teeth from extraction unless it is extensively decayed or fractured, according to the American Association of Endodontists. The only alternative to this is tooth extraction.

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Sinus Infection

The root tips of maxillary posterior tooth lie at the floor of the maxillary sinus. Sometimes the root actually protrudes into the sinus cavity. When the lining of the sinus becomes inflamed or infected, it is painful and can make the teeth ache, according to the Cleveland Clinic. Careful testing of each tooth with hot, cold and biting tests is critical to a correct diagnosis. Palpating the tooth, gum and bone surrounding the tooth will also provide needed information. Dental X-Rays combined with these tests determine if the toothache is of dental or sinus origin.

Gum Infection

Plaque accumulation between the gum and tooth surface results in periodontal disease. The gum tissue loses its attachment to the tooth and bone. A pocket forms that is no longer cleansable with brushing and flossing. A dental professional must clean this pocket in order for the gum to regain its attachment to the tooth. A pocket that is not appropriately treated may become infected. A gum infection can cause tooth sensitivity until it receives the necessary treatment, according to the National Institute of Dental and Craniofacial Research. A bad taste and swelling in the gum often accompany this condition.

TMJ Disorder

The temporomandibular joint is the joint that articulates the lower and upper jaws. Bone and soft tissue compose this joint positioned in front of each ear. Inflammation and pain in this joint can be confused with upper toothache, according to the University of Rochester Medical Center.


Rapidly seeking professional care when upper toothache begins can help prevent the development of a more serious problem such as the spread of infection. Treatment may include antibiotics, pain medication and dental treatment.

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