Tooth pain can take many forms: Gnawing or throbbing. Sharp or shooting. Sore or radiating. But one thing is for sure — a toothache can make you miserable. But why do your teeth hurt, exactly?
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Here's what causes tooth pain in general: The innermost layer of your teeth — called the pulp — contains large blood vessels and nerves, which are some of the most sensitive in your body, according to the Cleveland Clinic. So when they become irritated, inflamed or infected, you're likely to experience a painful twinge in your teeth.
Here, New York State Dental Association member Christopher Calnon, DDS, shares some of the most common reasons why your teeth hurt along with tips to help you get to the root of your dental discomfort.
If you have a toothache, see your dentist right away. The longer you wait, the greater the problem — and the pain — can become.
1. You Have a Cavity
But sudden tooth pain can be a sign you have a cavity, because as the decay progresses in size and spreads inward to the inner core of the tooth (nearing the nerve), it can trigger a toothache or symptoms like sensitivity to sweets, heat or cold (more on this later), he says.
Fix it: A smaller cavity (i.e. superficial decay) is usually treated by placing a filling (a material used to fill in the area where your dentist removes the rot), while a tooth with larger decay may require a crown (a protective cap placed on top of the damaged tooth), Dr. Calnon says.
"But if the decay progresses to a point where it impacts the nerve of the tooth, it can cause infection, which leads to the need for either a root canal or extraction of the tooth," he says.
Why Do Your Teeth Hurt When You Run?
Cavities may also be to blame for tooth pain when you run (or do other exercise), as the repetitive movement can trigger pulsating pain in the affected area. Outside factors — like exposure to cold weather — can likewise make a cavity ache.
2. You Have a Damaged Filling
Dental fillings don't last forever. Unfortunately, due to time or habits (like grinding), they can become damaged or loose.
"Damaged fillings can lead to big problems, and patients may not know about it until it's too late," Dr. Calnon says. In other words, until they experience excruciating pain.
"A healthy filling has a good seal between the tooth and the filling itself," Dr. Calnon says. This prevents bacteria from getting underneath and causing more decay.
"But if a filling is damaged, the seal may be compromised," Dr. Calnon says. This means bacteria may enter and create decay. The problem is, because the filling is still in place, decay may go undetected and grow, he adds.
Fix it: Going to regular dental check-ups is a great way to catch this problem before it balloons into a bigger issue. Your dentist will want to replace the filling "as soon as possible to prevent more decay from happening," Dr. Calnon says.
3. You Have a Sinus Infection
Have you ever been curious why your teeth hurt when you're sick or have a cold? Believe it or not, the reason all your teeth ache could be a side effect of sinus issues.
"Sinus infections can often mimic a toothache, especially on upper back teeth," Dr. Calnon says. That's because "pressure in the sinus cavity can be exerted on the nerves of nearby teeth, creating pain and sensitivity," he explains.
Fix it: Sinus infections are usually viral and clear up on their own in seven to 10 days, but you can try a few natural remedies to help you feel better in the meantime. If your symptoms don't improve in about 10 days, see your doctor, who may prescribe an antibiotic if they determine you're dealing with a bacterial infection.
"But if the sinus pressure is due to things like seasonal allergies, over-the-counter decongestants can sometimes help," Dr. Calnon says.
4. You Grind or Clench Your Teeth
If you're wondering why your teeth hurt at night or when you wake up, it could be the product of bruxism, a condition that happens when you unconsciously grind or clench your teeth.
"Grinding and clenching are very common and usually done at night when jaw movements cannot be consciously controlled," Dr. Calnon says.
Some people also grit their teeth during high-exertion activities like exercise, which is why your teeth may hurt when you bite down.
The problem is, "this [pressure] places far more force on the teeth than they are designed to receive," producing pain and sensitivity, Dr. Calnon says. Clenching can even cause cracked or chipped teeth and/or wear down your tooth enamel.
According to Johns Hopkins Medicine, other signs and symptoms of bruxism include:
- Facial pain
- Popping or clicking in the temporomandibular joint (TMJ)
Fix it: To break the habit of bruxism, your dentist may make you a custom mouthguard to wear at night, Dr. Calnon says. These mouthpieces help absorb the force of biting and decrease damage to the teeth, per Johns Hopkins Medicine. (If a custom guard isn't in the budget, you can consider buying an over-the-counter night guard.)
Learning to incorporate stress-reduction techniques is also an essential part of treatment, as tooth-grinding and stress have a strong correlation, Dr. Calnon says.
5. You Have Cold Sensitivity
If you've ever winced after sipping on an icy slushy because all your teeth hurt suddenly or had front tooth pain after biting down on an ice cream sandwich, you've likely experienced the discomfort of cold sensitivity.
Cold sensitivity is extremely common and has several possible causes. If the sensitivity is brief in duration and minor in severity, it's likely related to tooth grinding or recession of the gum tissue, Dr. Calnon says.
"Cold sensitivity that lingers for several minutes or is severe in nature can indicate a bigger problem, like decay or tooth fracture," he says.
Fix it: "Controlling the grinding with a mouthguard or using sensitivity toothpaste for gum recession are typical first-line treatments," Dr. Calnon says.
But if you're dealing with decay or a tooth fracture, treatment options may include placement of a filling, a root canal or, possibly, extraction of the tooth, depending on the diagnosis, he says.
6. You Have a Tooth Fracture
Just like a broken bone, a crack in your tooth can create pain. A fractured tooth can occur due to something simple like biting into a hard candy or something more serious like a sports injury, according to the Cleveland Clinic. Tooth grinding and clenching also increase your chances for a fracture.
"Tooth fractures have a wide range of severity based on the size and depth of the fissure," Dr. Calnon says. "Many teeth with superficial fractures cause no symptoms."
But as a fracture grows, it can become painful. "This happens when either a piece of the tooth breaks off or neighboring pieces of the same tooth are forced in opposite directions when biting down," he says.
Fix it: To fix a tooth fracture, your dentist may place a filling or a crown on the tooth. In some cases, if the fracture extends deeper into the tooth, it may require a root canal or extraction, Dr. Calnon says.
Visit your dentist right away if you fracture your tooth. In the meantime, you can ease tooth pain by using an ice pack, rinsing your mouth with salt water and taking over-the-counter pain medicine, per the Cleveland Clinic.
7. You Have Gum Disease
Your gums could be the reason why your teeth hurt. Yep, mild forms of gum disease like gingivitis can initiate inflammation and irritation of the gum tissue (think: red, swollen or itchy gums that bleed when you brush your teeth), Dr. Calnon says.
And if you're wondering why your teeth hurt when you eat, that's because gingivitis can also create sensitivity to hot or cold foods and tenderness or pain when chewing (which is why all your teeth may hurt on one side), according to the Cleveland Clinic.
Severe cases of gum disease can even lead to infections of both the gums and the surrounding teeth, Dr. Calnon says.
What's worse, when not properly treated, gum disease can weaken the bone structures that support the teeth, causing them to become loose, according to the Centers for Disease Control and Prevention.
Fix it: Mild gum disease is best managed with proper oral hygiene practices and regular dentist visits (including professional cleanings), Dr. Calnon says. "Depending on the severity of gum disease, treatment may also include deep cleanings, gum surgery or even removal of the teeth," he adds.
To avoid gum problems, prevention is key. Here are some tried-and-true tips to counteract gingivitis, per the Cleveland Clinic:
- Brush twice a day and floss daily.
- Manage your diabetes, which can increase your risk of gum disease.
- Don't smoke or use other tobacco products.
- Limit alcohol and sugar intake.
- Go for annual dental checkups (more often if you have any symptoms or a family history of gum disease).
Sometimes seemingly harmless habits can damage your gums, like brushing your teeth too hard. Avoid hurting your gums by using soft-bristled toothbrushes and only applying light pressure while you scrub.
8. You Have an Abscessed Tooth
An abscessed tooth can be agonizing. An abscess is a painful pocket of pus caused by a bacterial infection inside the tooth, according to the Cleveland Clinic.
"Tooth abscesses often result from large decay that has entered the nerve tissue of the tooth," Dr. Calnon says. "The abscess can travel beyond the tooth and into the surrounding tissues, leading to swelling and significant pain."
Per the Cleveland Clinic, other signs of an abscess besides tooth pain include:
- Tooth sensitivity to hot or cold temperatures
- Bitter taste in the mouth
- Foul-smelling breath
- Gum redness and swelling
- Loosening of the tooth
- Swollen area in the upper or lower jaw
- Open sore on the side of the gum
- Swollen neck glands
Fix it: "Tooth abscesses should be treated immediately," Dr. Calnon says. Initial treatment usually involves draining the abscess and/or taking antibiotics, but sometimes an abscess may require a root canal or extraction of the tooth, he says.
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.