Causes Of Severe Toothaches

January 25, 2019 by dalvarengadds0

Toothaches occur when there is an irritation to the nerve located at the root of the tooth or teeth. A severe toothache can be a minor issue in some cases while in other cases it is a major concern depending on how the pain started. It is important to understand that some cases of severe tooth pain can be easily fixed while others require a specialist (dentist) intervention.

Pain can also be from some other part of the body and is radiating to the jaw and thus being confused as tooth pain, however, this is rare and can be experienced in individuals suffering from cardiovascular disease and this pain also radiates to the left shoulder, but it is originally from the sternum. Other common sources of radiating pain to the jaw include the ears, sinuses, throat and temporomandibular joint. Some symptoms are specific to tooth pain and have been used to distinguish referred pain from the actual tooth pain. The symptoms include:

  1. Pain when the tooth is touched for example during chewing or when one taps a tooth.
  2. Pus or any other form of discharge around a tooth or the gums.
  • History of a recent trauma or injury to the jaw or tooth.
  1. Increased sensitivity to stimulus especially hot or cold substances in the mouth.
  2. Bleeding of the gums around a tooth.
  3. Presence of swelling around the tooth or the entire jaw.
  • The throbbing of the affected tooth.
  • Tooth discoloration.

Some of the causes of a severe toothache include:

  1. Worn enamel

Worn enamel refers to damage to the enamel which is the outer covering of a tooth. The damage is caused by exposure to excessive sugars or acid.  Tooth pain caused by worn enamel is characterized mainly by increased sensitivity to temperatures.

  1. Cavities

A cavity also called a tooth decay, is simply a hole in the tooth. This hole is caused by progressive damage to the enamel which eventually leads to exposure of the sensitive nerves of the tooth. Severe tooth pain caused by cavities is characterized by sharp pain especially during biting and chewing.  If a dentist does not fill the cavities, they could result to serious infection and inflammation of the tooth.

  1. Injury to the tooth

Injury to a tooth or teeth can be caused by biting hard substances, trauma or a mechanical damage to the teeth or jaw. The injury results to exposed nerves deep inside the tooth which eventually lead to severe tooth pain. If your tooth is cracked or chipped, a dentist can fix this by placing a crown to seal the crack or replace the chipped part.

  1. Abscess

An abscess is caused by the infection of the tooth mainly due to extended periods of having untreated cavities.  Severe tooth pain caused by an abscess will be characterized by redness, throbbing pain, swelling, discharge and a bad taste in your mouth. At this stage, a dentist is required to ensure proper treatment is done. The treatment includes drainage of the abscess, the introduction of a root canal to remove the infected tissue. Antibiotics are also administered to deal with the bacteria causing the infection.

  1. Previous poor dental work

Poor placement of crown to fill cavities or repair damaged tooth may be a cause of severe tooth pain especially when the placed crowns become loose, crack or eventually fall off resulting to the relapse of the original condition.

  1. Gum disease

Gum diseases such as gingivitis are characterized by redness and swelling of the gums. If untreated, they eventually lead to periodontitis which damages the bony structure supporting your teeth. The gum may also become infected and eventually spread this infection to the tooth, and this can cause severe tooth pain.


  1. Indirect causes

In most cases, referred pain to the jaw or tooth is not severe, but a sinus infection may present with severe referred tooth pain. This pain is characterized by throbbing pain, a dull ache and in some cases difficulty in feeding. The pain is usually molar as the sinus is close to the nerve roots of the molar teeth. Infection of the sinus thus causes pressure to these roots leading to severe tooth pain.


There are different ways to manage severe tooth pain. Medical intervention is needed in cases that present with the following features:

  1. Severe tooth pain that is not relieved by over the counter drugs or analgesics.
  2. Severe tooth pain that is experienced 2- 3 days after a tooth extraction. This pain is caused by a condition known as alveolar osteitis or the dry socket syndrome, and one is encouraged to seek medical intervention within 24 hours of experiencing this pain.
  • Severe tooth pain that is associated with the swelling of the gums or the face.
  1. Presence of discharge around a tooth. The discharge is mainly associated with  a bacterial infection or an abscess, and thus surgical and medical intervention is necessary to treat the condition
  2. Severe tooth pain associated with broken or knocked out teeth.
  3. Pain that is persistent every time you try to open your mouth wide. This pain is associated with the temporomandibular joint, and a dentist intervention is needed.
  • Trouble swallowing or excessive bleeding from the gums.
  • Dental or gum infections in individuals with a history of diabetes, a weakened immune system or a history of steroid use. Any infections in individuals with the stated medical issues require aggressive treatment and thus medical intervention is needed.
  1. Any jaw pain that is associated with pain elsewhere in the body such as chest pain. This case represents referred pain from elsewhere in the body and a doctor is needed to treat the underlying condition.
  2. Severe tooth pain associated with fever.

In cases where the above features do not apply, home remedies may be used to relieve the pain, but if persistent, then medical intervention is needed. Some of the recommended home remedies are;


Saltwater rinse is an effective method to remove stuck food. You can swish warm salty water in your mouth to remove the stuck food which could be irritating to the nerves leading to the pain. The water should not be swallowed.


You can place an ice pack on your cheek to relieve the pain especially if your face is swollen. This method is used in cases where a chipped or cracked teeth is the cause of the pain.


Over the counter pain relievers usually help to ease the pain. Acetaminophen is recommended for children while adults may use aspirin or ibuprofen. The drugs are to be swallowed and not put on the tooth.


These pain relievers, unlike analgesics, are applied directly to the teeth or tooth from which the pain is emanating. They are usually in gel or liquid form and contain benzocaine. Unfortunately, they only relieve pain for a short period.


You can rub the clove oil directly to the tooth or soak a cotton ball and dab the clove oil against the affected tooth or gum. This is a natural remedy, and it has been found to be as effective as benzocaine.


Placing chopped garlic pieces on your affected tooth has been found to relieve the pain. Garlic has been found to have pain-relieving and antibacterial properties which helps to ease the pain.


This chemical can be used alone or it can be mixed with warm water.  You gargle for a few minutes and then spit it out. Swallowing is not recommended.


You can bite a peppermint tea bag for a few minutes until the pain subsides.


Onion, like garlic, has both pain-relieving and antibacterial properties. A freshly chopped onion should be placed close to your aching tooth for a few minutes, and this will help ease the pain.


Apple cider vinegar is acidic and has both antiseptic and anti-inflammatory properties. It kills the bacteria causing the toothache. You soak a ball of cotton wool in the vinegar and press it gently on the tooth.


The swishing of alcohol kills the germs causing the toothache and also works as a pain reliever. Alcohol that can be used includes whiskey, vodka, scotch or brandy.


  1. You can buy a mouth wash that has methyl salicylate. The organic compound has been found to be one of the best pain relievers for pain experienced in any part of the body. This mouthwash will help with the pain.
  2. Decongestant for tooth pain with a sinus infection. This method can be used especially if the pain is in the upper rear teeth which signifies that the sinus is involved. Ibuprofen has been found to be the most effective.

It is important to remember that home remedies and over the counter management of severe tooth pain is only used to relieve pain for a short while. The ADA recommends that you do not go to the Emergency room for toothaches, instead visit our dental office in lake forest for emergency treatment. If the pain is accompanied by the features mentioned earlier, then it is advisable that one visits a dentist so that proper management can be done.

Copyright by Dr. Daisy Alvarenga, DDS 2019. All rights reserved.

Copyright by Dr. Daisy Alvarenga, DDS 2019. All rights reserved.

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