Getting to grips with toothache: Causes, treatments, and prevention

Common causes of toothache

There are several factors that can trigger the onset of toothache. These include:

Tooth decay

Tooth decay occurs when a build-up of plaque develops and damages the surface of the tooth. Left untreated, this can progress and cause cavities (holes) in the teeth that usually require a filling. It can lead to toothache if the nerve in the inner tooth becomes impacted. Tooth decay can also lead to sensitivity, characterised by pain or tenderness when consuming hot or cold food and drink.

Dental abscess

A dental abscess is an oral infection causing a build-up of pus in the teeth or gums that requires urgent treatment from a dentist. They may prescribe antibiotics to help clear up more serious infections. It can occur as a result of tooth decay or gum disease, an oral injury, or if a tooth has had trouble growing out of the gum properly. You may also be more likely to develop a dental abscess if you’re undergoing chemotherapy or radiotherapy treatment.

A cracked tooth

A cracked or chipped tooth can occur as a result of teeth grinding during sleep, a mouth injury from activities like playing contact sports, or eating certain food types that are particularly hard. Although not usually serious, you should see your dentist for advice and to reduce the risk of complications. The NHS recommends keeping the tooth fragment in milk or saliva and taking it to your dental appointment as it may be possible for the dentist to glue it back on.

Oral infection

Mouth infections can cause pain and discomfort. They are often caused when a tooth isn’t able to fully break through the gum as it grows. This may affect adult teeth coming through in children, or wisdom teeth in adults. Speak to your dentist for advice if the infection does not clear up on its own.

Filling complications

If you’ve had one or more fillings, these can become loose or damaged over time and cause irritation and discomfort. If you notice a filling has become broken or loose, make an appointment with your dentist to have it repaired or replaced.

Issues with braces

Teeth straightening and alignment can sometimes cause discomfort. This is most likely when a brace is first fitted or when it is periodically tightened. Speak to your orthodontist about what you can do to help alleviate any pain caused during or after your appointments. An orthodontist is a dental expert who specialises in teeth alignment.

Helping to treat toothache at home

The best treatment for your toothache will depend on the cause, although there are things you can do to help ease pain and discomfort:

• Painkillers such as ibuprofen or paracetamol can usually help to relieve toothache. Ensure you follow the guidance outlined in the patient information leaflet.

• Rinsing your mouth with salt water can also help to keep the affected area clean. To do this, mix half a teaspoon of salt in a glass of warm water (boiled from the kettle and left to cool) then rinse around your mouth before spitting the solution out. This can be done several times a day if you find it provides relief. This is only appropriate for adults and not suitable for children.

• Use a soft-bristled toothbrush to reduce irritation when cleaning your teeth.

• Try a pain-relieving oral gel such as Bonjela to cool and soothe the affected area.

• Opt for soft, smooth foods that won’t irritate your gums and teeth. Yoghurt, soups, or scrambled eggs provide good sources of nutrition and should be more gentle on the mouth.

When should I see a dentist?

You should make an appointment to see your dentist if:

• You notice swelling around the mouth, cheeks, or jaw area

• You have a temperature above 38°C, inflamed gums, an unpleasant taste in your mouth, or pain when you bite

• Painkillers don’t relieve the discomfort your toothache is causing

• You’ve had toothache for longer than 2 days

If you develop swelling in the neck or eye area with your toothache or have swelling that’s interfering with your breathing, speech, or ability to swallow, call 111 or visit A&E straight away.

Preventing the leading causes of toothache

Toothache can negatively impact everyday life, causing pain, discomfort, and irritation. However, there are steps you can take to help prevent the leading causes of toothache.

Limit your sugar intake

High-sugar food and drink is the number one cause of tooth decay. Reducing the amount of sugary snacks and drinks you consume can help to protect teeth, along with other health benefits.

Set a good oral hygiene routine

Clean teeth twice daily for around 2 minutes each time, using a fluoride toothpaste. You can also help to protect your teeth and prevent plaque build-up by using an interdental brush to remove debris and food from between the teeth.

See your dentist regularly

Depending on your oral health, the dentist will advise when you should see them for a check-up. This may be between 12 months to 2 years if your teeth, gums, and mouth are relatively healthy. Find out what to expect from your dental visit in this NHS guide.

Get help to quit smoking

Smoking can have a significantly negative impact on your oral health, from gum disease to mouth cancer to losing teeth and tooth decay. If you’re a smoker, find help and advice to stop smoking in our Health Hub.