What causes a toothache?
The cause decides the fix, so it is worth knowing the usual ones:
- Decay that has reached close to the nerve. It often starts as a twinge with cold or sweet things and becomes an ache that lingers after the cold has gone.
- A cracked tooth, which tends to give a sharp pain when you bite down or let go, and can look perfectly normal. A chip or a broken tooth is easier to spot.
- A dental abscess, which is an infection at the tip of the root or in the gum. Expect a constant, throbbing ache, tenderness when you bite, and sometimes a bad taste or a small bump on the gum.
- A gum infection, often around something wedged under the gum, such as a popcorn hull.
- Sinus pressure, which can make several upper back teeth ache at once, often worse when you bend over.
- Grinding or clenching, which leaves the teeth and jaw muscles sore, often first thing in the morning. TMJ treatment looks at the jaw side of that.
What to do for a toothache right now
Until you are seen, these are worth doing:
- Rinse your mouth with warm water to clear out anything caught around the tooth.
- Floss gently on both sides of the tooth. Sometimes the whole problem is a piece of food pressing on the gum.
- Take an over-the-counter pain reliever, exactly as the label directs, if it is safe for you to take.
- Hold a cold compress against your cheek, in short spells, to ease swelling and throbbing.
- Sleep with your head raised on an extra pillow, which can take the edge off a throbbing ache at night.
- Do not hold an aspirin against the gum next to the tooth. It is an old remedy that burns the gum and does nothing for the tooth.
When is a toothache an emergency?
Some toothaches can wait for an ordinary appointment. Call now, rather than waiting to see whether it settles, if you have any of these:
- Swelling in your face, jaw or gum.
- A fever along with the toothache.
- Pain that wakes you at night, throbs, or is set off by heat.
- A bad taste in your mouth or a bump on the gum near the tooth.
When to go to the emergency room instead
A dental office is the wrong place for some problems. Go to a hospital emergency room now for swelling that is closing an eye or spreading down the neck, for difficulty breathing or swallowing, for a suspected broken jaw, or for bleeding that will not stop after firm pressure. Those need a hospital first. Call us afterward and we will take care of the dental side.
What happens when you call
Call 540-921-3323. Appointment scheduling is available 24/7, so there is no need to wait for office hours to pick up the phone. Tell whoever answers what has happened and they will get you seen. We are at 300 Tazewell Street in Pearisburg, with parking at the door.
At the appointment we ask where it hurts and what sets it off, look at the tooth, test it, and take a digital X-ray, which needs a fraction of the exposure that film did. Then we explain what we found, what the options are and what each costs, before anything is done. Depending on the cause, the fix might be a filling, a root canal to clear the infection from inside the tooth, or taking out a tooth that cannot be saved.
If you are nervous, say so when you call. The tooth is numbed properly before we start, we explain each step before we take it, and nitrous oxide is available if you would like it.
Why a toothache should not wait
A toothache rarely fixes itself. The pain can come and go, but the cause is usually still there, and a tooth that could be saved with a filling this month can need a root canal or an extraction later. Seeing it early usually means the smaller, cheaper fix.
If it has been longer than you would like to admit since you last saw a dentist, that is the usual reason people call. Nobody here is going to make you feel bad about it.
Questions patients ask
Can a toothache go away on its own?
The pain sometimes does, but the cause usually does not. A toothache that stops suddenly can mean the nerve inside the tooth has died, while the infection that killed it carries on. It is worth having the tooth checked even after it goes quiet.
Should I go to the emergency room for a toothache?
Go to the emergency room if you have swelling that is closing an eye or spreading down your neck, or any difficulty breathing or swallowing. For a toothache without those signs, a dentist is the right place, because an emergency room can ease the pain but usually cannot treat the tooth itself.
Why does my toothache get worse at night?
Lying down sends more blood to your head, so an inflamed nerve can throb harder once you are in bed. Pain that wakes you is a sign the nerve is involved, and it is worth calling about rather than waiting.
Could my toothache be coming from my sinuses?
It can. The roots of the upper back teeth sit close to the sinuses, so congestion can make several upper teeth ache at once, often worse when you bend over. If the pain is in one tooth, or in a lower tooth, the sinus is a less likely cause.