What’s Causing My Toothache? 5 Common Causes and When to Call the Dentist

Tooth pain can start small and quickly turn unbearable. Whether it throbs when you chew or lingers after a sip of cold water, a toothache is your body’s way of signaling that something is wrong. Knowing what causes it helps you act fast and avoid serious dental problems later.

five common causes of toothache

Here are five common causes of toothache and when you should call a dentist.

1. Tooth Decay

Tooth decay is the most common reason people feel pain in their teeth. It happens when bacteria feed on leftover food particles and produce acid that wears away the enamel. Over time, this decay reaches the inner layers of the tooth, where nerves become exposed and sensitive.
You might feel:

Sharp pain when eating sweet or cold foods.
Visible holes or dark spots on your tooth.
A dull, constant ache that worsens at night.

If the pain persists for more than two days, you need a dental checkup. Early treatment prevents the cavity from spreading deeper.

2. Gum Disease

Gum disease starts with swollen or bleeding gums. When bacteria build up along the gumline, they irritate the tissue and pull it away from the tooth. This creates pockets where infection grows, causing pain that feels like it comes from the teeth.
Look out for:

Red or swollen gums.
Bleeding when you brush or floss.
Bad breath that does not go away.

If ignored, gum disease can cause destruction of your underlying jawbone. A professional cleaning and improved oral care can stop it from getting worse.

3. Tooth Fracture

A cracked tooth can hurt even if the crack is too small to see. According to Cleveland Clinic, It often happens when you bite something hard or grind your teeth at night. The pain appears when you chew or expose the tooth to temperature changes.
You might notice:

Sudden, sharp pain when biting down.
Sensitivity to hot or cold.
Pain that comes and goes.

A dentist can seal the crack or apply a crown to protect the tooth. Waiting too long may cause infection or tooth loss.

4. Dental Abscess

An abscess forms when bacteria infect the root of a tooth or the gum around it. The pain is usually severe and constant. You might also feel swelling in your face or jaw.
According to Health and Safety Executive (Ireland), symptoms include:

Throbbing pain that spreads to your ear or neck.
Swelling in the cheek or gums.
Fever or general weakness.

This is a dental emergency. Call your dentist right away. The infection needs drainage and antibiotics.

5. Teeth Grinding (Bruxism)

Grinding your teeth wears down enamel and stresses the jaw. Many people do it during sleep without knowing. The constant pressure causes tooth sensitivity and pain in the morning.
Watch for:

Flattened or chipped teeth.
Jaw pain when you wake up.
Headaches near the temples.

Your dentist might suggest a night guard to protect your teeth and reduce strain.

When to Call the Dentist

Mild tooth sensitivity after eating something hot or cold often passes quickly. That type of discomfort is usually not a reason for concern. But when the pain becomes persistent or stronger, it signals something more serious that needs a dentist’s attention.

You should schedule a dental visit if:

The pain lasts longer than two days.
Short, occasional discomfort can happen from temperature changes or brushing too hard. Continuous pain that lingers means the tooth’s nerve or surrounding tissue might be inflamed or infected. A dentist can identify the source before it spreads or worsens.
You have swelling in your jaw, gums, or face.
Swelling means infection is present. This can spread beyond the tooth into surrounding tissues or even the bloodstream. If you notice visible puffiness, tenderness, or difficulty opening your mouth, call your dentist immediately.
You notice pus, a foul taste, or bad breath.
These signs often point to an abscess or severe gum infection. Pus forms when bacteria collect under the gum or around the tooth root. The only way to remove the infection is through professional treatment, which may include draining the abscess and using antibiotics.
You develop a fever.
Fever is your body’s response to infection. When it appears with tooth pain, it suggests the infection is spreading. Waiting too long increases the risk of complications, including bone infection or sepsis.
The tooth feels loose or changes position.
Adult teeth should never move. If one feels loose or shifts slightly, gum disease or bone loss might be developing beneath the surface. Early intervention can save the tooth.
You experience pain while chewing or biting.
Pain that occurs only when you bite down might indicate a cracked tooth or damaged filling. The pressure exposes the inner layers of the tooth, causing sharp pain. Treating it early prevents the crack from deepening.

Ignoring these signs often turns a small problem into a serious one. Even if the pain fades for a while, the cause may still be active beneath the surface. Contact us today at Glow Up Dentistry to book an appointment or learn best ways to protect your teeth and avoid long-term damage.

Dr. Ginger Unegbu DDS

Dr. Ginger Unegbu, DDS, is a highly skilled and compassionate dentist dedicated to providing exceptional oral care. A proud Houston native with Nigerian heritage, she earned her bachelor's degree in Exercise Science from the University of Houston before obtaining her Doctor of Dental Surgery (DDS) from Howard University College of Dentistry in 2019.

As a recognized expert in preventive, restorative, and cosmetic dentistry, Dr. Unegbu is an esteemed member of the Academy of General Dentistry and the International Dental Implant Association. She has received numerous accolades, including the prestigious Student of the Year Award from the Academy of Osseous Integration. Her commitment to patient education and advanced dental treatments ensures that individuals receive top-tier, evidence-based care for optimal oral health.