What the Type of Pain Tells Us
Different pain patterns usually point to different causes:
- Sharp pain with cold or sweet foods → enamel erosion, early cavity, or exposed root
- Lingering pain after cold or hot → decay approaching the nerve
- Sharp pain when biting → cracked tooth or high filling
- Throbbing, constant pain → likely infected nerve or abscess
- Dull, persistent ache → possible grinding, sinus pressure, or gum inflammation
- Pain that wakes you at night → typically an infected or dying nerve
- Swelling + pain + fever → abscess; this is an emergency
Common Causes
Cavities. The most common cause. Starts painless, then sensitive, then throbbing as decay approaches the nerve.
Cracked or chipped tooth. Sharp, intermittent pain when biting down is classic.
Infected pulp (nerve). When decay or trauma reaches the nerve, it can become infected. Often requires a root canal.
Gum disease. Sore, swollen gums and pain at the gumline.
Abscess. A bacterial infection at the root. Often includes swelling, fever, and a bump on the gum. Needs immediate care.
Teeth grinding (bruxism). Generalized soreness, often worst in the morning.
Impacted wisdom teeth. Pressure and pain at the back of the mouth.
Sinus infection. Upper back teeth can hurt when sinuses are inflamed.
Failed filling or crown. Sudden sensitivity where a restoration recently loosened or fell out.
What to Do Right Now
- Rinse with warm salt water (1 tsp in a glass of water)
- Floss to remove anything stuck between teeth
- Cold compress on the outside of your cheek for swelling
- Ibuprofen (as directed) — reduces pain and inflammation
- Avoid extreme temperatures in food and drink
- Never place aspirin directly on the gum — it burns the tissue
- Call us. Pain that lasts more than 24 hours or is severe needs evaluation.
When It's an Emergency
Call immediately — don't wait for business hours to return — if:
- Pain is severe and unrelenting
- You have facial swelling or a fever
- There's a bad taste or pus in your mouth
- Swelling is affecting your ability to swallow or breathe (go to the ER)
- Pain followed recent trauma to the mouth
- A tooth is visibly broken, loose, or discolored
How We Treat Tooth Pain
Treatment depends entirely on the cause. Options include:
- Filling for a cavity
- Crown for a cracked or weakened tooth
- Root canal + crown for nerve infection
- Extraction if the tooth can't be saved
- Deep cleaning for pain caused by gum disease
- Nightguard for grinding
- Antibiotics for active infection (always combined with treatment of the source)
We also use sedation options for anxious patients so pain relief doesn't come with more stress.