A toothache that will not settle
The single most common reason anybody dials an emergency dentist, and the one where waiting costs the most.
What this covers
- Pain that arrives in waves
- Sharp on cold or sweet, gone within seconds. Usually the least alarming pattern, and often the earliest one, which is why it is also the cheapest moment to get looked at.
- Pain that does not stop
- A dull, constant ache that outlasts whatever set it off. Sustained pain generally means the nerve inside the tooth is involved rather than just the surface, and that is a different conversation.
- Pain that wakes you up
- Night pain, or pain that gets worse lying flat, is the pattern dentists take most seriously. It is the one worth a call first thing rather than at the end of the week.
- Pain on biting
- A tooth that is fine until you put weight on it can point at a crack, a high filling, or something going on at the root tip. Cracks in particular are easy to miss and hard to ignore later.
- Pain with a swollen face
- Once the swelling is visible from outside, this has stopped being a routine toothache. It is dealt with on its own page, and it is the one situation on this site that can turn into a hospital problem.
What happens, in order
- 01
Write down when it started
The date, and whether it has been constant since. It is the first thing anyone will ask and the first thing pain makes you forget.
- 02
Note what sets it off
Cold, heat, sweet, biting, or nothing at all. Each of those points somewhere different, and pain that needs no trigger is the one that gets seen soonest.
- 03
Check whether the outside of your face has changed
Swelling along the jaw or under the eye moves this into a different category. Look in a mirror rather than going by how it feels.
- 04
Call and describe it
Ring (765) 330-8726 and say those three things in that order. That is a useful call. Asking a receptionist to guess the cause is not.
Why a toothache is a late symptom, not an early one
Decay is usually well through the enamel and into the softer dentine underneath before a nerve gets involved enough to hurt. Gum disease can take bone for years and never hurt at all. By the time a tooth is genuinely painful, whatever is causing it has normally had months of quiet head start. That is not meant as a scolding. It is the reason a toothache is worth ringing about on the first bad day rather than the fourth.
The painkiller trap
Over the counter painkillers work on a toothache, and they work well enough that a lot of people manage a week on them and then a second week. The pain going quiet does not mean the cause went quiet. Nerves die, and a dying nerve stops complaining. A tooth that hurt badly for five days and then suddenly felt fine is one of the situations dentists most want to see, not one of the ones they want to hear about a month later.
What a dentist is actually looking for
An exam for tooth pain is mostly a process of elimination, because a tooth cannot say where it hurts with any precision. Pain from an upper molar is regularly felt in the lower jaw and the other way round. That is why the exam and the films cover the whole area rather than the one tooth you point at, and why nobody sensible will tell you what it is over the phone.
Worth knowing
Aspirin does not go on the gum
Dissolving a tablet against the sore area is an old remedy that burns the soft tissue and does nothing for the tooth. Painkillers are swallowed.
Heat on a swollen face is the wrong instinct
Warmth feels better and encourages exactly the thing you do not want if there is infection involved. If the outside of your face is swollen, that page has the detail.
A tooth that stops hurting has not necessarily healed
Sudden relief after days of severe pain is worth a call, not a sigh.
A toothache that will not settle, asked and answered
Can you tell me what is wrong from a description?
No. Nobody can, and the ones who try are guessing. Two people describing an identical ache regularly have completely different things going on. The call is for arranging to be looked at.
How long can a toothache wait?
That depends entirely on what is behind it, which is the thing nobody knows yet. Pain that is constant, that wakes you, or that comes with facial swelling is the version to ring about immediately.
Should I keep taking painkillers until my appointment?
Follow the instructions on the packet and tell the practice what you have already taken and when, on the call. That last part matters more than people expect.
People reading this also needed
Swelling, and when it stops being dental
The one page on this site that will tell you to go somewhere other than a dentist, and mean it.
A chipped or broken tooth
Most of these do not hurt on the day, which is exactly why so many of them get left.
A filling or crown that came out
Usually undramatic, usually painless for a day or two, and one of the quickest problems on this list to get expensive.
Nothing on this page can look at your tooth.
This is general information about a toothache that will not settle. Whether it is what you have, and whether it can be handled here, are both questions for the call.