Pain is your body’s way of letting you know that something is wrong, but it can be difficult to determine the exact source of your pain. Toothache pain, for instance, can have numerous causes—each of which requires a different approach to both treatment and resolution. Below, we will examine some of the most common causes of toothaches and how you can go about relieving the problems associated with them.

1. Cavities

Cavities (also called dental caries) are one of the top causes of toothaches. A cavity is a localized area of tooth decay and is caused by the action of bacteria in your mouth. While most cavities are not painful, a cavity that is large or deep enough can lead to tooth sensitivity or to pain. Your teeth are alive and are filled with nerves and blood vessels, and decay can cause irritation to these structures.

The best treatment for a cavity is a filling from your dentist. If you suspect you have a cavity, or if you experience a toothache, you should make an appointment right away. In the meantime, brush your teeth as you normally would. Do not avoid brushing the painful area, but also be careful not to scrub that location too vigorously or to pick at it. You may use Listerine or another antiseptic mouthwash, following the label directions, but this will likely not resolve the pain from a cavity.

2. Infected Tooth

A dental infection is a potentially serious issue. Decay or trauma can lead to infection of the soft tissue in the inner canal of a tooth. Left unchecked, such an infection can threaten your tooth and your health. The infection could enter your bloodstream, moving throughout your body. Remember that any oral infection requires immediate professional treatment. Your dentist may be able to save your tooth with a root canal. Additionally, antibiotics may be prescribed, if appropriate, and other measures may be taken to help control and eliminate the infection.

Some patients visit the emergency room for severe toothaches, but this should not be your first choice for treatment. ER personnel may be able to provide temporary pain relief until you can see a dentist, but they will not be able to definitively treat your infected tooth.

3. TMJ Issues

The temporomandibular joints (TMJ) are another name for your jaw joints. Sometimes these joints become inflamed or suffer other problems, leading to pain that may radiate to your teeth. Collectively, these issues are known as temporomandibular joint disorder (TMD). Many cases of TMD are mild, and you can try over-the-counter pain relievers like acetaminophen to treat the pain. However, if the pain does not resolve or if it is more severe, it is time to see your dentist who can diagnose the root of the problem, recommending effective treatment.

4. Transferred Muscular Pain

In addition to the muscles of your jaw, other muscles in your head can cause pain to be transferred to your teeth. These muscles include those in your face and in the occipital (back of the head) region. When these muscles become sore or irritated, you may also feel toothache. Again, acetaminophen may be a good choice for an initial treatment attempt, but you will need to visit your dentist or your physician if the problem persists.

5. Bruxism

Bruxism is the medical term for teeth grinding, typically during sleep. Telltale signs of bruxism include waking with an aching jaw or excessive wear of your teeth. Uncontrolled bruxism can lead to TMD, to chronic pain, and even to tooth loss. Fortunately, bruxism is treatable. Speak with your dentist right away to get set-up with a custom nightguard to protect against nocturnal teeth grinding and the resulting toothaches.

6. Migraine

Migraines are more than simple headaches and can cause light and sound sensitivity, nausea, and severe pain. Once again, this pain may be transferred throughout your head, including to your teeth. The goal in this situation is to control your migraines. Talk with your family doctor or with your neurologist about treatment strategies to prevent migraine episodes or to limit their occurrence.

7. Dental Trauma

Of course, dental trauma is likely to result in dental pain. If you take a fall or are in an accident and injure your teeth, you will likely notice some soreness. Over-the-counter pain medication will usually take care of the problem, as long as all your teeth are intact.

However, if you have a loose or missing tooth, you need to see your dentist right away. In the event a tooth was knocked out, handle it by the crown and not by the root. Place the tooth back in the socket, if possible. Otherwise, keep it in a glass of milk or in clean water. Remember, time is of the essence. You should try to see your dentist immediately.

8. Cardiac Problems

The symptoms of a heart attack or a myocardial infarction can include pain that is felt in the teeth or face. Chest pain that is typical of angina can also spread to your teeth. Of course, just because you have a toothache does not mean you are having a heart attack. However, you should be aware that cardiac issues can manifest as pain in both your mouth and teeth, as well as in your arm.

You should always consider chest pain to be a medical emergency. If you notice chest pain or tightness, call 911, or get to an emergency room immediately.

9. Temperature Sensitivity

Sensitivity to hot and cold can be another cause of toothaches. Cold drinks, ice cream, coffee, and hot foods can all trigger pain or aching in your teeth. If you notice this problem, bring it to your dentist’s attention. The issue could just be mild teeth sensitivity, but it could also be a sign of a larger concern. Your dentist may prescribe special toothpaste or other treatments to alleviate the pain. You should also note that teeth sensitivity is a particular problem for many women during pregnancy.

10. Diabetes

Uncontrolled diabetes can have many health consequences, including dental pain. Chronically high blood sugar affects circulation, such as blood flow to the teeth. Restricted blood flow can prevent the necessary nutrients from reaching your teeth, decreasing their ability to heal. Additionally, diabetics may experience nerve pain in their teeth.

Let your dentist know if you have diabetes, and keep them updated on your level of blood sugar control. Also, apprise your dentist if you are experiencing any kind of dental pain. Finally, work closely with your dentist, your primary care physician, or your endocrinologist to keep your blood sugars at optimal levels.

Not sure what type of toothache you have? Millennium Dental can check for all these causes and help you get the expert care you need. We know teeth!


  • Ardila, C.M. et al. “Association between dental pain and caries: a multilevel analysis to evaluate the influence of contextual and individual factors in 34 843 adults.” Journal of Investigative and Clinical Dentistry. 2016 Nov;7(4):410-416.
  • Currie, C.C. et al. “Dental Pain in the Medical Emergency Department: A Cross-Sectional Study.” Journal of Oral Rehabilitation. 2017 Feb;44(2):105-111.
  • Kruger, M.S. et al. “Dental Pain and Associated Factors Among Pregnant Women: An Observational Study.” Maternal and Child Health Journal. 2015 Mar;19(3):504-10.
  • Schames, S.E. et al. “Nonodontogenic Sources of Dental Pain.” CDA Journal. 2016 August;44(8):507-513.

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