Toothache: Know the 10 main causes

Dentist making dental contact lenses
Dr. Natália Morales is a specialist in Endodontics, Implantology, Dental Prosthesis and 3d Dentistry and has been dedicated for 14 years to caring for patients with odontophobia. Reference in humanized care.

In addition, in general, any inflammation that affects the tooth can cause some level of pain (in some cases, the discomfort can be very intense) and, depending on how long the discomfort has been felt, it is necessary to seek support from a dentist.

The truth is that defining toothache is not an easy task, as there are many reasons for this disorder. Some harmful habits for your health can also trigger the problem, which means that you should not only evaluate your health, but also your lifestyle.

In this article, we have selected the main causes of toothache, as well as what you should do when any discomfort arises. Check out!

What are the main causes of toothache?

Your toothache can have several causes and some of them require deeper attention from your dentist. Regardless of what they are, don't ignore any type of oral discomfort, as it could be a sign of a bigger problem, about to affect your health as a whole.

Click here and read our article 10 Tips to keep your teeth healthy and white


This is certainly one of the most common reasons for toothache. But how does caries arise? This is an injury caused by bacteria, which pierce the teeth and damage their structure. In its initial stage, many cavities can be asymptomatic and go unnoticed, but, as the lesions increase, bacteria and other aggressive agents can reach the nerve, causing more intense discomfort.

Typically, the pain caused by decay can appear when eating some very cold, hot or sweet food. Depending on the advancement of the injury, it is possible to feel a nuisance even when touching the affected tooth. Other symptoms of cavities are the feeling of discomfort when chewing, stains on the teeth and bad breath - as leftover food is more easily trapped inside the newly formed cavities.

gum problems

Gum disease, also known as periodontal disease, is another strong cause of toothache. Injuries or wounds at the site can expose the roots of teeth, for example, and cause pain, as this region is more sensitive.

The accumulation of plaque in the gums also causes its retraction, due to the inflammation generated in its initial stages. If left untreated, this inflammation can evolve into periodontitis.


Periodontitis occurs when inflammation affects the structures that provide support to the teeth, such as the alveolar bone and its tissues that promote attachment to the tooth (periodontium). A part of this bone becomes damaged, creating spaces between the teeth and the bone structure - called periodontal pockets, which can also inflame and contaminate the pulp of the tooth.

In that case, by reaching the nerves of the tooth directly, the infection causes a lot of pain and is one of the main causes of tooth loss in adults. When the inflammation of the pockets is not treated, the root of the teeth tends to form some deposits of pus accumulation, known as dental abscesses, which cause an even more intense level of pain.

Abscesses in the roots of teeth

As you just learned, abscesses are deeper inflammations in the region of the roots of the teeth, with the formation of pockets of pus. In more severe cases, bacteria from abscesses can be transmitted through the blood, taking the infection to other parts of the body, such as the neck, head and other regions.

In addition to intense pain, some symptoms of the abscess are swelling, a bad taste in the mouth, redness in the gums, fever, difficulty swallowing and even breathing. Often, the problem also causes an internal bulge in the gum, similar to a pimple. If you pierce it and see fluid oozing out, be sure you have an abscess: that fluid is pus.

dental sensitivity

Also known as dentin hypersensitivity, tooth root sensitivity is a very common cause of pain, affecting 1 in 8 adults. According to a recent survey commissioned by Sensodyne, this sensitivity is the main oral disorder of Brazilians.

Dentin hypersensitivity appears when the gum retracts, revealing the root of the teeth, or when enamel erosion occurs, exposing one of the deepest layers of the tooth — the dentin. Because it has many nerve endings, it is common to feel discomfort when experiencing temperature changes. Therefore, some conditions that wear down teeth can also trigger sensitivity, such as misplaced mobile orthodontic appliances or bruxism.

Although not severe or constant, toothache caused by sensitivity requires a few visits to the dentist when it is very severe and does not improve with the use of toothpastes designed for this problem. In these cases, the professional should recommend the application of fluoride varnish or fixing agents to facilitate the waterproofing of the enamel and dentin surface.


Speaking of tooth wear, bruxism is also associated with this problem because it consists of a dysfunction that causes teeth to grind or clench. In some cases, this is done with great force and is capable of causing problems even in the jaw joints.

Among the main symptoms of bruxism, we have an increase in sensitivity in the teeth, dental wear, pain on the side of the face and even severe headaches. It is worth noting that the grinding of teeth caused by this condition can even cause it to break. Therefore, the dentist usually recommends using an acrylic or silicone plate while sleeping, in order to avoid possible tooth wear and damage.


Incredible as it may seem, in addition to bruxism and other jaw joint problems, toothaches can also arise due to sinusitis and even because of earaches. This is because these inflammations happen in regions very close to the teeth, and can also “reflect” on your nerves.

If you often experience pressure-like pain in your teeth when you have the flu or a bad cold, it could be related to the cavities around your nasal passages. This is because the sinuses, teeth and their nerves are very close together, so the floor of the sinus is right on top of the teeth. Therefore, the feeling of discomfort located in the upper dental arch is a frequent symptom of this type of inflammation.

One way to know if tooth pain is caused by sinusitis is to see if the uncomfortable feeling is limited to just one tooth. If the problem really is respiratory, several points in the dental arcade will be sensitive. Your best bet, in this case, rather than going to the dentist, is to have the infection treated by a specialist doctor.

birth of wisdom teeth

It is common for there to be toothache during the birth (or even in other stages of growth) of the so-called wisdom teeth, either because of the pressure that these new teeth put on the neighbors of the dental arch and jaws, or because of inflammation in the gums during the birth of the wisdom teeth — called pericoronitis by dentists.

Although many clinical cases do not require the extraction of wisdom teeth, the discomfort felt during the birth of these teeth can be a strong sign that surgery is necessary. The sooner the intervention is carried out, the lower the chances of changing the positioning of the other teeth and impairing the aesthetics of your smile.

impacted teeth

If a blow hit you in the jaw area or a fall caused part of a tooth to break, you already know that pain is to be expected. After all, any damage or wear on the surface of the tooth can expose its pulp, which is rich in nerve endings.

Often, toothache is caused by trauma or injuries that go unnoticed by patients. Biting some solid food or suffering some kind of blow to the jaw can cause cracks and injuries to the teeth, even if not visible at first.

poor bone formation

Pain in the teeth, back, head and neck can be the result of poorly developed dental arches. This problem, in turn, can also be the result of a genetic or acquired bone malformation during life, caused by bone loss, for example.

A defective or very small bone structure can make the teeth misaligned, causing pain and making it difficult to breathe. In this sense, the tongue needs to reposition itself inside the mouth, preventing the passage of air. Thus, the salivary glands do not receive the correct stimulus and this prevents the stabilization of saliva acidity.

Recent dental procedures

Some procedures done by the dentist, such as whitening or a root canal, can also cause tooth pain. This happens because the correction of some oral problems creates chances for the emergence of a temporary inflammation inside the tooth or for an increase in its sensitivity.

It's also not surprising that anyone who has had orthodontic work is likely to feel a little uncomfortable right after leaving the office. It makes sense, for example, that moving your teeth causes pain—essentially, it's a controlled form of injury. The wires in the braces put pressure on the ligament in the jaw, which reconditions the bone and allows the teeth to move.

The good news is that the pain you experience is normal and should only last a few days or a few weeks. In the meantime, you can take over-the-counter anti-inflammatory pain relievers for the first 24 to 48 hours after your orthodontic adjustment or a new aligner. However, you should also discuss symptoms with your dentist if the pain level is beyond bearable for more than 24 hours.

What habits favor the incidence of toothache?

In addition to some health problems (such as caries, sinusitis or periodontitis), some bad habits result in toothaches, especially when followed in the long term. In this topic, you will find out what they are.

Click here and read our article 7 Essential Actions for Oral Health: Definitive Checklist

Brush your teeth hard

It's no wonder that many dentists ask their patients with sensitivity to use toothbrushes with soft bristles. Many people think that brushing your teeth hard is a more efficient way to clean them, but the truth is that brushing should be done smoothly and without haste.

Too much intensity when cleaning your teeth helps to damage the enamel, exposing the dentin. In addition, very strong brushing can irritate and retract the gum, also exposing the root of the teeth. The results are harmful for all oral health: pain, bad breath and sensitivity.

Eating erosive foods

A balanced diet promotes numerous benefits to the body and is also important for maintaining oral health. After all, many types of food, as harmless as they may seem, have immense potential to erode the outer surface of your teeth and cause pain, especially when oral hygiene is not done right after meals.

A prominent group with high corrosive potential are sugary foods, especially those with a sticky consistency, such as candies and chewing gum, which stick to the lining of the teeth. In this scenario, bacteria in the mouth convert sugar into an acid that eats away at tooth enamel, paving the way for cavities.

Sweets are not the only culprits when it comes to foods with erosive potential. Some drinks like coffee, sports drinks, red wine and white wine also contain dyes and a level of acidity that can be harmful to your teeth. Within this group, soft drinks are the worst villains, because, in addition to containing a very high amount of sugar, they also have phosphoric and citric acids, which corrode tooth enamel.

Diet sodas allow you to skip the sugar, but they can have even more acid in the form of artificial sweeteners. On the other hand, some of the good foods for oral health, such as ginger, milk and apple, as they have antioxidant properties.

Using teeth as tools

Opening product packages and even bottle caps with your teeth is often convenient, but this is a habit that worries many dentists. Using your teeth as tools can cause cracks, injuries and even break them in half. Instead, keep scissors and bottle openers handy.


Cigarettes — as well as cigars, pipes and other tobacco products — can stain teeth and even cause them to fall out as a result of periodontal disease. Tobacco is also capable of causing cancer of the mouth, lips and tongue. If you were looking for one more reason to quit smoking, think about the quality of your smile!

Chewing items that are not food

Do you bite your nails or chew the back of your pen while trying to concentrate at work? This habit can cause your teeth to chip or even break. If you feel the need to keep something in your mouth, sugarless gum is a less harmful option. They trigger the flow of saliva, strengthening teeth and protecting against acids that damage tooth enamel. When in doubt, always remember that your teeth should only be used for eating.

Make "snacks" out of time

There is nothing wrong with eating between the three main meals of the day (breakfast, lunch and dinner), but you should be aware that constant snacks result in leftover food and plaque on your teeth for a longer period of time.

In addition, when we “pinch” something between meals, the production of saliva in the mouth is not great, compared to the moment when we have lunch or dinner. It helps keep our teeth healthy by coating them with minerals and calcium. Other than that, it also acts to neutralize the acids in food, which can harm enamel.

By producing less saliva on snacks between meals, our teeth are less protected. Not to mention that sweet snacks facilitate the development of harmful gum plaques. If you need to snack between meals, consider foods that minimize plaque buildup — some good choices are apples, nuts and carrots.

How to prevent toothache?

In addition to avoiding the habits that cause toothaches, some simple attitudes make the difference to prevent this evil. See what can be done to take care of your oral health and avoid future unpleasant sensations.

Keep stress under control

Even if you don't have bruxism or don't grind your teeth at night, it's possible that you're putting pressure on your jaw during the day, even if you don't realize it.

This is such a common stress response that many dentists already know how to help patients in situations like these: by teaching them relaxation techniques.

Some simple attitudes, such as taking a deep breath, dragging your fingers along the sides of your face and then exhaling slowly will help your muscles relax. It also takes a good dose of self-knowledge to know how to identify when you are clenching your teeth when witnessing a situation of tension or nervousness.

The pain caused by this kind of pressure will spread all over the side of the face, especially below the ears or at least one side of the jaw. Keep in mind that the habit of "squeezing" your teeth hard can cause wear and even future bone loss, as the intensity of movement is something your teeth are not prepared to support.

Change your toothbrushes regularly

With the frequency of use, toothbrush bristles stretch and wear, losing their effectiveness. Therefore, ideally, these accessories should be replaced every three months. Furthermore, when changing them, give preference to brushes with a small head, which have soft, level and flat bristles, without variations in direction.

consume more water

A sugar-controlled diet isn't enough to keep your teeth healthy if you forget to keep your body hydrated. In addition to contributing to the proper functioning of the digestive system, for example, the consumption of at least two liters of water per day is important to balance the oral PH, keeping teeth safer.

Use dental floss daily

Although many people forget about it, flossing after brushing is essential for complete oral hygiene. That's because the toothbrush can't remove all the food remnants in the mouth - and the floss comes into play to complement your work.

clean the tongue

Often overlooked as part of your oral health, keeping your tongue clean is a great way to help prevent toothaches. This practice also removes harmful bacteria from the mouth and, as a bonus, still helps to keep your breath fresher.

How to treat toothache?

Because it has several causes, toothache can only be properly treated by a dentist, who will also assess which treatment option is most suitable for the problem. This can range from a simple recommendation for a new toothpaste to antibiotics, fillings, root canals or extractions (for the most severe cases).

If there is no possibility of seeing a dentist immediately, you can dilute a teaspoon full of salt in a 300 ml glass of water and swish this mixture for 30 seconds, spitting out all the liquid soon after. The salt water mouthwash helps to clean the mouth, eliminating agents that may be causing the pain. Try to perform this procedure once every hour.

On the other hand, if you suspect that the pain is caused by a physical injury, applying cold compresses or sucking on an ice cube brings more instantaneous relief. After all, low temperature reduces blood flow in the affected region, also reducing swelling.

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When should I see a dentist?

If your teeth started feeling sore or sensitive overnight like never before, it's best to make an appointment with your dentist as soon as possible. The professional will recommend a simple treatment, such as a toothpaste with reduced sensitivity, but you will also need to assess whether your case requires a corrective procedure, such as filling or tooth extraction to relieve your pain.

Some more specific signs should never be ignored. Therefore, see your dentist immediately or contact another healthcare professional if you experience:

  • toothache that lasts more than 48 hours;
  • throbbing or sharp pain that does not go away after taking painkillers;
  • migraine sensation or headache that extends to the teeth;
  • toothache accompanied by fever.

Why is a visit to the dentist so important?

Anyone, who suffers from toothache or not, should visit the dentist at least once a year in order to keep their gums and teeth healthy. In a common dental checkup, the professional should look for cavities and may order an X-ray to check for any cavities between the teeth, as well as assess whether there are wisdom teeth and whether or not they need extraction.

The exam also includes a check for plaque and tartar on the teeth, as well as a thorough evaluation of the tongue, gums and throat. This is to look for signs of swelling, redness, or possible symptoms of serious illness. Teeth are also cleaned during regular visits, as tartar cannot be removed at home — during cleaning, your dentist will use special tools and products for this.

What can happen if toothache is not treated correctly?

When the cause of the toothache is unknown and untreated, the tendency is for the problem to begin to worsen to the point where the patient loses his tooth and needs an implant. This is very common in cases of cavities, periodontitis and tooth breakage.

This happens because, by not treating an oral problem, you create an environment more favorable to the proliferation of harmful bacteria. When multiplying, they also form infectious foci and, in some cases, migrate to other organs through the bloodstream.

Therefore, it is possible to say that an abscess, gingivitis or other periodontal problem can lead to a more serious infection in the lungs, kidneys and even the heart. Therefore, it is not an exaggeration to say that if you take good care of your teeth, you are completely protecting your body.

Many people tend to associate toothache directly with decay, as it is one of the best known causes for this discomfort. However, as you can see in this article, there are many reasons, circumstances and habits that trigger this type of pain. Being able to count on the help of a trusted dentist is essential to treat your case, whatever it may be, and prevent the emergence of painful and worrying oral problems.

Now that you already know everything about the importance of taking care of your oral health, how about making an appointment here at OdontoLiuzzi to cure your toothache for good? Schedule your visit right now and meet our team!

Here in OdontoLiuzzi, we bring a new concept in dentistry, combining comfort, technology, advanced techniques and a qualified team, offering customers excellence in dental treatments.

What are you waiting for to guarantee your new smile?

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