From a cavity to infected gums to a sinus infection, a toothache can have a lot of (sometimes surprising) causes. 

By Rachel Swalin and Sarah Klein

Updated on February 11, 2023

 Medically reviewed by 

Edmund Khoo, DDS

• There are many reasons why you might have tooth pain, from problems with your actual tooth to bad habits to gum or other conditions that occur outside of the mouth.

• Contact a dental provider when you begin to feel pain.

• A dental provider can help identify the source of pain and take steps to rectify it before it the condition gets even worse.

A toothache might feel dull and achy or sharp and throbbing, but whatever it feels like, it can totally throw off your routine. Tooth pain can make it hard to chew, talk, focus, or even sleep at night.

There are many reasons why your teeth might hurt, but all of them are worth a check-in with a dentist.¹

Ignoring discomfort just gives the underlying cause time to get worse, and it's easier to treat tooth pain before it becomes a serious problem, Manhattan-based prosthodontist Mazen Natour, DMD told Health.

"You don't want something that could have been fixed very easily with a simple filling to become a big production like a root canal or a crown," said Dr. Natour. Untreated tooth pain, added Dr. Natour, could eventually even lead to the loss of a tooth.

Check out these 13 reasons your teeth might hurt, and if any of these sound like what you're dealing with, talk through your tooth pain symptoms with a dental provider.

 20 Things That Can Ruin Your Smile

There's Something Wrong With Your Tooth

Sometimes your tooth hurts because of outside factors, and sometimes it's because there's an actual problem with the tooth. Here are some common issues.

A Cavity

A cavity is a hole in a tooth caused by decay that eats away at the hard outer surface of your teeth, called enamel.²

At first, cavities might not cause any symptoms, but they can eventually lead to a toothache, especially if the cavity gets very large and close to the nerves inside the teeth, said Dr. Natour.

Severe cavities typically cause sharp pain that's bad enough to wake you up when you're asleep, and the pain often gets worse when you lie down, said Dr. Natour.

Small cavities can usually be filled easily and forgotten about, but when a patient comes in with nearly unbearable pain, a dentist may be left with few treatment options other than a root canal, a treatment to clean out the roots of a tooth, added Dr. Natour.

Some people have a higher risk of developing a cavity. They include older adults, children, people who don't get enough fluoride, and people who don't have enough saliva due to certain diseases or medications. In addition to limiting foods high in sugar and starches, you can help prevent cavities by:³

• Brushing with fluoride toothpaste twice a day

• Regularly flossing your teeth

• Not using tobacco products, including smokeless tobacco

• Seeing a dentist at least twice a year for regular cleanings and checkups

If you have a cavity, in most cases a dental provider will typically remove the decayed dental tissue and fill the tooth with a filling material. In more extreme cases, you may need a root canal or the tooth would have to be pulled.³

A Filling Fell Out

A cavity filling can fall out if too much force is applied to the area, or the material breaks down, Gigi Meinecke, DMD, a spokesperson for the Academy of General Dentistry, told Health. Decay around or under a filling can also cause breakage.

Some patients may not even feel something missing until they bite down. "Food can get pushed into the area as they chew," said Dr. Meinecke. "The space can start packing food where the filling left a void and cause pressure." The area could also be sensitive to temperature until it's fixed.

Doing the following can help your fillings—and your teeth—stick around for the long run:⁴

• Have regular dental visits

• Practice good oral hygiene (e.g., brush your teeth twice per day)

• Maintaining a healthy diet

 Best and Worst Food for Your Teeth

An Abscess

That kernel of popcorn that got stuck in your teeth at the movies could come back to haunt you. When particles of food are jammed between your teeth and you keep chewing, you essentially push the food farther into the gums, said Dr. Natour.

"Over time, this creates inflammation and pain," added Dr. Natour. It can even produce a pocket of space called an abscess along the gum line, where lingering food and debris decays, breeding infection.

You might notice swelling and even pus at the site of an abscess. The sooner you get one treated the better—an untreated abscess can lead to gum disease.

People who consume a lot of added sugar, don't regularly brush and floss their teeth, and don't regularly visit the dentist are more at risk of developing an abscess. Maintaining healthy teeth and gums by reducing sugar consumption, brushing and flossing daily, and visiting the dentist at least twice a year can reduce that risk.⁵

To treat an abscess, a dental provider will typically drain the pus, clean the area, and possibly prescribe antibiotics.⁵

A Tooth Fracture

Your toothache could be caused by a crack or a break in a tooth. "Usually it's not the whole tooth, but a piece," said Dr. Natour. "If it's not separated completely and moving when you bite that will create pain."

People who clench or grind their teeth, or who play contact sports may be more at risk of a tooth fracture.⁶ More often than not, said Dr. Natour, biting on something hard caused the break.

To prevent a tooth fracture, talk to a dental provider about getting a mouthguard if you clench or grind your teeth. Avoid biting on hard objects like ice or pens, and wear a mouthguard when playing contact sports.⁶

According to Dr. Natour, depending on the severity of the break, you may need:

• A crown

• A cap that covers a broken tooth

• An implant to replace a severely damaged tooth

A Tooth Injury

If a bad hop off a ground ball at your last softball game whacked you in the jaw, you'll probably know to expect a little tooth pain.

But sometimes toothaches come from similar trauma or injury that you might not think twice about, Matthew Messina, DDS, a dentist at Ohio State University who is a consumer advisor for the American Dental Association, told Health.

An example might be a fender bender that made you slam your upper teeth against your lower teeth.

"Even if you don't think you hit your head, if your jaw smacks together that can cause some injury to the teeth, even if you're not left with a big bruise or a cut lip that would draw attention to it," explained Dr. Messina.

Inside the confined space of each tooth are arteries, veins, and nerves, and injury to the teeth can lead to swelling. "The swelling inside of the hard box of the tooth has nowhere to go," said Dr. Messina, adding that the pressure builds up, which your brain interprets as a toothache.

In other cases, you might have tooth pain from wear and tear or injury to ligaments that cushion your jaw when you chew, said Dr. Messina.

Luckily, most mild tooth injuries clear up after a couple of days, as long as you don't bite anything too hard, said Dr. Messina. But it's worth a visit to a dentist first so they can keep an eye on how your symptoms progress over time.

An Erupting Wisdom Tooth

Sometimes you may only feel mild discomfort when wisdom teeth (technically your third molars) are in the process of appearing—typically between the ages of 17 and 25, but sometimes much later.

At other times, you might feel more intense pain. That happens when wisdom teeth are trying to emerge from your gums in an awkward position or without enough space.

To make matters worse, you have a higher risk of painful inflammation or infection in the gums when this happens⁷—especially because those wisdom teeth are hard to reach with your toothbrush and floss.

People whose jaws are too small to handle two more teeth are most at risk of having their wisdom teeth grow in at odd angles. When a person feels pain, a dental provider will generally recommend removing wisdom teeth.⁸

You Have a Condition

In some cases, a toothache results not necessarily from your teeth themselves, but from something happening in your mouth or elsewhere in your body. Here are some conditions that may cause you to feel tooth pain.

TMJ

TMJ stands for the temporomandibular joint, which connects the side of your head and your jaw and allows you to yawn, chew, and talk.

Dysfunction or disorder of the joint, called TMD (or sometimes also TMJ), can lead to jaw pain that feels very much like a toothache. One telltale sign of TMJ disorders or TMD is a clicking or popping noise when a person tries to open their mouth.⁹

People who are more at risk for developing TMJ may have:¹⁰

• Arthritis

• Displacement or dislocation of the disk located between the jawbone and the socket

• A habit of clenching or grinding their teeth

The pain may go away on its own, or your dentist might recommend icing the sore area, eating soft foods, and taking pain medicine. Some patients may need surgery, although this is rare.⁹

A Sinus Flareup

If you have an ache in your teeth while nursing a bad cold or around hay fever season, it could be related to your sinuses. "The sinus floor sits right on top of the roof of your teeth," said Dr. Meinecke. "If the sinuses are full, people usually come in with pain in their upper teeth behind the eye."

Another common way to tell if the pain is sinus-related: The pain isn't limited to just one tooth. If it's your sinuses, several in the area will be sensitive.

If your tooth pain is sinus-related, clearing up the sinus issue should get rid of the pain. A healthcare provider can recommend treatment, which includes antibiotics, decongestants, and pain relievers.¹¹

You Have an Issue With Your Gums

Because your teeth and your gums are so closely related, any issue with your gums can make you feel like you have pain in your teeth. These two common gum-related situations can bring on a toothache.

Receding Gums

Some people with sensitive teeth have gum recession, which has caused the enamel at the gum line to wear away. "It's like [the tooth] doesn't have a coat, so it's exposed to all the elements," said Dr. Meinecke. The pain doesn't linger, but it will pop up every time the tooth hits hot or cold foods or silverware.

Risk factors for gum recession include:¹²¹³

• Brushing your teeth too aggressively

• Periodontal disease, which is a serious gum infection

• Dental plaque

• Trauma to the gum tissue

• Smoking

• Dental treatment

You can't reverse gum recession, but you can prevent it from worsening. Most dentists recommend brushing with toothpaste for sensitive teeth, like Sensodyne, but you need to use it exclusively, or else you'll disrupt the process, said Dr. Meinecke. (So take it with you when you travel, too.) Also, surgery is another treatment option.¹²

 5 Teeth Whitening Kits for a Brighter Smile

Gum Infection

True, a gum infection doesn't exactly cause pain inside a tooth. "[But] the body has difficulty differentiating tooth pain from gum pain," explained Dr. Messina. In the mild form of gum disease, called gingivitis, the gums can become red and swollen, causing some discomfort.¹⁴

People who are more at risk of developing gingivitis include:¹⁴

• People with certain diseases, such as diabetes

• People with poor dental hygiene

• People who are pregnant

• People who smoke

• People whose teeth are misaligned

• People who take certain medications

Left untreated, gingivitis can progress to periodontitis, a more serious form of gum disease that creates pockets of space in the gums that become infected, much like a tooth abscess.¹⁵

If you're experiencing uncomfortable gum swelling, taking anti-inflammatory pain medicine can help in the short term.

Also, to treat your condition, a healthcare provider will usually do a thorough cleaning and may apply medicine directly to your gums. Regularly brushing, flossing, and visiting a healthcare provider can prevent a gum infection.¹⁵

 Best and Worst Foods for Your Teeth

You're Grinding or Clenching Your Teeth

You may not even realize you're grinding or clenching your teeth, especially if you do it in your sleep. Teeth grinding—which is also called bruxism—can lead to tooth pain (and even cracked or broken teeth), and it's also associated with symptoms such as:¹⁶

• Headaches

• Pain in the facial muscles

• Stiff jaw

• Earaches

Clenching and grinding are associated with stress, and people who do it in their sleep may also have other sleeping issues, such as snoring or interrupted breathing.¹⁷

To protect teeth, a healthcare provider may recommend mouth guards or splints. Botox might be a good option. (Really.) It can stop the muscle that moves your jaw from generating the same amount of force.

Relaxation techniques such as yoga and meditation can also reduce stress, and focusing on relaxing your jaw and facial muscles throughout the day can also help to reverse the habit.¹⁶

"Something as simple as taking a deep breath, dragging the fingers down the sides of the face, then taking another deep breath helps trigger the body to learn to relax and helps the muscles of the face relax," said Dr. Meinecke.

 8 Tricks That Will Help You Really, Truly Relax

You Had a Visit to the Orthodontist

Anyone who has had orthodontic work done probably wouldn't be surprised to find themselves in a little bit of discomfort. And it makes sense that moving the teeth hurts.

Essentially, it's a controlled form of injury or trauma, said Dr. Messina: "The wires put pressure on the ligament in the jaw, which re-contours the bone and allows the teeth to move."

Anti-inflammatory medications during the first 24 to 48 hours after you have an orthodontic adjustment or pop in a new aligner can usually help alleviate some of the discomfort, but you should also discuss your symptoms with a dental provider if you're in a load of pain.