Question: What causes an acute toothache and when should I seek emergency care?
Explanation: Acute toothache is sudden, severe tooth pain, most often caused by pulpal inflammation from deep decay, a cracked tooth, or a failing restoration. It can also arise from an abscess, a sinus infection, or pericoronitis. The character of the pain gives clues. Sharp pain on cold that vanishes quickly suggests reversible pulpitis. Lingering, spontaneous, throbbing pain points to irreversible pulpitis. Pain on biting suggests periapical inflammation or a crack. Seek emergency care if there is facial swelling, fever, difficulty swallowing, or pain unrelieved by over-the-counter analgesics.
Related Questions:
What painkillers work best for a toothache?
Ibuprofen is generally more effective than paracetamol for dental pain because its mechanism is anti-inflammatory. Combining ibuprofen with paracetamol at staggered intervals gives better relief than either alone. Always follow dosing instructions and check for contraindications. Painkillers mask the symptom; they do not treat the cause.
Why does my toothache get worse at night?
Lying flat increases blood flow to the head, raising pressure within the rigid pulp chamber. Distractions also fall away in the quiet of night, making the pain more noticeable. Sleeping propped up on extra pillows can provide modest relief.
Can a toothache go away on its own?
The pain can subside, but that is not the same as the problem resolving. When an inflamed pulp dies, the nerve stops signalling and the pain stops. The infection then progresses silently until an abscess forms. Disappearing pain is frequently a warning sign, not a reassurance.
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