Toothache - Symptoms

Authored by Dr Ben Williams, 19 May 2017

Reviewed by:
Dr Hayley Willacy, 19 May 2017

The symptoms of toothache are frequently confusing. It can be difficult to decide which tooth is causing the pain or even whether it's coming from an upper or a lower tooth. Sometimes the pain can feel like it is coming from a distant site, like your ear for example. This is called referred pain.

The most common symptoms of toothache are:


Understanding the type of pain can help the dentist to treat you more effectively.

  • Is it a sharp shooting pain or a dull ache?
  • Does the pain last for a few seconds or half an hour?
  • Does anything make the pain worse or make it go away?

The longer each episode of pain lasts, the more serious the condition is likely to be.


Teeth with mild-to-moderate reversible pulpitis are usually more sensitive to cold or sweet food and drinks but rarely to hot ones.

Teeth with irreversible pulpitis are initially sensitive to cold but as the condition worsens the pulp becomes increasingly sensitive to hot things. Eventually, cold drinks can actually help to reduce the severe throbbing pain. This is because the cold temperature helps to reduce the pressure and inflammation inside the pulp, similar to an ice pack on a twisted knee or ankle.

Tenderness to pressure (TTP)

The more painful a tooth is to bite on, the more severe the pulpitis is likely to be. A tooth with reversible pulpitis might have no TTP at all. As the inflammation worsens to an irreversible pulpitis, the effects will spread beyond the root into the bone and make the tooth painful to bite on to. This makes teeth with irreversible pulpitis much easier to identify.

Pain on biting or pushing the side of a tooth can also indicate the presence of an infection spreading from the gums down the side of a tooth. It could also be due to inflammation or bruising around the tooth root if it has been knocked in an accident.

Inability to sleep

If your sleep is affected by toothache then you are likely you have irreversible pulpitis, especially if you are woken up in the middle of the night with a spontaneous throbbing toothache that can last for hours.

If you experience any of these symptoms for more than a day or two without any reduction in severity, arrange to see your dentist as soon as possible. If you delay, the pain is likely to get worse.

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