Written by Dr. Chhavi Kapur Motwani, B.D.S | 
Medically Reviewed by Dr. Sunil Shroff, MBBS, MS, FRCS (UK), D. Urol (Lond) on Sep 30, 2019


Toothache or pain in the tooth is one of the most dreaded and bothersome symptom and those who have had it at any time in life can never forget the awful feeling.

Toothache or odontalgia is an uncomfortable condition that interferes with daily activities.

The onset, nature, duration and intensity of the toothache are some important aspects which are taken into account when one attempts to get rid of it. These factors help to determine the underlying cause behind the tooth-ache and thus help in eliminating it.


When one has a tooth ache, he tries to diminish or relieve the pain before paying a visit to the dentist.

However, the Symptoms of toothache vary largely amongst individuals as the underlying cause differs. When one has a toothache, here are the few important questions that essentially need to be answered before providing any diagnosis and treatment:

  • When and how did the pain start? Is this a recurring pain or you are experiencing it for the first time?
  • Does the pain get worse or lessen at anytime in the day or night?
  • Does the pain increase while chewing hot and cold substances?
  • What is the nature of the pain? Is it a dull aching pain or is it a continuous throbbing pain?
  • Does the pain feel close to a tooth or does it feel like it is spread in a certain area in the mouth including the gums or any area of the jaw? Do you notice or feel any swelling or tenderness associated with the tooth ache or areas near it?
  • Is there any pain in the ears or while opening or closing your mouth? Is there any associated limitation of opening or closing of your mouth?
  • Was there any fever/pus/bleeding that was associated with the onset of pain?
  • Did you receive any dental treatments done for the tooth in question or in any tooth near it in the past?
  • Do you suffer from frequent headaches or sinusitis?
  • Do you have a habit of clenching or grinding your teeth in the night?
  • When and how did the pain start?
  • Does the pain get worse at any time?

Pain associated with a decayed tooth has been found to have varying intensity at different times of the day. It is often noticed that the pain gets worse on lying down or early in the morning. Though this kind of fluctuation is seen in pain associated with tooth decay, an absence of this change in the pattern of tooth ache doesn’t not rule out the possibility of the pain due to a decayed tooth.

A thorough evaluation of any of the above experienced situations should be done by an oral physician or dental surgeon. A diagnosis and treatment plan can be made only after doing a few investigations by the professional. These commonly include clinical examination, x-ray of the concerned tooth or region or entire upper and lower jaw. Few other tests can also be conducted by the physician including pulp-vitality tests, dye-penetration etc to check for the tooth vitality.

  • Is the pain continuous or intermittent?

Toothache sometimes continuously vary in its intensity. It may sometimes increase at a certain time during the day or while lying down. While at other times the pain might not be there.

A throbbing pain is often felt in cases where an underlying pathology might be associated with the tooth. This can vary from a minor abscess or granuloma to other underlying pathologies in the jaw. A dental x-ray is usually diagnostic of the etiology.

  • Does the pain increase while chewing hot and cold substances?

One might notice that the toothache worsens when one tries to bite their food from the offending side. This can be seen in a fractured or infected tooth.

Some tortures are physical
And some are mental,
But the one that is both
Is dental. ~Ogden Nash

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