What are the most common causes of toothache?

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Tooth Decay/Cavities

Cavities, or dental caries, cause tooth pain as bacteria destroy tooth enamel, then dentin. The acids excreted by cavity-causing bacteria cause inflammation when they reach the dentin and trigger swelling. 

Tooth pain is unique, in part because swelling in the pulp has no place to expand, causing excruciating pain until the inflammation and swelling go down. 

Dental Abscess

tooth abscess (periapical abscess) is a pocket of pus at the tip of the tooth root as a result of a bacterial infection. Tooth abscesses cause extreme tooth pain. 

A gum abscess (periodontal abscess) is a similar pocket within the gums that can also cause significant tooth pain.

Tooth abscesses often occur after trauma to the teeth or when the infection in untreated cavities continues to grow. Gum abscesses are more frequently a result of advanced gum disease.

Treatment and home remedies for dental abscesses differ depending on the type of abscess.

Fractured Tooth

Injury or trauma to a tooth can cause it to fracture or chip. A tooth fracture can cause severe tooth pain when you bite down, as well as severe tooth sensitivity to hot and cold foods or drinks.

Root Sensitivity

Mild, infrequent tooth pain may be caused by tooth root sensitivity. If your teeth hurt immediately after eating candy or drinking soda, there’s a good chance root sensitivity is to blame.

Root sensitivity occurs when things like acidic foods have made your dentin more porous. When this happens, brushing your teeth wears away dentin, causing sensitivity.

Bruxism/Teeth Grinding

Grinding your teeth can lead to tooth sensitivity and toothache over time. This trauma to the tooth can weaken enamel and dentin, leading to more frequent tooth decay.

The weaker your dentin, the more likely you are to wind up with a painful fracture that causes a toothache. 

Damaged or Lost Filling

If a dental filling falls out or becomes damaged, it may cause a toothache when sensitive dentin is exposed.

Schedule a dental appointment right away if this happens. As saliva remineralizes the newly exposed dentin, the pain may begin to subside. However, this is not a permanent fix and your tooth will still need repair.

Adult or Wisdom Teeth Eruption

Any form of teething has the potential to cause pain, but wisdom teeth (“third molars”) coming in is most likely to cause a toothache. Any adult or wisdom tooth may not have enough space to come in and put pressure on nearby teeth, causing tooth pain.

Often, pain from wisdom teeth comes from food impaction issues caused by teeth crowding or impaction. This may cause a cavity to form, as the teeth are not ideally seated next to one another and may create a space more likely to develop decay.

Gum Disease

If you suffer from gum disease (periodontal disease), it’s likely that gum recession will expose the upper parts of your tooth root, which can hurt very easily when exposed to hot or cold. 

Gum disease, the first sign of which is bleeding gums, can eventually lead to more frequent cavities, food getting stuck in teeth, and generally painful dental issues.

Sinus Infection (Sinusitis)

Inflammation or infection of the sinuses can cause tooth pain from sinus pressure and drainage. Usually, this pain is isolated to upper teeth near the back of your mouth (closest to your sinuses).

An infected tooth may also be a cause of sinusitis, so it’s important to work with your dentist and primary care physician to determine which issue is the root cause of your tooth pain.


Pain in your temporomandibular joint (TMJ), also known as TMD, usually affects your jaw. However, over time, it may cause aching in your teeth from referred pain.

Are you suffering from any form of tooth pain today? Contact us for a quick consult!