Toothache? A Guide to What Might Be Causing It

A toothache is miserable. There’s just no other way to say it. It can keep you awake at night. It can make eating feel like a chore. And worst of all? You don’t always know why it’s happening or whether you need to call a dentist right now.

Let’s fix that. At Horizon Family Dental Care in Baltimore, we’ve helped thousands of patients figure out what’s causing their tooth pain. Here’s a simple guide to help you do the same.

Sharp Pain When You Bite Down

Does it hurt the moment your teeth come together? Does it feel like a sudden, electric jolt?

That kind of pain often means one of two things. You might have a chipped tooth that you can’t see. When you bite, the fracture opens up just a little, and the nerve underneath screams in protest. It could also mean you have a loose filling or a cavity that has reached the inner layer of the tooth.

Either way, sharp bite pain doesn’t usually go away on its own. Call your dentist.

Constant Throbbing That Won’t Quit

This is the pain that wakes you up at 2 a.m. It’s a deep, pulsing ache that seems to have a heartbeat of its own. Sometimes it spreads to your jaw or your ear.

Constant throbbing usually means the nerve inside your tooth is infected or inflamed. That’s called pulpitis. If the infection is severe, it can lead to an abscess, a pocket of pus at the root of the tooth.

You need to see a dentist for this. The sooner, the better. An abscess won’t heal without treatment, and the infection can spread to other parts of your body.

Sudden Sensitivity to Hot or Cold

Do you wince when you sip hot coffee or bite into ice cream? Does the pain shoot through your tooth and then fade away after a few seconds?

Mild sensitivity is pretty common, especially if you’ve just had a filling or your gums have receded a bit. But if the pain lingers for minutes after the hot or cold is gone, that’s a bigger deal. Lingering sensitivity often means the nerve is damaged or dying. That’s a sign you shouldn’t ignore.

A Dull, Constant Ache With No Clear Trigger

This one is tricky. Your tooth just feels off. It’s not screaming in pain, but it’s not happy either. You might notice it more when you lie down or when you’re stressed.

A dull ache can come from teeth grinding (bruxism). You might be clenching your jaw at night without even realizing it. It can also come from sinus pressure; your upper back teeth sit right below your sinus cavities, so a sinus infection can actually feel like a toothache.

Try an over-the-counter sinus medication. If the pain goes away, it was probably your sinuses. If it doesn’t, call your dentist.

Pain That Moves Around

Does it hurt on the top one day and the bottom the next? Does it feel like you can’t quite point to which tooth is bothering you?

Referred pain like this often points to a problem with your jaw joint (TMD) or your gums rather than a specific tooth. We can help figure out the real source.

When to Call an Emergency Dentist

Some tooth pain can wait a day or two. But call right away if you have:

Swelling in your face or cheek
Fever along with the tooth pain
Trouble breathing or swallowing
A bad taste in your mouth that won’t go away (which can mean an abscess has burst)

Toothache? A Simple Guide to What Might Be Causing It