What to do in case of extreme toothache?

Extreme toothache can occur suddenly and be quite intense. The pain can be throbbing, stabbing, or constant, and sometimes radiates to the ear, temple, or jaw. This can make sleeping, eating, and even normal functioning difficult.
Severe toothache is usually a signal that something is wrong with a tooth or the surrounding tissue. Painkillers can temporarily reduce the symptoms, but they do not remove the cause.
Do you have severe toothache that does not subside or is getting worse? Then contact a dentist to have the cause investigated.

Below you can read about possible causes, what you can do yourself in the meantime, and when you should seek emergency help.

What can cause extreme toothache?

Severe toothache can have various causes. Without an examination, it is not always possible to determine exactly where the pain is coming from.
A common cause is a deep cavity where the dental nerve becomes irritated or inflamed. A crack or fracture in a tooth, inflammation around the root, or gum problems can also cause pain.
Other possible causes include:

• a deep or leaking filling;
• an inflamed or dead dental nerve;
• an inflammation around the root of a tooth;
• a broken or cracked tooth;
• inflammation around a partially erupted wisdom tooth;
• problems with the gums or jawbone.

Sometimes it feels as if one specific tooth hurts, while the actual cause lies elsewhere. Therefore, an examination by a dentist is important.

What can you do yourself for severe toothache?

If you cannot see a dentist immediately, there are a few things you can do to make the period until your appointment as bearable as possible.

Keep the mouth carefully clean.
Continue brushing your teeth, including around the painful area, unless contact is truly impossible. Food debris between teeth can sometimes worsen symptoms.

Avoid what triggers the pain.
If a tooth reacts strongly to cold or hot drinks, try to avoid these triggers temporarily. If possible, chew on the other side of the mouth.

Use a suitable painkiller if necessary.
Paracetamol can be used for toothache according to the dosage in the package leaflet. For some adults, an NSAID such as ibuprofen can provide additional pain relief, but this is not suitable for everyone, depending for example on medication use, pregnancy, and certain stomach, kidney, heart, or other conditions. Follow the leaflet and ask a doctor or pharmacist for advice if in doubt.

Pain relief is intended to make the symptoms temporarily more bearable. It does not replace dental treatment.

Does cooling help with toothache?

When swelling is present, a cold compress against the outside of the cheek can sometimes feel pleasant.
Do not place ice directly on the skin and certainly do not place it directly against the tooth or gums. Extreme cold can actually cause extra pain to a sensitive tooth.
Cooling does not treat the cause of the inflammation. If swelling increases, the cause must be assessed by a dentist.

What should you avoid doing?

In case of severe pain, it is tempting to try everything just to get relief. However, some home remedies can do more harm than good.

For example, do not place aspirin or other painkillers directly against the tooth or gums. Also, do not use corrosive or highly concentrated substances in the mouth.

Additionally, do not attempt to prick a swelling or open an inflammation yourself.
And perhaps most importantly: do not postpone a dentist visit for days because painkillers help temporarily. The cause may remain present in the meantime.

When should you call a dentist on the same day?

Contact us the same day if the pain is very severe, worsening rapidly, you can hardly sleep due to the pain, or if pain relief is insufficient.
Clear swelling of the gums, cheek, or jaw is also a reason to contact us quickly.
A dentist can then assess the cause and whether immediate treatment is necessary.

When is swelling with toothache dangerous?

A small local swelling and a spreading infection are not the same.
Seek medical/dental help urgently when a swelling increases rapidly or spreads towards the neck or around the eye, or when you experience problems with swallowing or breathing.
Fever in combination with increasing swelling or becoming clearly ill also warrants a rapid assessment.
In case of serious breathing problems or a rapidly spreading swelling, this is not something to wait for a regular dental appointment.

Are antibiotics necessary for extreme toothache?

Not automatically.
Antibiotics are not a standard treatment for ordinary toothache and do not, for example, remove an inflamed dental nerve. In many situations, the cause in or around the tooth must be treated.
Depending on the diagnosis, the dentist may, for example, treat the tooth, relieve an inflammation, or perform another dental treatment.
For certain infections involving spreading or general symptoms of illness, antibiotics may indeed be indicated. This is assessed per situation.

What does the dentist do for extreme toothache?

The treatment depends entirely on the cause.
The dentist first asks about your symptoms and examines the teeth. They often check if the tooth reacts to certain stimuli and if pain occurs when biting or applying pressure. If necessary, an X-ray is taken.
Depending on what is found, treatment may consist of, for example:

• treating a cavity;
• repairing a damaged tooth or filling;
• starting or performing a root canal treatment;
• treating or relieving an inflammation;
• treating problems around a wisdom tooth;
• or, if a tooth can no longer be preserved, removing the tooth.

The goal is therefore not only to suppress the pain, but primarily to find and treat the cause of the pain.

Is a root canal treatment always necessary for severe toothache?

No. Severe toothache does not automatically mean you need a root canal treatment.
When the dental nerve is irreversibly inflamed or infected, a root canal treatment may be an option to preserve the tooth. But there are also many other causes of toothache.
Therefore, a diagnosis is made first before a treatment is chosen.

Can extreme toothache disappear on its own?

It can, but unfortunately, that does not always mean the problem has disappeared.
In the case of a severely inflamed dental nerve, the pain may change or decrease when the nerve tissue dies. The underlying infection can then still be present.
Therefore, have severe toothache assessed, even if the pain suddenly decreases after a period.

Emergency dentist in Leiden for severe toothache

Do you have a severe toothache? Please contact We Smile Tandartsen in Leiden. We can assess what is going on and what treatment is required.
Outside the practice’s opening hours, you can use the designated emergency dental service for acute dental complaints.

Do you have severe swelling with difficulty swallowing or breathing? Seek medical help immediately.