DENTAL PROBLEMS & CONCERNS
Why Does My Tooth Hurt? Common Causes of Tooth Pain
Tooth pain can come from a cavity, a cracked tooth, an infection—or sometimes from something that isn’t a tooth at all. Dr. William Scott explains common causes of toothaches and why finding the source of the pain is the first step toward treating it.
BY DR. WILLIAM SCOTT · ORIGINALLY PUBLISHED MAY 1, 2020 · UPDATED JULY 2026
A toothache is one of the most common reasons patients call us for an urgent dental appointment.
Sometimes the cause is obvious—a tooth has broken, a filling has come out, or swelling has developed. Other times, a tooth simply starts hurting without any clear explanation.
And where you feel the pain is not always where the problem actually is.
Pain that feels like a toothache can originate from the tooth itself, the surrounding gums and tissues, the jaw, or even another area of the face or head.
That is why the first step in treating a toothache is not simply making the pain go away. It is determining what is causing it in the first place.
THE QUICK ANSWER
Why Does My Tooth Hurt?
Tooth pain can have many different causes, including decay, a cracked or damaged tooth, an infection, gum problems, or sensitivity. Sometimes pain that feels like a toothache may even be referred from another area, such as the sinuses or jaw.
Because different problems can cause similar symptoms, the type and location of the pain alone may not tell you exactly what is wrong. A dental examination can help identify the source of the pain and determine the appropriate treatment.
What Are the Most Common Causes of Tooth Pain?
A toothache is a symptom—not a diagnosis. Several different problems can cause pain that feels as though it is coming from a tooth.
Some of the most common causes include tooth decay, a cracked or fractured tooth, inflammation or infection inside the tooth, gum problems, exposed root surfaces, or a damaged dental restoration.
The way the pain feels can sometimes provide clues. You may experience sensitivity to hot or cold, pain when biting, a dull persistent ache, or sudden throbbing pain.
However, different dental problems can produce very similar symptoms, which is why an examination is often necessary to identify the actual source.
Can a Cavity Cause a Toothache?
Yes—but cavities do not always hurt, especially when they are small.
As decay progresses deeper into the tooth, it can begin to irritate the sensitive inner tissues and cause sensitivity or pain. If bacteria eventually reach the pulp—the area containing the tooth’s nerves and blood supply—the pain may become more persistent or severe.
This is one reason waiting for a tooth to hurt is not a reliable way to know whether you have a cavity. Decay can progress for some time before causing noticeable symptoms.
Can a Cracked Tooth Cause Pain?
Yes. A crack can allow the inner layers of a tooth to become irritated, particularly when pressure is placed on the tooth while chewing.
Cracked-tooth pain can sometimes be difficult to pinpoint. You may notice a sharp pain when biting down—or when releasing your bite—or sensitivity that seems to come and go.
Not every crack causes the same symptoms, and some cracks can be difficult to see. The appropriate treatment depends on where the crack is located, how far it extends, and how much healthy tooth structure remains.
What Does an Infected Tooth Feel Like?
When the tissue inside a tooth becomes severely inflamed or infected, the pain may become persistent, throbbing, or increasingly intense.
You may also notice prolonged sensitivity to temperature, pain when biting, swelling, tenderness in the gums, or a small bump near the affected tooth. In some cases, however, an infected tooth may cause surprisingly little pain—or the pain may temporarily disappear if the nerve inside the tooth is no longer functioning.
A decrease in pain does not always mean the underlying problem has resolved.
HOT OR COLD SENSITIVITY
Temperature changes trigger discomfort or pain.
Sensitivity may be related to exposed tooth structure, decay, a damaged restoration, or irritation within the tooth. How long the discomfort lasts can help your dentist evaluate the possible cause.
PAIN WHEN BITING
Pressure on the tooth causes a sharp or localized pain.
Pain with chewing may be associated with a crack, an inflamed tooth, a damaged restoration, or problems with the tissues surrounding the tooth.
ACHING OR THROBBING
The pain is persistent or seems to occur without a trigger.
Ongoing or increasingly intense pain can indicate significant inflammation or infection and should be evaluated promptly.
REFERRED PAIN
The tooth may not actually be the source of the discomfort.
Problems involving the sinuses, jaw muscles, or other nearby structures can sometimes create pain that feels as though it is coming from a tooth.
Can Tooth Pain Come From Somewhere Other Than a Tooth?
Yes. Sometimes pain that feels like a toothache is actually coming from another area.
Sinus pressure, for example, can sometimes cause discomfort that feels as though it is coming from the upper back teeth. Jaw muscles and the temporomandibular joints can also produce pain that may be difficult to distinguish from a dental problem.
Pain can even be referred from one tooth to another, making it difficult to identify exactly which tooth is causing the problem based on symptoms alone.
This is why diagnosing tooth pain sometimes requires more than simply pointing to where it hurts. A dental examination, X-rays, and other diagnostic tests can help determine whether the pain is coming from a tooth—and, if so, which one.
When Should You See a Dentist for a Toothache?
If you have new, persistent, or worsening tooth pain, it is a good idea to have it evaluated rather than waiting to see whether it goes away on its own.
You should seek prompt dental care if the pain is severe or accompanied by swelling, fever, drainage, a bad taste in your mouth, or difficulty opening your mouth. Significant facial swelling or difficulty breathing or swallowing requires urgent medical attention.
Even when the pain is manageable, identifying the cause early may allow the problem to be treated before it becomes more complicated.
What Can You Do for Tooth Pain Until You See a Dentist?
If you are experiencing a toothache, the most important step is to have the source of the pain evaluated.
While you are waiting for your appointment, keeping the area clean and avoiding foods or temperatures that trigger the pain may help reduce discomfort. Over-the-counter pain medication may also be appropriate for some people when taken according to the label directions and your individual medical considerations.
Avoid placing aspirin directly against the tooth or gums, as this can irritate and damage the soft tissues.
These measures may help manage symptoms temporarily, but relieving the pain does not treat the underlying cause of a toothache.
The Bottom Line
So, why does your tooth hurt?
Tooth pain can have many different causes, and the location or type of pain does not always reveal exactly where the problem is coming from.
Decay, cracks, infection, gum problems, and sensitivity can all cause dental pain—and sometimes discomfort that feels like a toothache may originate somewhere else entirely.
Finding the source of the pain is the first step toward choosing the appropriate treatment and helping you feel better.
LET’S FIND THE SOURCE OF YOUR TOOTH PAIN
If you’re experiencing tooth pain, sensitivity, or discomfort that doesn’t seem to be going away, Dr. Scott and our team can help determine the source of your discomfort and recommend the appropriate next step.