My tooth aches. I’m in pain. What do I do?

Up until now it was easy to ignore that dull ache. But not anymore. Now your tooth aches so much you can’t think straight. In fact, now the whole of your head is screaming at you. Tooth pain is the worst.

We can all ignore mild toothache. Even though we know it isn’t a good idea, it’s easier to do that than ring the dentist, make an appointment and fix the problem. After all, not one of us really wants to go to the dentist. And anyway, we’re all busy. There’s work, family, looking after the house, going to the gym, or just doing things we like doing. With a pain killer, the toothache calms down a bit, and is easier to ignore. That is, until it isn’t.

We can be sure that when our tooth aches the pain will ramp up just before an important meeting, when we’re on a trip, or when we’ve planned a big social event. Most probably it will be at a time when the dentists are all closed, and we’re left to suffer, regretting that we hadn’t done something sooner.

But there’s hope. There are dentists ready to help out.

• Practices offer emergency appointments, even if you’re not a registered patient.

Important note:

Unfortunately, although your tooth aches a lot, pain alone is not considered urgent. Urgent conditions requiring immediate care are:

• bleeding that will not stop.
• swelling of the mouth or throat which is getting worse and may obstruct airways.
• trauma to the face, mouth or teeth.
• a permanent tooth knocked out.

For urgent advice, you can call the NHS helpline – 111.

What can I do to stop my tooth aching?

As your tooth won’t stop hurting by itself, you’ll need to see a dentist as soon as possible. Even if the pain subsides a bit, that doesn’t mean that the problem has gone away.

So the first thing to do is call a dentist.

Explain that you’re experiencing pain and want to book an emergency appointment. Most dentists keep slots open in their schedules for emergency appointments. It’s best to call your surgery as early as you can in the morning, as the gaps in the day’s diary soon fill up with other emergency patients.

Meanwhile, some temporary relief from pain may help:

• Rinse your mouth often with water. An antibacterial mouthwash may be helpful too.
• Eat soft foods to avoid pressure.
• Avoid things that are very hot, cold, sweet or spicy.
• Try some numbing gel (perhaps you have some in the house for a teething baby) on the gum.
• If there’s a chemist open near you, ask a pharmacist for advice on pain medication.
• Take care if you use non-prescription painkillers.
  • Follow the instructions for use.
  • Ask a healthcare professional about compatibility with other medications.
• If you have prescribed pain-killers, check and follow the recommended dosage.
•  Remember:
  • a painkiller only disguises the problem.
  • do not rely on them, and
  • do not avoid treatment.

Why does my tooth ache?

• The most common cause of toothache is a tooth infection. Dental decay begins on the outside surface of the tooth and then the bacteria eat their way through the protective layer of enamel. Pain begins once the sensitive inside pulp and nerves of the tooth are exposed.
• Dental abscesses cause pain. They are a bacterial infection caused by an infected tooth, or gum disease. Left untreated an abscess can cause further complications leading to further pain and other complications, such as sinus infection, as the bacteria spread.
• Some people have sensitive teeth that feel changes in temperature. Sensitivity itself is a sign that hard, protective tooth enamel has weakened, opening a pathway, however miniscule, to underlying tissues. It is possible that this lower level of pain will increase, especially if it indicates the beginning of a dental cavity.
• Wisdom teeth, the very back molars, usually start to break through in the late teenage years. Pressure on the soft tissue or other teeth can lead to pain and infection which, if left untreated, can cause sudden inflammation.

What will my dentist do?

• The dentist will examine your mouth, and take x-rays, to find the cause of the problem, and come up with a solution.
• In most cases, the dentist can reduce the pain for you with immediate treatment.
• A dentist can also prescribe medication, such as pain relief and antibiotics, as needed.

“My dentist managed to promptly provide treatment to stop the pain and has since then completed a permanent solution.” a SpaDental Plymouth patient

• During your emergency appointment the dentist will aim to reduce your pain. It is often necessary, however, to schedule other treatments later, such as a root canal or restoration work. Your dentist will prepare a treatment plan to restore optimum oral health.

Can I prevent toothache?

• In about 95% of cases, the pain of tooth decay is avoidable.
• A good oral hygiene routine at home, is important. These days there are great products on the market that help to maintain a healthy mouth such as fluoride toothpaste, mouth wash, floss, interdental brushes and some people swear by tongue scraping too. It is worth considering investing in an electric toothbrush too.
• Parents and guardians have a duty to ensure children and young people look after their teeth. Ask your dentist about topical fluoride treatments to help strengthen young teeth.
• Maintaining a healthy mouth also means making regular appointments. A dentist can spot dental problems in the early stages and prevent pain occurring.
• Everyone should see a dentist every six months. In some cases, a patient will need more regular dental checks.
• Diet has a direct impact on our teeth. Try to cut down on sugar, especially in breakfast cereals and fizzy drinks, as well as cutting down on very salty or acidic food and drink.
• Be proactive to prevent pain. Once oral health deteriorates, managing or restoring your teeth often means longer, more difficult and more costly treatments. It’s worth taking action at the very first signs of bleeding gums, sensitivity or toothache.

In short, regular appointments with your dentist will keep you pain-free.

Pages with useful local information in an emergency:

• • Somerset? Emergency care in Chard
  • Devon or Cornwall? Emergency care in Plymouth
  • Gloucestershire? Emergency care in Tewkesbury
  • Shropshire? Emergency care in Whitchurch
  • About NHS urgent care out of hours

Useful Links & Information