A toothache has a sneaky way of hijacking your entire day. It can start as a mild twinge when you sip coffee, then turn into a full-on throb that makes it hard to focus, sleep, or even talk without wincing. The tricky part is knowing when you can manage it safely until your next dental appointment—and when you should treat it like an emergency.

Not every toothache is a crisis, but some are your body’s way of waving a big red flag. Infections can spread, cracked teeth can worsen, and pain can be a sign of something deeper than a simple cavity. This guide will help you sort through the most common toothache scenarios, recognize the signs you shouldn’t ignore, and make a smart plan for what to do next.

We’ll also talk about what “emergency” really means in dentistry, why timing matters more than most people think, and how to protect yourself while you’re waiting to be seen.

What a toothache is really telling you

Tooth pain isn’t a diagnosis—it’s a symptom. Your tooth can hurt because of decay, a crack, gum inflammation, a failing filling, sinus pressure, or even clenching your jaw at night. The nerves in and around your teeth are excellent at sending distress signals, but they’re not great at telling you the exact cause.

That’s why toothaches can feel confusing. A problem in one tooth can radiate to the jaw, ear, temple, or neck. In some cases, pain that feels like it’s coming from a tooth is actually coming from the gums or the muscles of the jaw. The only way to be sure is to have a dental professional examine you and, if needed, take X-rays.

Still, there are patterns that can help you decide how urgently you need care. The next sections break down symptoms and situations that should move you from “I’ll wait and see” to “I need help now.”

Dental emergency vs. “urgent” vs. “can wait a bit”

People often use the word “emergency” to mean “this hurts a lot,” and that’s understandable. But in dentistry, an emergency usually means there’s a risk of rapid worsening, infection spread, uncontrolled bleeding, trauma, or airway issues. Those are the situations where delaying care can lead to serious complications.

“Urgent” problems are the ones that are unlikely to become life-threatening in the next few hours, but can get worse quickly or cause unnecessary damage if you wait too long. Think: a broken tooth with sensitivity, a lost filling that exposes the tooth, or escalating pain that’s interfering with sleep. These often need same-day or next-day attention.

Then there are issues that can typically wait a short period—like mild sensitivity that comes and goes, or a small chip with no pain. Even those shouldn’t be ignored, but you usually have a bit more time to schedule a regular appointment.

Signs your toothache is an emergency you shouldn’t ignore

Swelling in the face, jaw, or gums

Swelling is one of the biggest warning signs because it often points to infection. If you notice puffiness in your cheek, jawline, or under your eye—or your gums look ballooned near a tooth—your body may be reacting to bacteria that have moved beyond the tooth structure.

Pay attention to how fast the swelling is developing. Swelling that’s increasing over hours, feels warm to the touch, or is accompanied by a bad taste or pus is especially concerning. Dental infections can travel into deeper spaces of the face and neck, and in rare cases can affect breathing.

Even if the pain isn’t severe, swelling is a “don’t wait” sign. It’s one of the clearest indicators you need prompt professional care.

Fever, chills, or feeling run-down

A toothache with fever isn’t just “a bad tooth.” Fever suggests your immune system is fighting something more systemic. Chills, body aches, fatigue, or swollen lymph nodes under the jaw can all be clues that an infection is spreading.

Sometimes people try to push through with pain relievers, assuming the fever is unrelated. But when a toothache and fever show up together, it’s safer to treat it as urgent at minimum—and potentially an emergency depending on severity and other symptoms.

If you have fever plus swelling, difficulty swallowing, or trouble opening your mouth, seek immediate help.

Difficulty breathing, swallowing, or opening your mouth

These symptoms are the line in the sand. If you’re having trouble breathing or swallowing, or you can’t open your mouth normally (a condition called trismus), you may have a serious infection or swelling in spaces that affect the airway.

These aren’t “wait for Monday” problems. They can escalate quickly and require emergency medical evaluation. If you’re experiencing these symptoms, go to an emergency room or urgent care right away—especially if you can’t reach a dental professional immediately.

It’s better to be overly cautious here. Airway-related symptoms are never something to monitor at home.

Severe, unrelenting pain that won’t respond to medication

Pain is subjective, but there’s a difference between discomfort and pain that feels impossible to manage. If you’ve taken appropriate over-the-counter medication as directed and the pain is still severe—especially if it’s keeping you from sleeping—that’s a sign something significant may be happening inside the tooth or surrounding tissues.

Deep throbbing, pressure-like pain can be associated with an inflamed or infected pulp (the nerve tissue inside the tooth). Sometimes the pain spikes when you lie down because blood pressure changes increase pressure in the area.

Severe pain doesn’t always mean an emergency in the life-threatening sense, but it does mean you should seek urgent dental care as soon as possible to prevent worsening and to protect the tooth.

Trauma: a tooth knocked out, displaced, or fractured

If you’ve had an accident—sports injury, fall, or impact—and your tooth is knocked out or pushed out of position, time matters. A knocked-out permanent tooth has the best chance of being saved if it’s reimplanted quickly (often within an hour).

Even if the tooth isn’t fully out, a displaced tooth or a fracture that exposes the inner tooth can lead to nerve damage or infection. Trauma can also injure the jawbone or cause hidden cracks that worsen with chewing.

In these situations, it’s wise to treat it like an emergency. Quick action can be the difference between saving the tooth and losing it.

Bleeding that won’t stop

Bleeding after brushing or flossing can be common with gum inflammation, but bleeding that won’t stop after an injury or after a tooth extraction is different. Persistent bleeding can indicate a clotting issue, a problem with the wound, or disruption of a clot.

If you’re soaking gauze repeatedly and bleeding continues, you need guidance. Sometimes it’s a simple fix—pressure in the right spot for the right amount of time—but sometimes it needs professional intervention.

Uncontrolled bleeding is one of those “don’t tough it out” issues. Get help promptly.

Toothache symptoms that are serious even without swelling

Cold sensitivity that lingers

A quick zing when you eat something cold can happen with minor enamel wear or gum recession. But if cold sensitivity lingers for 30 seconds or more after the cold is gone, that can be a sign of deeper irritation or inflammation in the tooth.

Lingering sensitivity sometimes points toward a cavity that’s getting close to the nerve, or a crack that’s letting temperature changes reach sensitive structures. It can also happen when a filling is failing or a tooth is under stress from grinding.

This isn’t always an emergency, but it is a strong signal to schedule a dental visit soon—especially if it’s new or worsening.

Pain when biting or chewing

Tooth pain that shows up mainly when you bite down can indicate a crack, a high filling, or inflammation around the root. Sometimes it feels like a sharp, pinpoint pain that disappears when you stop chewing.

Cracks are tricky because they can be microscopic at first and then spread. Chewing on a cracked tooth can cause the crack to deepen, making treatment more complicated. It’s one of those scenarios where “waiting it out” can backfire.

If you have biting pain, avoid chewing on that side and try to get evaluated promptly so the tooth can be stabilized before more damage occurs.

A bad taste, odor, or drainage

If you notice a persistent bad taste, foul odor, or fluid that seems to drain near a tooth, it could be a sign of infection. Sometimes an abscess creates a small pimple-like bump on the gum (a fistula) that drains intermittently, temporarily reducing pressure and pain.

That temporary relief can be misleading. Drainage doesn’t mean the infection is gone—it often means the infection has found a pathway out. The source still needs treatment.

Any sign of pus or drainage is a reason to get seen quickly, even if the pain is manageable.

Common causes of toothaches—and why timing matters

Cavities that have reached the nerve

Early cavities may not hurt much at all. But when decay gets deep enough to irritate the pulp, pain can ramp up fast. At that stage, you might feel spontaneous throbbing, lingering sensitivity, or pain that wakes you up at night.

When the pulp becomes inflamed, it may still be reversible in some cases—but there’s a window. If inflammation progresses to infection or the nerve tissue dies, you may need more involved treatment to save the tooth.

Getting evaluated early can mean a simpler fix and a better chance of keeping the tooth healthy long-term.

Cracked teeth and fractured fillings

Cracks can happen from biting something hard, grinding, or even from large old fillings that weaken the tooth structure over time. A crack might start as sensitivity and progress to sharp pain with chewing.

Fractured fillings can expose dentin (the layer under enamel) and cause sensitivity or pain. They can also create gaps where bacteria collect, accelerating decay beneath the restoration.

These issues often start small but become expensive and complicated if ignored. Early repair can prevent the need for root canal treatment or extraction.

Gum disease and gum infections

Not all toothaches originate in the tooth. Gums can be the culprit, especially if you have tenderness, bleeding, or a “bruised” feeling around a tooth. Gum infections can create localized swelling and pain that feels tooth-related.

Periodontal (gum) disease can also cause dull aching and sensitivity, particularly if the gums have receded and root surfaces are exposed. Sometimes food packing between teeth can inflame the gums and mimic tooth pain.

Because gum issues can progress quietly, regular professional checkups matter. If it’s been a while since you’ve had a cleaning or exam, it’s worth prioritizing an appointment.

Wisdom teeth and partially erupted molars

Wisdom teeth can cause pain even if they’re not “bad” teeth. When they partially erupt, a flap of gum can trap bacteria and food, leading to inflammation and infection (pericoronitis). This can cause swelling, bad taste, and pain that radiates to the ear or throat.

These infections can escalate quickly, especially if swelling increases or you have trouble opening your mouth. They can also recur if the underlying issue—limited space or partial eruption—remains.

If you suspect wisdom teeth are involved and symptoms are escalating, it’s a good idea to seek prompt evaluation.

What to do right now if you think it’s an emergency

Use safe, practical pain control (and what to avoid)

Over-the-counter pain relievers can help you get through the short term, but they’re not a cure. Many people find alternating acetaminophen and ibuprofen (following label directions and personal medical guidance) can provide better relief than taking either alone. If you have medical conditions, are pregnant, or take blood thinners, check with a clinician before taking anything new.

A cold compress on the outside of the cheek can reduce swelling and numb pain. Warm saltwater rinses can soothe irritated gums and help keep the area clean. If you suspect a cracked tooth, avoid chewing on that side and stick to softer foods.

Avoid placing aspirin directly on the gum or tooth—this can burn the tissue. Also avoid using heat on facial swelling when infection is suspected; heat can increase circulation and potentially worsen swelling.

Know when to call a dentist vs. go to urgent care or the ER

If you have severe swelling, fever, drainage, or intense pain, start by calling a dental office that handles urgent visits. Dentists can often treat the source—whether that’s draining an abscess, starting appropriate care, or stabilizing a tooth.

If you have difficulty breathing or swallowing, rapidly spreading swelling, or signs of a severe systemic infection, go to the ER or urgent care. Medical teams can manage airway risk, provide imaging if needed, and coordinate with dental specialists.

When in doubt, err on the side of getting evaluated. Waiting “just one more day” is a common way dental emergencies become bigger medical problems.

What information to have ready when you seek help

When you call for help, you’ll get faster guidance if you can describe: where the pain is, how long it’s been going on, whether you have swelling or fever, what makes it worse (cold, biting, lying down), and what medications you’ve taken.

If you’ve had recent dental work, mention it. If there was trauma, describe what happened and when. If you see a pimple on the gum or notice drainage, mention that too.

These details help the dental team triage your situation and prepare the right treatment plan.

How dental teams typically treat emergency toothaches

Getting the source under control

Emergency dental care is usually focused on two goals: stopping the pain and controlling the cause. That might mean removing decay, adjusting a bite that’s hitting too hard, stabilizing a cracked tooth, or addressing an infection.

If infection is present, treatment may include draining an abscess, cleaning infected tissue, or performing a root canal procedure when appropriate. Antibiotics can be helpful in certain situations, but they’re not always the primary solution—especially if the infection is confined and can be treated directly.

The key is that pain relief is most reliable when the underlying issue is treated, not just masked.

When extraction becomes the safest option

Sometimes a tooth is too damaged to save, or the infection risk is too high to delay definitive treatment. In those cases, extraction may be recommended. While that can sound scary, removing a severely infected or fractured tooth can be the fastest route to relief and can protect surrounding teeth and bone.

Extractions range from straightforward to more complex surgical procedures depending on the tooth’s condition and root anatomy. Your clinician will explain what’s involved and what the next steps are for replacing the tooth if needed.

If you’re dealing with a tooth that may require a surgical approach, it can be helpful to know there are specialists and teams equipped for that level of care, such as the oral surgeons at Elite Smiles who handle surgical extractions and related procedures.

What “temporary fixes” actually mean

In emergency dentistry, sometimes the first visit is about stabilization. For example, a dentist might place a temporary filling, smooth a sharp edge, or prescribe medication to reduce inflammation while planning a definitive restoration like a crown.

Temporary solutions are valuable because they stop the immediate pain and prevent further damage. But they’re not the finish line. If you don’t return for the final treatment, the issue can come back—often worse.

If you receive a temporary fix, schedule the follow-up before you leave the office if possible. That’s one of the easiest ways to avoid repeat emergencies.

Toothache triggers that surprise people

Sinus pressure that mimics a toothache

Upper back teeth share close proximity to the sinus cavity. When you have sinus congestion or infection, pressure can create aching in the upper molars that feels like a dental problem. The pain may worsen when you bend forward or when sinus symptoms flare.

The challenge is that sinus issues and dental issues can overlap. A true dental infection in an upper tooth can sometimes cause sinus symptoms, too. If the pain is localized to one tooth, worsens with chewing, or comes with swelling or drainage, it’s more likely dental.

If you’re unsure, a dental exam and X-ray can help clarify what’s going on so you don’t treat the wrong problem.

Grinding and clenching (especially during stress)

Jaw clenching and teeth grinding can create soreness that feels like tooth pain. You might notice morning headaches, tight jaw muscles, or teeth that feel “tender” without obvious decay. Over time, grinding can cause cracks, wear, and gum recession—each of which can lead to sensitivity.

Stress often makes clenching worse, and many people do it without realizing—especially while sleeping. If toothaches come and go and you’ve been under pressure lately, this could be part of the picture.

Addressing grinding might include a night guard, bite adjustments, or stress-reduction strategies. It’s worth discussing with a dentist if you suspect it’s contributing to your pain.

Orthodontic movement and aligners

If you’re using aligners or braces, some soreness is normal—especially after switching to a new tray. That discomfort is usually generalized pressure, not sharp, localized pain in one tooth. If you feel a sudden spike of pain in a specific tooth, or pain that worsens with biting, it deserves attention.

Sometimes aligners can highlight a pre-existing issue like a small crack or cavity because the tooth is under new forces. That doesn’t mean aligners are “bad,” but it does mean you should get checked if something feels off.

For people exploring straighter teeth, it’s smart to choose treatment with proper dental oversight. If you’re researching options, dental aligner solutions Pflugerville can be a helpful example of professionally guided clear aligner care where your overall oral health is part of the plan—not an afterthought.

How to reduce the chances of a toothache turning into an emergency

Don’t ignore “small” symptoms that keep repeating

A lot of emergencies start as minor annoyances: mild sensitivity, an occasional twinge, a filling that feels slightly rough, or gums that bleed now and then. Because the symptoms come and go, it’s easy to tell yourself it’s nothing.

But teeth rarely heal themselves. Small issues usually either stay the same or gradually worsen. Catching them early often means simpler treatment, lower costs, and less time in the chair.

If you’ve noticed a repeating symptom for more than a week or two, it’s worth getting it checked—before it turns into a weekend emergency.

Keep up with exams so problems don’t hide

Some of the most serious dental problems are the quiet ones. A cavity between teeth might not hurt until it’s deep. Gum disease can progress with minimal pain. Small cracks can be invisible without magnification and careful testing.

Routine dental visits help spot these issues early. X-rays can reveal decay under old fillings, infections at the root, or bone changes that you can’t see in the mirror. Cleanings also reduce inflammation and help keep gums healthier.

If you’re due for a checkup, scheduling a mouth health check Pflugerville can be a practical step toward preventing the kind of toothache that escalates quickly.

Use simple habits that protect enamel and gums

Daily habits matter more than fancy products. Brushing twice a day with fluoride toothpaste, flossing or using interdental cleaners, and limiting frequent sugary snacks can dramatically reduce your risk of decay.

If you sip sweetened drinks throughout the day, your teeth spend hours bathing in acid. Swapping to water between meals and keeping sugary drinks to mealtimes can help. If you have dry mouth from medication, ask about strategies to increase saliva and protect enamel.

And if you grind your teeth, treating that habit can prevent cracks and sensitivity that lead to pain later.

Emergency toothache scenarios and what they usually mean

“It hurts, then it suddenly stopped”

This is one of the most misunderstood situations. People often think the problem resolved itself. Sometimes, though, a sudden stop in pain can mean the nerve inside the tooth has died. That might reduce pain temporarily, but infection can still develop at the root.

If you had intense pain that vanished and you still notice pressure, swelling, or discomfort when biting, don’t assume you’re in the clear. A dental exam can determine whether the tooth is still healthy or if it needs treatment.

In other cases, pain can stop because the irritant (like food stuck in a gum pocket) is gone. The key is whether the symptom pattern makes sense and whether there are any lingering warning signs.

“My tooth hurts when I drink cold water, but heat feels better”

Cold sensitivity can be common, but when cold triggers strong pain and warmth seems to soothe it, that can suggest inflammation inside the tooth. It’s not a perfect rule, but many people with pulp irritation report this pattern.

Because this can progress, it’s a good idea to schedule an evaluation soon. Waiting until it becomes constant pain can shrink your options.

Try to avoid extreme temperatures and chew on the other side until you can be seen.

“My gum is swollen near one tooth and tastes bad”

This combination often points toward infection and drainage. Even if the pain is mild, the presence of swelling and a bad taste is a sign the body is trying to manage bacteria.

Rinsing gently with warm saltwater can help keep the area clean, but it won’t remove the source. You’ll want prompt dental care to address the underlying issue and prevent spread.

If swelling increases or you develop fever, treat it as urgent or emergency depending on severity.

What to do if you can’t get immediate dental care

Short-term steps that are actually helpful

If you’re stuck waiting—traveling, weekend timing, or limited appointment availability—focus on protecting the area. Keep it clean with gentle brushing and warm saltwater rinses. Avoid chewing on the painful side. Stick to soft foods and avoid very hot, cold, or sugary items that trigger pain.

Use over-the-counter pain relief responsibly and follow dosing instructions carefully. If swelling is present, use a cold compress on the outside of the face in short intervals.

If a filling fell out, temporary dental repair kits from a pharmacy can sometimes reduce sensitivity until you’re seen. They’re not a substitute for treatment, but they can make you more comfortable.

Red flags that mean you should stop waiting

If you’re waiting and symptoms shift into any of these categories—facial swelling, fever, worsening pain, difficulty swallowing, trouble breathing, or spreading redness—don’t keep waiting for a dental appointment. Seek urgent medical evaluation.

Also be cautious if you have a compromised immune system, uncontrolled diabetes, or you’re undergoing chemotherapy or taking immunosuppressants. In those cases, infections can progress faster and need earlier intervention.

Your goal isn’t to “tough it out.” It’s to prevent a manageable dental issue from becoming a serious health problem.

Why this matters beyond your mouth

It’s easy to think of toothaches as isolated problems, but oral infections can affect the rest of your body. Chronic inflammation is linked with broader health concerns, and acute infections can cause systemic symptoms quickly. Even when it doesn’t become dangerous, untreated dental pain can disrupt sleep, appetite, and mental well-being.

There’s also the practical side: dental emergencies are expensive and inconvenient. They tend to happen at the worst times—before a trip, during a busy work week, or on a holiday weekend. Preventive care and early treatment are usually far simpler than emergency interventions.

If there’s one takeaway, it’s this: your mouth is part of your overall health, and persistent pain is worth taking seriously.

A quick self-check guide for deciding your next step

Seek emergency help now if you have:

Difficulty breathing or swallowing, rapidly spreading swelling, severe facial swelling, high fever, uncontrolled bleeding, or trauma with a knocked-out/displaced tooth. These situations can’t wait.

If you’re unsure and symptoms feel intense or are worsening quickly, it’s safer to get evaluated urgently.

When in doubt, prioritize safety—especially with swelling and systemic symptoms.

Seek urgent dental care within 24–48 hours if you have:

Severe pain disrupting sleep, swelling localized to the gum, drainage/bad taste, pain on biting, a cracked tooth with sensitivity, or a lost filling/crown causing significant discomfort.

These problems can often be treated effectively if you act quickly, and early care can reduce the chance of infection or tooth loss.

Try to avoid chewing on the area and keep it clean while you arrange care.

Schedule a regular dental visit soon if you have:

Mild sensitivity that comes and goes, minor chips without pain, occasional gum bleeding, or discomfort that’s noticeable but stable. Even these deserve attention—just with slightly less urgency.

Many dental issues are easiest to treat before they become painful. If you’re catching it at the “annoying” stage, you’re ahead of the game.

And if symptoms change or worsen, move it up the priority list.