There are several causes for toothache, ranging from dental cavities to grinding and clenching. The most concerning cause of a toothache is an abscessed tooth. An abscessed tooth is a tooth with an infection inside the tooth itself. While all toothaches warrant a dental appointment, an abscessed tooth can spread to surrounding bone and tissue, so it is imperative to see a dentist immediately if you feel the tooth may be abscessed. There are several key differences between a toothache and an abscessed tooth that help differentiate between the two.
Do a pressure test. Chew something hard with the tooth. If you feel a sharp pain from the pressure on the tooth, you may have an abscessed tooth. If you have cavities or just sore teeth from grinding or clenching, the tooth will not hurt when you bite down.
Gauge your pain. A pain that is intense and throbbing indicates an abscessed tooth.
Check for cold sensitivity. Take an ice cube and press it against your tooth. If it's an abscessed tooth, you may not feel anything, or it may even relieve the pain. The gases that build up from the bacterial infection associated with abscesses shrink with the cold, lessening the pressure inside the tooth. If the tooth pain is not from an abscess, you will be able to feel the cold, and it may cause pain from hypersensitivity due to a cavity.
Try some heat. While cold doesn't cause any problems for abscessed teeth, heat causes severe pain when applied to an abscessed tooth. If you drink a hot beverage and experience significant pain, it may be a sign of an abscess. The heat causes the gases from the bacteria to expand further, resulting in intense pain.
Determine how long the tooth has hurt. A new tooth pain is probably not an abscess. Pain that's been around for weeks or months is more likely due to an abscessed tooth. Usually pain from abscessed teeth gets worse over time and then suddenly disappears when the nerve completely dies.
Take your temperature. A tooth abscess is an infection, and infections can cause a fever. A fever accompanying tooth pain is a key sign of an abscessed tooth.
Peek at the mirror. The inflammation associated with the infection in the abscessed tooth can cause facial swelling around the tooth. Check for symmetry in the mirror to determine if there is any swelling in the cheeks or jaw around the tooth.
Feel your gums. An abscessed tooth can cause swelling in the surrounding gums. If the toothache is the result of an abscessed tooth, the gums on either side of the tooth may be swollen or very tender to touch. Tooth pain caused by other conditions will not cause this gum swelling.
Some abscessed teeth cause no symptoms. Always make an appointment with your dentist for tooth pain that lasts more than a day or two.