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Odontología

Dealing With Severe Toothaches:
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A toothache can go from annoying to unbearable in the blink of an eye. When pain wakes you up at night or lingers no matter what you do, it’s time to figure out what’s really going on. This guide walks you through common causes, what you can do at home, when a toothache signals an emergency, and what treatment looks like. 

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Reviewed By Dr. Dennis Rollins, DDO | Julio 2025 - 6 min Read

Woman experiencing toothache at dentist and holding jaw in pain

When a Toothache May Require Care

Illustration of a tooth with black cavity and gum swelling, showing abscess

Abscessed Tooth

 Intense, throbbing pain with swelling in the gums or jaw may mean an infection, which often requires drainage or a root canal.

Illustration of a tooth with deep crack on top surface, symbolizing fracture

Cracked Tooth

If biting down triggers sharp pain or exposes a nerve, you’ll likely need quick restorative treatment.

Illustration of a cracked tooth with thermometer, representing sensitivity

From Sensitive to Serious

Sensitivity that lingers long after hot or cold foods may signal pulp damage that can only be treated with a root canal.

Illustration of a face profile with orange shading on nose, showing sinus pain

Non-Dental Causes

 Sometimes jaw or tooth pain actually comes from sinus infections or, in rare cases, heart issues. These require prompt medical attention.

Tejido inflamado

Encías hinchadas y sensibles que hacen que masticar resulte incómodo o doloroso.

Pus o absceso

Los focos de infección visibles cerca de las encías requieren atención dental urgente.

What to Expect During a Dental Visit for a Toothache

Evaluación

Your dentist will examine the painful tooth, test its sensitivity to hot and cold temperatures, and may take X-rays.

Diagnóstico

They’ll explain whether it’s inflammation (pulpitis), infection, or another dental issue.

Tratamiento

Options can include fillings, a root canal, antibiotics for infection, or extraction if the tooth can’t be saved.

Por qué no debe esperar

Putting off treatment for a severe toothache almost always makes things worse. What begins as irritation in the nerve can quickly turn into an abscess, spreading infection into your jaw, face, or even your bloodstream. In rare cases, tooth pain can even mask more serious conditions, such as heart problems. Getting care early can mean the difference between a simple filling and losing the tooth altogether. If you notice swelling, fever, or pain radiating to your jaw or chest, don’t delay; call a dentist or go to the ER. Acting quickly protects your health and prevents dangerous complications.

What to Do When a Severe Toothache Hits

  • Rinse with warm saltwater: Helps calm inflammation and wash away bacteria.
  • Floss gently: Remove any trapped food or debris that may be causing irritation.
  • Apply a cold compress: Ease swelling on your face, cheek, or jaw.
  • Over-the-counter pain relief: Take ibuprofen or acetaminophen as directed.
  • Skip aspirin or benzocaine on the gums: They can cause burns or other complications.
  • Watch for warning signs: Fever, swelling that spreads, trouble breathing or swallowing, or pain reaching into the jaw or chest.
  • Call your dentist immediately: If pain or swelling lasts more than 48 hours or suddenly worsens.
  • Go to urgent care or the ER if needed: When dental access isn’t available and symptoms are severe.
  • At the dentist: Expect an exam and possibly x-rays, with treatment such as a root canal or extraction depending on the diagnosis.
Infographic with steps for toothache relief: rinse, floss, compress, meds, call dentist, X-ray

Costes, seguros y opciones de pago

Severe tooth pain doesn’t always come at a time that’s convenient for your budget. Most offices accept dental insurance, but coverage for emergency visits can vary. Even if you don’t have insurance, you still have options: many clinics offer payment plans, in-house membership programs, or same-day cash discounts. The best thing to do is to ask when you call, because staff are used to helping patients understand pricing quickly. Don’t let the cost stop you from getting care. Left untreated, a toothache can lead to much bigger (and more expensive) problems down the road.

Illusration of a dental payment schedule, insurance card, and dollar sign symbol

¿Urgencias o dentista? Elegir bien

Go straight to the ER if you can’t breathe, swallow, or open your mouth normally, or if your pain is paired with major facial swelling, fever, and chills. These symptoms can mean the infection is spreading dangerously. For most other situations—such as a cracked tooth, severe cavity pain, or suspected abscess—an emergency dentist is the right choice. Not sure where to go? Call a 24-hour dentist first. They’ll help you decide whether you can be seen in the office or if you need to go to the hospital first.

How to Manage Pain While Waiting

If you can’t get to a dentist right away, there are safe and effective ways to reduce pain until your appointment. Start with a warm saltwater rinse to clean the area and calm inflammation. Gently floss to remove any food that is causing pressure. Apply a cold compress to the outside of your cheek to reduce swelling. For short-term relief, rotate ibuprofen and acetaminophen, if they’re safe for you to take. Avoid putting aspirin or numbing gels directly on your gums, which can cause burns or other side effects. While you wait, avoid chewing on the sore side, smoking, or consuming very hot liquids.

Detectar y prevenir complicaciones

Ignoring a toothache can turn discomfort into danger. An untreated infection can lead to swelling, fever, or in severe cases, sepsis. Follow your dentist’s instructions closely to avoid complications, such as worsening of the infection. If you’ve already had treatment and your pain gets worse, or if swelling spreads to your face or neck, call your provider right away. Also watch for pain radiating into your chest, because this could be heart-related and require immediate ER care. Staying alert to these red flags helps you act fast and protect your health.

Pregunte a un dentista: Dr. Dennis Rollins:

¿Cuándo una extracción dental es urgente y cuándo puede esperar?

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Find Emergency Toothache Relief Near You

Tooth pain doesn’t wait.
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Tooth pain doesn’t wait. Call now to book a same-day appointment for toothache relief near you.

Preguntas frecuentes

What home remedies actually work for toothache pain?

Saltwater rinses, cold compresses, and safe use of ibuprofen or acetaminophen can provide temporary relief.

If you have swelling, fever, trouble swallowing, or pain that won’t go away, seek care right away.

Reversible pulpitis improves once the cavity is treated. Irreversible pulpitis means the nerve is damaged, often needing a root canal.

Yes. Pain radiating to your jaw or chest can sometimes be cardiac. If you suspect this, go to the ER immediately.

Not always. Antibiotics only help if the infection has spread. Pain alone isn’t a reason to take them.

They only mask symptoms. If pain persists for more than 48 hours, see a dentist.

It can ease mild sensitivity, but it won’t fix cavities or infection.

No. With anesthesia, you’ll feel pressure, not pain, and most patients feel relief afterward.

This is not recommended, as it can cause side effects and does not address the root cause.

Infection can spread, leading to abscesses, sepsis, or even hospitalization.

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