Tooth pain: what's causing it, and how urgent is it?
Reviewed by a registered dentist · Last reviewed 13 August 2026
Toothache is not one condition. The pattern of your pain — what sets it off, how long it lasts, whether it wakes you — tells a dentist more than its severity does. This guide walks through what each pattern usually means, what you can do for relief tonight, and the signs that mean you should not wait.
Read your pain: what the pattern means
| What you notice | What it usually means |
|---|---|
| Sharp zing with cold or sweet, gone in seconds | Exposed dentine — early decay, a worn neck of the tooth, gum recession or a leaking filling. Reversible if treated. |
| Lingering ache for minutes after something cold or hot | The pulp is inflamed beyond recovery. Usually root canal treatment or extraction. |
| Throbbing that wakes you at night, hard to point to one tooth | Irreversible pulpitis. This rarely settles on its own. |
| Sharp pain only when you bite, or when you release a bite | Cracked tooth, high filling, or a tooth under a failing restoration. |
| Constant, well-localised pain; the tooth feels “long” and hurts to touch | Infection has reached the tip of the root — an apical abscess. |
| Dull ache behind the last molar, gum flap sore and swollen | Pericoronitis around a partly erupted wisdom tooth. See our wisdom tooth guide. |
| Ache across several upper back teeth, worse bending forward, with a blocked nose | Often sinus rather than tooth — the roots sit close to the sinus floor. |
| Sore jaw joint, morning headaches, teeth feel tender all over | Clenching or grinding, not decay. |
The common causes, in order of how often we see them
1. Decay reaching the nerve
Decay is painless for a long time. It only starts to hurt when it gets close to the pulp — the nerve and blood supply inside the tooth. At first the pulp is reversibly inflamed and a filling will settle it. Past a certain point the inflammation cannot recover, and no filling will help: the tooth needs root canal treatment or removal. That crossover is what separates a ₹800 filling from a ₹6,000 root canal, which is why early decay is worth catching. See our guide to cavities.
2. A cracked tooth
Very common in people who chew hard things or grind. The classic sign is pain on releasing a bite rather than on biting down. Cracks are notoriously hard to see, often invisible on X-ray, and need a clinical examination with a bite test.
3. An abscess
Once bacteria reach the root tip, pus collects in the bone. The tooth feels raised, hurts to touch, and the pain becomes constant. Sometimes a gum boil appears and the pain suddenly reduces — that is the abscess draining, not healing. It still needs treatment.
4. Gum problems
Deep gum pockets, food packed between teeth, or an acute gum infection can all cause pain that feels like toothache. See our gum disease guide.
5. Sensitivity without disease
Recession, aggressive brushing and acid erosion expose dentine. It zings, but it is not decay. See tooth sensitivity.
What to do tonight
Toothache has several different causes, and the safe thing to do depends on which one you have — treating the wrong cause at home can make it worse. The fastest safe route is a short video consultation: the dentist works out what is driving your pain and tells you exactly what is safe for you tonight, and what needs to be seen in person.
Talk to a dentist — book a ₹199 consult
What a dentist will actually do
Expect a history, a look, tapping and biting tests, a cold test to check whether the nerve is alive, and usually a small X-ray. Treatment then depends on the diagnosis: a filling if the pulp is healthy; root canal treatment if it is not and the tooth is worth keeping; extraction if it is not restorable; drainage and antibiotics if there is a spreading infection; a night guard if the cause is grinding.
Typical costs in India
Indicative private ranges, which vary widely by city and clinic. Government dental colleges and hospitals charge substantially less.
| Treatment | Typical range |
|---|---|
| Consultation and X-ray | ₹200 – ₹800 |
| Filling | ₹500 – ₹2,500 |
| Root canal treatment | ₹3,000 – ₹10,000 |
| Crown after root canal | ₹3,000 – ₹15,000 |
| Simple extraction | ₹500 – ₹2,000 |
Ranges are for guidance only and are not a quotation. See our medical disclaimer.
Can an online consultation help with toothache?
For working out what it is and how urgent it is, yes — that is largely a history-taking exercise, and a good deal of it can be done over video with your phone's torch. A twenty-minute consultation will usually tell you the likely cause, whether it is safe to wait until the weekend, what to take for relief, and what treatment to expect so you are not surprised by the quote.
What it cannot do is take an X-ray or treat the tooth. If you need a filling, root canal or extraction, you will be told exactly that, and what to ask for at the clinic.
Not sure how urgent yours is?
Ask a registered dentist today for ₹199 and get a straight answer plus a written summary.
Book a consultationFrequently asked questions
How do I stop tooth pain immediately?
A standard dose of a painkiller you know you tolerate, warm salt-water rinses, sleeping propped up, and avoiding hot, cold and sweet foods on that side. These measures control the pain; they do not treat the cause, and pain that keeps returning always has a cause worth finding.
Why is it always worse at night?
Lying flat raises blood pressure in the head, which increases pressure inside an inflamed pulp, and there is nothing to distract you. Pain that reliably wakes you from sleep is a strong sign the nerve is irreversibly inflamed.
Will antibiotics fix it?
No. They can settle a spreading infection, but the source is inside the tooth and antibiotics cannot reach or remove it. Pain typically returns after the course. They have a place in genuine spreading infection, not in pain alone — taking them unnecessarily drives antibiotic resistance.
The pain suddenly stopped. Am I fine?
Often not. Pain sometimes stops because the nerve has died, or because an abscess has burst and drained. The underlying infection is still there and will usually return, frequently worse. Get it checked even if it feels settled.
Can wisdom teeth cause this?
Yes, especially a dull ache at the very back of the jaw with a sore gum flap over a partly erupted tooth. See our wisdom tooth guide.
Related guides
Cavities & tooth decay · Tooth sensitivity · Bleeding gums · Wisdom tooth pain