young woman with toothache with purple background

Do you have aching teeth? Before you start googling, “Why does my tooth hurt” or worrying about an emergency dentist appointment for your tooth pain, there are some important things to rule out. Depending on the type and severity of your tooth pain, toothaches and aching teeth can be caused by a wide array of conditions. Here’s everything you need to know: 

What Is A Toothache?

When your head hurts, you’ve got a headache. Does your ear hurt? Welp, you’ve got an earache. When your tooth hurts, we simply call it a toothache. But toothaches—along with earaches, kidney stones, and giving birth—can be about the most painful thing a person will ever experience in their lifetime. [1]

Some toothaches are dull and achy, and they flare up off and on. Others are sharp and strong, making it impossible to think through the tooth pain. The type, location, and severity of your aching teeth will give you clues as to what the cause is behind your toothache. It means you get to play a little detective work!

15 Causes of Aching Teeth

Ok. If you’re headed to your dentist’s office because of tooth pain, they’re probably going to start an old-fashioned game of 20 Questions with you. Depending on how you answer, most aching teeth are going to be pretty easy to diagnose. But occasionally, your dentist may have to do things like temperature tests, have you bite down on something (to check for cracks,) and obviously take an X-ray to see the inside of your tooth to know what’s really going on. 

Before you call your dentist’s office for an exam, here are the top 15 causes of tooth pain, and one of them could be the reason why your tooth hurts. 

1. You’re Stressed   

If you’re stressed out or pouring all of your concentration into something, there’s a good chance that you’re probably clenching your teeth together. Bruxism or teeth grinding also happens at night, leaving you with aching teeth in the morning when you wake up. Your jaw might hurt, too, and there’s a good chance you could have a headache.[2]

Treatment

People who suffer from teeth grinding and clenching tend to benefit from wearing a nightguard while they’re sleeping or even Botox treatment to relax the muscles around their jaws. Cognitive behavioral therapy with a licensed counselor or medication (for anxiety) can also be extremely helpful. When your mouth is at rest, your lips should be touching, but your teeth shouldn’t. 

Related: Best Night Guards for Teeth Grinding

2. You’re Whitening Your Teeth

One of the first things I ask anyone who is complaining about sensitive, tooth pain is if they’re using any type of teeth-whitening product. It could even be a whitening toothpaste, for that matter. Since teeth whitening agents open up the tiny pores in our tooth enamel, they are very prone to triggering tooth sensitivity, especially if it’s a toothpaste you use every day.

Treatment

If you’re using a whitening toothpaste, definitely make the switch to one that’s made for sensitive teeth. For at-home whitening products, alternate using them every other day instead of daily. In most cases, the toothpaste for teeth sensitivity will help within a couple of weeks, but it’s one of those things you have to keep using.[3]

Related: Best Teeth Whitening Products for People with Sensitive Teeth

3. Sinus Infection

You wouldn’t believe the number of times I’ve seen patients with tooth pain who have nothing wrong with their teeth at all. The true cause is sinus pressure, inflammation, or some type of sinus infection. Their sinus lining presses into the roots of their top back teeth, mimicking the symptoms of a toothache. 

Treatment

Does the tooth pain feel worse when you bob your head or move it side to side? It’s probably sinus related. Try taking a decongestant or talking to your doctor about a prescription for your sinus infection. Once it starts to clear up, your toothache symptoms should, too. 

4. Gum Recession  

Your gum tissues should cover the entire root surface of each tooth. If the gums pull back because of periodontal disease or you’re brushing too hard, and the gums are receding, it will expose your tooth root surfaces. Receding gums cause the tiny nerve endings in the pores of your tooth (which aren’t covered by enamel or gum tissue at that point) to become hypersensitive to all of the stimuli around them. Brushing your teeth, eating, drinking, or even breathing can make your teeth hurt.

Treatment

Depending on the cause and severity of your gum recession, you might need a gum graft, fluoride, desensitizing treatment, or even bonding over your tooth. Definitely talk to your dentist about chronic nerve pain. 

5. TMD

Temporomandibular joint disorder—aka “TMJ” or TMD—can cause everything from toothaches to migraines and ear pain. After all, they’re all closely related to your TMJ. Other symptoms include limited mobility and pain whenever you’re biting or chewing food. 

Treatment

TMJ disorder is usually managed through non-surgical methods, like Botox, orthodontics, massage, or wearing a bite splint if you’re clenching your teeth all the time. You can also apply a warm compress during flare-ups to help with the jaw pain. 

6. Medications 

Most prescription and over-the-counter medications have some type of a dental side effect. A dry mouth is one of them, which can make teeth more sensitive and prone to tooth decay. Some drugs even cause people to clench and grind their teeth more, which can make your teeth sore. 

Treatment

Talk to your doctor about dosing, the time of day you’re taking medications, and even if alternative drugs are available. Then work on managing the symptoms of your tooth pain by wearing a nightguard or supplementing with fluoride each day. 

7. Pregnancy Tooth Sensitivity 

Hormones can do a number on your body, not to mention your mouth. Some women experience things like “pregnancy gingivitis” or “pregnancy tumors” on their gums (but don’t worry; it’s usually temporary.) If you find that you’re throwing up a lot because of morning sickness, the enamel erosion can make your teeth sensitive too. 

Treatment

Oral infections can spread to your baby, so it’s important to have great oral hygiene before and during your pregnancy. Gently brush your gums daily, floss every day, and use a fluoride gel or mouth rinse whenever you feel like your acid levels (nausea) are on the rise.

8. Endurance Training

Athletes can really see a lot of issues like enamel erosion (from acidic sports drinks) and worn tooth enamel (from clenching their teeth) after long bouts of training. Not to mention the dry mouth they develop if they run low on fluids, breathe in through their mouths, or jaw pain from clenching. 

Treatment

Always wear a mouthguard while you’re involved in contact sports or something where you’re clenching your teeth a lot, like weight lifting or CrossFit. Drink plenty of water instead of sports drinks, and stay up to date on your dental checkups to keep ahead of preventable issues.

9. Gum Disease  

Periodontal disease (gum disease) can cause tooth pain, sensitivity, and sore gums. The receding gumlines and bone loss may even make your teeth feel mobile or cause them to fall out if the gum infection is severe enough. You might also have issues with bad breath and visible tartar buildup, not to mention bleeding gums.

Treatment

Deep cleanings are key to stopping the cycle of gum disease. Aggressive periodontal disease will need more than a scaling and root planing, though. If your gum disease is severe, bone or gum grafting, antibiotic therapy, or laser tissue treatments may also be necessary to prevent missing teeth. 

10. Acidic Diet  

Acidic foods, like lemons for example, can erode right through your tooth enamel causing tooth decay and severe pain. The more frequently you eat acidic foods, the more enamel erosion you’ll experience. Eroded enamel is thinner, smooth to the touch, and usually looks a little more translucent than before. 

Treatment

Don’t suck on lemons or drink a lot of orange juice every day. If you have an acidic meal, make sure you’re rinsing your mouth with water right afterward and then using fluoride to help remineralize your tooth. Severely eroded teeth will need treatments like crowns or veneers to reinforce the weak enamel that’s left behind. 

11. GERD  

Gastroesophageal reflux disease causes severe heartburn symptoms where stomach acids are coming back up into your mouth during the day. Usually, people with GERD will have tiny, hollowed-out little divots on the cusps of their back molars. The enamel erosion may be hard to miss, especially since not everyone experiences obvious heartburn symptoms. 

Treatment

For teeth that are damaged by GERD, the treatment process is similar to someone eating an acidic diet. Try to address the cause of the acid exposure (i.e., prescription medications) and rinse your mouth with water frequently throughout the day. See your dentist regularly and ask about a prescription for fluoride.

12. Dehydration

A dry mouth means you don’t have a saliva “buffer” around your teeth, which can make them more sensitive to different foods or temperature changes. A dry mouth also increases your chances of tooth decay, which in turn causes sensitive and aching teeth. 

Treatment

Make sure you’re drinking plenty of water. If chronic xerostomia (dry mouth) is an issue, use a saliva substitute such as a rinse or spray to keep your mouth moist. Chewing gum that has xylitol in it can also be beneficial against dry mouth and tooth decay.

13. Enamel Erosion

GERD, nausea, and acidic diets aren’t the only things that can cause enamel erosion. Teeth can also erode if you’re clenching and grinding them all the time, or if you’re brushing too hard with your toothbrush or too much candy. Brushing your teeth too hard will wear away your tooth structure over time resulting in sensitive teeth.

Treatment

Physically eroded teeth usually have to have some type of outside reinforcement placed over them so that they don’t hurt or break apart from everyday use. A full-coverage dental crown may be the only option, depending on the severity of your enamel erosion. 

14. Rinsing Your Mouth Too Often

Using a heavy-duty mouth rinse can dry out your mouth (which can make your teeth sorer than they already are.) If you’re using a whitening mouth rinse, you might get the same sensitivity side-effects that you do if you’re brushing with a whitening toothpaste.

Treatment

Just cut out the mouth rinse altogether or switch to something for sensitive teeth. Fluoride rinse usually helps with sensitivity and strengthens your enamel at the same time. 

15. Oral Cancer

Unfortunately, oral cancer is really hard to identify by yourself. If it reaches the point where there’s some type of pain involved, it’s probably in an advanced stage of the disease. Early warning signs include mouth sores that don’t heal and tissues that look different from the ones around them. There might even be cysts visible on your dental X-rays.

Treatment

The best treatment for oral cancer is early and regular screenings. The earlier abnormal tissues are identified, the better the outcome is likely to be. 

Preventing Aching Teeth

Why do my teeth hurt? Well, it can be a few things. What can you do to prevent aching teeth? Here are some important and helpful tips to reduce tooth pain:

  • Always wear a mouth guard if you’re prone to clenching your teeth or are involved in contact sports.
  • Schedule regular checkups to have your dentist screen for tooth enamel erosion, especially if you know you have GERD or tend to eat a lot of acidic foods. 
  • Use a fluoride mouth rinse and toothpaste each day. Sensitivity toothpaste is also helpful, but it can take at least a couple of weeks before you see the best results.
  • Check yourself for sinus infections or chronic allergies, which can mimic tooth pain. 
  • Address symptoms of gum disease sooner rather than later. 
  • If you’re using whitening products causing tooth sensitivity, then stop! Alternate which days you use them instead of back-to-back days of whitening. ( also use a tooth sensitivity toothpaste)
  • Don’t brush your teeth too hard since it can trigger gum recession and enamel abrasion/erosion in the areas where you’re exerting a lot of pressure. 
  • Drink plenty of water throughout the day to stay hydrated and limit acid levels in your mouth.
  • Have your dentist screen for other conditions like TMD, sleep apnea,  or bruxism.

Talk With Your Dentist 

If you have aching teeth, don’t ignore them. Anything that lasts more than a few days is worth looking into further. Especially if it’s radiating from a specific tooth like your wisdom teeth, as opposed to overall sensitivity. If you have tooth pain that’s triggered by hot temperatures or sweet foods, definitely talk to your dental professional or dentist as soon as you get a chance. [4]

Your visit with your dentist will probably include a limited exam and a small X-ray of the tooth that’s causing you problems. At that point, the two of you can review all of the other symptoms that are present and make a game plan about what to do next. 

Overcoming Tooth Pain

“Why does my tooth hurt,” you ask? Aching teeth or tooth pain might just be from the teeth whitening gel you’re using, gum recession from brushing too hard, or a dozen other reasons (some of which are pretty serious.) If your tooth hurts for more than a few days, make a point to talk to your dentist about your symptoms. Ideally, it’s best to get ahead of dental issues by watching out for early warning signs; that way, your dental team can treat them when they’re minor, less invasive to your tooth, and friendlier on your wallet. 

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