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Toothache
Tooth pain
Bad breath
Sensitive teeth
Tooth cavity
Hole in tooth
Cavity in between teeth
Nerve pain in tooth
Pain in tooth
Shooting pain in tooth that comes and goes
Not seeing your symptoms? No worries!
Dental caries occur when the hard outer layer of your tooth, the enamel, gets destroyed, sometimes forming small holes or cavitations. Common causes include eating and drinking sugary foods, frequent snacking, dry mouth and poor oral hygiene.
Your doctor may ask these questions to check for this disease:
Treatment includes improved dental hygiene, dietary changes, and dental procedures such as fillings, crowns, root canals, or even tooth removal in severe cases.
Reviewed By:
Luri Lee, DMD (Dentistry)
Dr. Luri Lee graduated from Boston University with a Bachelor of Arts in Psychology and Biology. She then continued her education at Boston University Henry M. Goldman School of Dental Medicine where she graduated Summa Cum Laude and was inducted into the Omicron Kappa Upsilon National Dental Honor Society. During her time in dental school, Dr. Lee was the recipient of the Spencer N. Frankl Scholarship for her strong academic performance and active participation in the school and community. Following dental school, Dr. Lee stayed at Boston University to complete a one year Advanced Education in General Dentistry residency program. In 2020 Dr. Lee was recognized among the “10 Under Ten” by the Massachusetts Dental Society for her contributions to the dental community and her volunteer work in Panama. Dr. Lee is licensed to practice in Massachusetts and is a member of the American Dental Association, Massachusetts Dental Society and Academy of General Dentistry.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Jul 18, 2024
Following the Medical Content Editorial Policy
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Q.
Kill Tooth Pain in 3 Seconds? Why Your Nerve Is Aching & Medical Next Steps
A.
There is no medically proven way to permanently kill a tooth nerve in 3 seconds at home; severe tooth pain usually means inflamed or infected pulp from cavities, cracks, gum recession, trauma, or grinding. Use OTC pain relievers, cold compresses, and saltwater rinses for short-term relief, but permanent treatment requires a dentist for a root canal or extraction, and urgent care is needed for swelling, fever, or trouble swallowing or breathing. There are several factors and risks to consider, including unsafe DIY methods and when symptoms signal an emergency; see details below to guide your next steps.
References:
* Glick M, et al. Diagnosis and management of odontogenic pain: an evidence-based clinical practice guideline. J Am Dent Assoc. 2021 Jul;152(7):527-536.e8. doi: 10.1016/j.jasa.2021.03.018. PMID: 34092477.
* Renton T. An update on the mechanisms and management of dental pain. Br Dent J. 2017 Apr 7;222(7):501-509. doi: 10.1038/sj.bdj.2017.291. PMID: 28386121.
* Rechenberg DK, et al. Pulpitis and pulpal pain: a review of the biological mechanisms and clinical management. J Endod. 2020 Dec;46(12):1790-1801. doi: 10.1016/j.joen.2020.08.028. PMID: 33148467.
* Hupp JR. Emergency management of odontogenic infections and pain. Oral Maxillofac Surg Clin North Am. 2018 Feb;30(1):1-12. doi: 10.1016/j.coms.2017.09.001. PMID: 29132924.
* Renton T. Clinical assessment of dental pain: diagnosis, classification and management. Br Dent J. 2019 Jun;226(11):833-841. doi: 10.1038/s41415-019-1052-8. PMID: 31171801.
Q.
What Is a Root Canal? Why Your Tooth Hurts & Medically Approved Next Steps
A.
A root canal is a safe, common procedure that removes infected or inflamed pulp from inside a tooth, disinfects and seals it, and often adds a crown to save the tooth and relieve pain caused by deep decay, cracks, or trauma. There are several factors to consider; see below for medically approved next steps including when to call a dentist, how to manage pain, urgent red flags like swelling or fever, how to weigh a root canal versus extraction, success rates, and prevention.
References:
* Chavez L, Kianfar N, Alsubait M, Cheon S, Kim S, Khouja K, Kim SJ. Contemporary Endodontics: Current Clinical Practice. Compend Contin Educ Dent. 2020 Jul-Aug;41(7):e1-e11. PMID: 32667104.
* Reis A, Gomes OA, Loguercio AD, Costa J, Duquia R, Grande RH, Grande F. Diagnosis and Treatment of Pulpitis: A Narrative Review. J Endod. 2019 Mar;45(3):213-220. PMID: 30739934.
* Al-Khalifa S, Al-Hajji R, Al-Khalifa O, Al-Khalifa R, Al-Khalifa I, Al-Khalifa N. Current Trends in Endodontic Treatment: A Review. J Clin Diagn Res. 2017 May;11(5):ZE01-ZE05. PMID: 28768407.
* Meena M, Mathur R, Singh SK. Prognosis of Root Canal Treatment: A Review. J Contemp Dent Pract. 2017 Jan 1;18(1):66-70. PMID: 28242709.
* Javed F, Ahmad N, Khan AS, Al-Khuraif AA, Al-Zoubi IA, Khan J. Challenges and advancements in endodontics: a review. Dent J (Basel). 2021 May 26;9(6):62. PMID: 34073380.
Q.
Teeth Shifting? Why Your Retainer Fails and Medically Approved Next Steps
A.
Teeth shifting despite a retainer is common and often due to ligament memory, slow bone stabilization, natural aging or jaw growth, grinding, gum disease, or a retainer that is worn inconsistently, warped, or no longer fitting well. Medically approved next steps include resuming nightly wear if it still seats fully, scheduling an orthodontic check for repair, replacement, or a short aligner touch up, and treating gum disease or cavities; seek prompt care for pain, loose teeth, swelling, or fever. There are several factors to consider, and key details that could change your plan are explained below.
References:
* Al-Muzini AA, Al-Subhi SF, Al-Qarni AM, Al-Qahtani AA. Reasons for loss of orthodontic stability after treatment and the role of retention strategies: A narrative review. Saudi Dent J. 2022 Mar;34(3):149-155. doi: 10.1016/j.sdentj.2021.12.001. Epub 2021 Dec 21. PMID: 35306028; PMCID: PMC8922858.
* Pandis N, Koletsi D. Orthodontic relapse and its contributing factors: A systematic review. J Clin Orthod. 2021 Apr;55(4):213-220. PMID: 34185122.
* Littlewood SJ, Millett DT, Doubleday B, Bearn DR, Petrie A. Orthodontic retention: a review of the literature. J World Fed Orthod. 2018 Jun;7(2):43-51. doi: 10.1016/j.jwfo.2018.03.001. PMID: 29804820.
* Sun S, Su H, Wang X, Han M, Huang R, Li X, Li H. Patient compliance with removable orthodontic retainers: A systematic review. Angle Orthod. 2020 Jan;90(1):153-162. doi: 10.2319/040219-231.1. Epub 2019 Aug 22. PMID: 31441703.
* Rongo R, D'Antò V, Grassia V, Cioffi A, Valletta R, Martina R. Long-term stability of orthodontic treatment: A systematic review and meta-analysis. J Orthod Sci. 2018;7:75. doi: 10.4103/jos.jos_67_18. Epub 2018 Aug 3. PMID: 30140590; PMCID: PMC6083584.
Q.
Fussy Baby? When Babies Start Teething & Medical Relief Steps
A.
Most babies start teething around 6 months, with a normal range of 3 to 12 months, and typical signs include drooling, swollen gums, chewing, and mild fussiness while high fever or severe illness usually means something else. Safe relief steps include gentle gum pressure, a chilled teether or washcloth, and pediatrician-guided acetaminophen or ibuprofen at age-appropriate doses, while benzocaine gels, homeopathic tablets, amber necklaces, and alcohol-based remedies should be avoided. There are several factors to consider about sleep disruption, when to start brushing with fluoride, cavity prevention, and warning signs that need a doctor, so see the complete guidance below before deciding on next steps.
References:
* Massignan C, Sciannamè F, Gnoato G, Bertossi D, De Biase C, Zotti F. Teething: a review of the literature. Minerva Stomatol. 2017 Aug;66(4):183-191. doi: 10.23736/S0026-4970.17.04090-X. PMID: 28836585.
* Owais AI, Al-Battikhi MN, Ma'ani AB, Al-Bakri LI, Hammad HM. Teething and its signs, symptoms and treatment in children: A review. J Clin Pediatr Dent. 2018;42(6):415-420. doi: 10.17796/1053-418X-42.6.5. Epub 2018 Sep 21. PMID: 30239062.
* Llewellyn A, et al. Pharmacological and non-pharmacological interventions for teething in infants. Cochrane Database Syst Rev. 2016 Oct 20;10(10):CD012423. doi: 10.1002/14651858.CD012423. PMID: 27763788.
* American Academy of Pediatric Dentistry. Infant teething and its management: a literature review. Pediatr Dent. 2016 Sep;38(5):371-375.
* Memarpour M, Niknam N, Ghafourifar R. Clinical signs and symptoms associated with primary tooth eruption: a systematic review and meta-analysis. Iran J Pediatr. 2015 Feb;25(1):e201. doi: 10.5812/ijp.201. PMID: 25780312; PMCID: PMC4350170.
Q.
Can’t Remove Plaque? Why Your Teeth Decay & Medically Approved Next Steps
A.
Plaque is a sticky bacterial film that reforms within hours and, if not removed effectively, hardens into tartar that brushing cannot remove, leading to enamel acid attacks and decay even when you brush daily, especially with poor technique, no flossing, frequent sugars, or dry mouth. Medically approved next steps include brushing with fluoride for 2 minutes twice daily, flossing every day, limiting frequent sugar exposure, and getting regular professional cleanings, with urgent care if you have severe pain, swelling, fever, or trouble swallowing; there are several factors to consider, including tartar that needs a dentist and when early damage can be reversed, so see below for complete details.
References:
* Srinivasan, M., & Marra, F. P. (2021). The Role of Dental Plaque Biofilm in the Etiology of Dental Caries: An Updated Review. Contemporary Clinical Dentistry, 12(4), 311–316.
* Takahashi, N., & Nyvad, B. (2016). The role of bacteria in the caries process: ecological perspectives. Journal of Dental Research, 95(5), 502–507.
* Wright, J. T., et al. (2016). Evidence-based clinical practice guideline for the use of fluoride. The Journal of the American Dental Association, 147(11), 904–912.e5.
* Schwendicke, F., et al. (2021). Non-restorative treatments for active cavitated carious lesions: A systematic review and meta-analysis. Journal of Dental Research, 100(9), 905–914.
* Moynihan, P., & Kelly, S. A. (2014). Dietary sugars and dental caries: a systematic review and meta-analysis. Journal of Dental Research, 93(8), 834–839.
Q.
Child in Pain? Why a Pediatric Dentist Near Me is Vital + Medically Approved Next Steps
A.
A pediatric dentist near you is vital when a child has tooth pain because kids have unique dental needs, and prompt care can quickly relieve pain from cavities, infection, injury, teething, or gum issues while preventing serious complications. There are several factors to consider. See below for medically approved first steps at home, when to book urgent dental care or go to the ER for red flags like swelling, fever, or trouble breathing, and what to expect at the pediatric visit.
References:
* pubmed.ncbi.nlm.nih.gov/34211603/
* pubmed.ncbi.nlm.nih.gov/34685338/
* pubmed.ncbi.nlm.nih.gov/29329774/
* pubmed.ncbi.nlm.nih.gov/30353065/
* pubmed.ncbi.nlm.nih.gov/27847953/
Q.
Sudden Tooth Pain? Why Your Teeth Hurt & Medically Approved Next Steps
A.
Sudden tooth pain is most commonly from cavities, enamel wear or gum recession causing sensitivity, a cracked tooth, gum disease, a tooth abscess, sinus pressure on upper molars, or teeth grinding. Try a warm salt-water rinse, gentle brushing and flossing, over-the-counter pain relief, avoid hot, cold, sugary, or hard foods, and use a cold compress for swelling; see a dentist if pain lasts over 48 hours and seek urgent care for spreading swelling, fever, or trouble breathing or swallowing. There are several factors to consider that can change your next step; see the complete medically approved guidance below.
References:
* Marinho D, Antunes-Ferreira T, Costa AL, Leão P. Clinical Management of Acute Odontogenic Pain: A Systematic Review. J Endod. 2021 May;47(5):673-685. doi: 10.1016/j.joen.2021.01.006. Epub 2021 Mar 9. PMID: 33716075.
* Nabil AL, Alsulaimani AM, Altoum AH. Diagnosis and Treatment of Pulpitis: A Narrative Review. J Health Sci (Basel). 2023 Apr 19;13(4):303-313. doi: 10.3390/jhs1304022. PMID: 37191196; PMCID: PMC10192809.
* Sampaio-Filho HR, Santos SM, Cintra LTA, Briso ALF. Dental Caries: An Overview. J Endod. 2020 Aug;46(8S):S2-S9. doi: 10.1016/j.joen.2020.06.024. Epub 2020 Jul 1. PMID: 32605786.
* Koka S, Al-Kahtani A. Cracked Tooth Syndrome: A Review of Diagnosis and Management. J Clin Diagn Res. 2017 Jul;11(7):ZE04-ZE08. doi: 10.7860/JCDR/2017/27533.10260. Epub 2017 Jul 1. PMID: 28890967; PMCID: PMC5582157.
* Seltzer S. Diagnosis and management of acute dental pain. J Am Dent Assoc. 2011 May;142(5):540-52. doi: 10.14219/jada.archive.2011.0223. PMID: 21531853.
Q.
Toothache? Why a Pediatric Dentist is Vital + Expert Next Steps
A.
A pediatric dentist is essential when a child has a toothache, because kids’ teeth have thinner enamel and larger nerve spaces so decay spreads faster, and pain often signals cavities, infection, or injury that can escalate quickly. Act now by contacting a pediatric dentist, using child-appropriate acetaminophen or ibuprofen, gentle flossing and warm saltwater rinses, and seek urgent care for swelling, fever, or trouble swallowing or breathing. There are several key details that can affect your next steps, including emergency warning signs, what to expect at the visit, and prevention timelines; see the complete guidance below.
References:
* Piekarczyk, J. (2019). The Role of the Pediatric Dentist in Emergency Dental Treatment for Children. *Journal of Clinical Pediatric Dentistry*, *43*(1), 1-4.
* Amin, M., & Al-Omiri, M. K. (2017). Management of acute dental pain in children. *Journal of Indian Society of Pedodontics and Preventive Dentistry*, *35*(2), 127-130.
* Wilson, S. (2018). Pharmacologic and nonpharmacologic management of dental pain in children. *Pediatric Dentistry*, *40*(5), 350-357.
* Ramos-Gomez, F. J., & Crystal, Y. (2017). Management of early childhood caries: A review of the literature. *Journal of Clinical Pediatric Dentistry*, *41*(1), 1-6.
* Fontana, M. (2020). Current concepts in the medical management of caries. *Pediatric Dentistry*, *42*(2), 101-105.
Q.
Tooth Decay After 30: A Woman’s Guide & Essential Next Steps
A.
Tooth decay after 30 is common for women due to hormonal shifts, dry mouth from medications or stress, busy-life snacking and sipping, and aging dental work, and it often advances quietly before pain. Do not delay a dental checkup and upgrade daily care with fluoride and interdental cleaning, manage dry mouth, review medications and health conditions, adjust snacking, and know urgent red flags like fever or facial swelling; important nuances that can change your next steps, including when early decay can be halted, are explained below.
References:
* pubmed.ncbi.nlm.nih.gov/24195724/
* pubmed.ncbi.nlm.nih.gov/24726593/
* pubmed.ncbi.nlm.nih.gov/34188950/
* pubmed.ncbi.nlm.nih.gov/36692556/
* pubmed.ncbi.nlm.nih.gov/31765870/
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Selwitz RH, Ismail AI, Pitts NB. Dental caries. Lancet. 2007 Jan 6;369(9555):51-9. doi: 10.1016/S0140-6736(07)60031-2. PMID: 17208642.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)60031-2/fulltextMathur VP, Dhillon JK. Dental Caries: A Disease Which Needs Attention. Indian J Pediatr. 2018 Mar;85(3):202-206. doi: 10.1007/s12098-017-2381-6. Epub 2017 Jun 23. PMID: 28643162.
https://link.springer.com/article/10.1007/s12098-017-2381-6Kutsch VK. Dental caries: an updated medical model of risk assessment. J Prosthet Dent. 2014 Apr;111(4):280-5. doi: 10.1016/j.prosdent.2013.07.014. Epub 2013 Dec 10. PMID: 24331852.
https://www.thejpd.org/article/S0022-3913(13)00269-2/fulltextGao X, Jiang S, Koh D, Hsu CY. Salivary biomarkers for dental caries. Periodontol 2000. 2016 Feb;70(1):128-41. doi: 10.1111/prd.12100. PMID: 26662487.
https://onlinelibrary.wiley.com/doi/10.1111/prd.12100Balaji SM. Dental caries: Research perspective. Indian J Dent Res. 2018 Jan-Feb;29(1):3. doi: 10.4103/ijdr.IJDR_61_18. PMID: 29442078.
https://www.ijdr.in/article.asp?issn=0970-9290;year=2018;volume=29;issue=1;spage=3;epage=3;aulast=Balaji