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Find the source
The dentist tests the tooth, checks your bite and takes an X-ray. Ten minutes usually identifies decay, a crack, a failing filling or an infection.
Same-day dentists available
Severe Toothache: Causes, Relief Tonight and When To See a Dentist
A toothache that is severe, constant or waking you at night usually means the nerve inside the tooth is inflamed or infected. Painkillers buy time, but only treatment stops it.
1-855-219-4656 Is a severe toothache an emergency?
Usually, yes. Call 1-855-219-4656 to be seen today. Pain that throbs, lingers after hot or cold, or stops you sleeping points to an inflamed or dying nerve, and that does not settle on its own. Head to the emergency room instead if the pain comes with facial swelling that is spreading, a high fever, or any trouble breathing or swallowing.
Nobody plans a toothache, and it rarely arrives at a convenient hour. The reassuring part is that most severe tooth pain has one of a handful of causes, and each of them can be diagnosed and calmed in a single visit. Our partner dentists keep same-day slots for exactly this.
Signs the toothache is serious
- Constant throbbing that gets worse when you lie down or bend forward
- Lingering sensitivity, where hot or cold triggers pain that lasts more than a few seconds
- Pain on biting or when you tap the tooth, a sign of inflammation around the root
- Pain that wakes you or that over-the-counter painkillers barely touch
- A bad taste, gum swelling or a bump near the tooth, which suggests infection
Short, sharp twinges that stop as soon as the cold drink is gone are usually a smaller problem, such as a worn area or a leaking filling. Pain that lingers, throbs or arrives on its own is the nerve telling you it is in trouble.
What to do tonight, before you are seen
| Do | Don't |
|---|---|
| Take ibuprofen with acetaminophen, following the package directions for each | Do not exceed the labeled dose, even if the pain is severe |
| Rinse gently with warm salt water to clear debris from around the tooth | Do not place aspirin, clove oil or any tablet directly on the gum |
| Floss carefully around the sore tooth in case trapped food is the trigger | Do not chew on that side or test the tooth with hot and cold |
| Keep your head raised on an extra pillow at night | Do not put off the appointment because the pain eased for a few hours. A nerve that dies can go quiet before it abscesses |
What happens at the emergency visit
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Stop the pain
Local anesthetic numbs the area first. Depending on the cause, the dentist either starts a root canal, places a sedative filling, or removes the tooth if it cannot be saved.
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Plan the final repair
Most emergency visits end with a temporary filling or dressing. A crown or permanent filling is scheduled for a follow-up once the tooth is calm.
What a toothache visit costs
| Treatment | Without insurance |
|---|---|
| Emergency exam + X-ray | $100–$250 |
| Temporary or sedative filling | $90–$300 |
| Root canal | $700–$1,500 |
| Simple extraction | $150–$400 |
| Drainage + antibiotics if infected | $200–$500 |
Estimates from partner clinic fee schedules. Your dentist quotes the exact fee before treatment. See the emergency dental cost guide and the no-insurance guide.
Treatments and related guides
Treatments a dentist may use: Emergency root canal, Emergency tooth extraction, Abscess drainage and antibiotics.
Severe Toothache FAQ
Need help right now? Call 1-855-219-4656, free, 24 hours a day.
Is a severe toothache an emergency?
If the pain is constant, throbbing, keeping you awake or not responding to painkillers, treat it as one and see a dentist today. Mild sensitivity that comes and goes can usually wait a day or two.
Why does my toothache get worse at night?
Lying flat increases blood flow to the head, which raises the pressure inside an inflamed tooth. There are also fewer distractions, so the pain feels louder. Sleeping propped up helps.
What is the fastest way to ease tooth pain at home?
A combination of ibuprofen and acetaminophen, taken as the labels direct, works better than either one alone. Add a warm salt water rinse and a cold compress on the cheek. This is a bridge to treatment, not a cure.
Can a toothache go away on its own?
Sometimes the pain fades because the nerve has died, not because the problem is fixed. The bacteria are still there and often return as an abscess weeks later. Get the tooth checked even if it has gone quiet.
Will the dentist pull the tooth?
Not necessarily. If the tooth is structurally sound, a root canal removes the infected nerve and keeps the tooth. Extraction is reserved for teeth that are too broken down or cracked to restore.
Medically reviewed by Dr. FULL NAME, DDS. Last reviewed . Sources: Mayo Clinic, Toothache first aid, ADA MouthHealthy, Dental Emergencies. Editorial policy.
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