Toothache no cavity

Toothache without a visible cavity may come from a crack, irritated pulp, exposed dentine, gums, a root, or nearby structure.

A visual check may miss a crack, early decay between teeth, inflammation inside the pulp, or a problem beneath an existing filling. Other possibilities include sinus pressure affecting upper teeth, food impaction, gum infection, clenching, or pain referred from another tooth, so the painful tooth is not always the source.

A dentist localises the source with a history, percussion, bite testing, cold or electrical pulp tests, gum measurements, and selected radiographs. Until assessed, avoid chewing on the painful side, keep the area clean, and note triggers such as cold, heat, pressure, or spontaneous pain.

Seek prompt care if pain lasts, wakes you, worsens, or comes with swelling, fever, a bad taste, or difficulty opening your mouth. Breathing or swallowing difficulty with facial swelling needs emergency help.

Ask which tests identified the source and whether the pulp, root, gum, bite, sinus, or neighbouring tooth is involved. Ask when imaging or a review is needed if the first examination is inconclusive.

A normal-looking surface does not rule out pulp inflammation or a crack.