How to stop a very bad toothache

A very bad toothache needs prompt dental examination; pain medicine and a cold compress can reduce symptoms temporarily but do not remove the cause.

Toothache can come from inflamed pulp inside the tooth, a dental abscess, decay, a crack, exposed dentin, gum infection, or an overload from the bite. The pain pattern, temperature response, swelling, and dental tests help identify the source.

Rinse gently with warm water, clean around the painful tooth, use a cold pack on the cheek for short intervals, and take an over-the-counter pain reliever only as directed on its label and appropriate for you. Do not place aspirin or concentrated chemicals on the gum.

Seek prompt care for severe or persistent pain, pain that wakes you, swelling, fever, a bad taste, or difficulty opening the mouth. Go urgently for trouble breathing or swallowing, rapidly spreading facial swelling, or swelling near the eye.

Ask which tooth or tissue is causing the pain, whether an X-ray or pulp tests are needed, and whether the treatment is a filling, root canal, extraction, drainage, or another procedure.