Tooth pain commonly comes from one of four patterns: decay irritation, crack stress, bite overload, or infection.
Call today if:
- Pain wakes you up
- Facial swelling is present
- Fever occurs
- Swallowing feels difficult
- Pain is rapidly worsening
Tooth pain is discomfort arising from irritation or inflammation of the pulp, the surrounding ligament, or supporting bone. It may be triggered by temperature, pressure, infection, fracture, or cumulative bite stress.
Pain intensity alone does not determine severity. Pattern and duration matter more than volume.
Common patterns and what they can mean
| Pattern | Often related to | Urgent |
|---|---|---|
| Sharp pain when biting | Crack, high bite point, compromised filling | Usually no |
| Cold sensitivity that lingers | Dentin exposure, early decay, irritation | Sometimes |
| Hot sensitivity that lingers | Inflamed pulp, deeper irritation | Often yes |
| Throbbing, pressure, night pain | Deeper inflammation, possible infection | Often yes |
| Swelling with pain | Infection or flare-up | Yes |
Patterns guide urgency. The goal is to identify what is driving the pain before options narrow.
- Swelling that spreads
- Severe pain lasting hours without relief
- Pain with fever
- Difficulty swallowing or breathing
- Brief cold sensitivity
- Mild pressure soreness
- Occasional chewing discomfort
- Short term gum irritation
Is this urgent
More urgent patterns include:
- Night pain that does not let you sleep
- Swelling that is spreading
- Fever or feeling sick
- Severe pressure pain that is increasing
Mild pain that comes and goes often allows time for evaluation. The key is not to wait until the pain becomes constant.
Tooth pain when biting
Pain on biting often points to structure or bite load. Common causes include a crack, a high bite point, or a compromised restoration.
If it is sharp on one specific bite point, do not ignore it.
Tooth pain with cold or hot
Cold discomfort can happen when dentin becomes exposed. Hot pain can matter because it may suggest deeper irritation.
If hot pain is strong or lingering, evaluation should not be delayed.
Tooth pain that comes and goes
Intermittent pain can happen when inflammation is early or when a trigger is not constant. It can also happen with cracks that only activate under certain forces.
When pain is becoming easier to trigger over time, that usually means progression.
Tooth pain worse at night
Night pain often matters because it suggests deeper irritation. In quiet conditions, pressure or throbbing can become more noticeable.
If night pain is consistent, evaluation should not be delayed.
Tooth pain after dental work
Temporary sensitivity can happen after fillings, cleanings, or bite adjustments. It should trend better, not worse.
If pain increases over days, or biting becomes sharp, it is worth rechecking the bite and structure.
Tooth pain but no obvious cavity
Sometimes pain is driven by bite overload, a small crack, gum inflammation, or irritation under an old restoration.
When the cause is not obvious, calm evaluation protects options. Guessing often leads to repeated dentistry.
Tooth pain that feels like sinus pressure
Upper back teeth can feel sore when the sinus area is inflamed. The important step is to confirm whether the tooth itself is involved.
If pain is one sided, triggered by biting, or accompanied by swelling, it should be evaluated.
What we evaluate
Tooth pain is not treated well by guessing. We identify the pattern and evaluate long term stability.
If you want the deeper decision layer, our Structural Decision Framework explains how we evaluate stability before irreversible treatment.
What to do now
If pain is mild:
- Avoid chewing on that side
- Avoid very cold or very hard foods
- Schedule a visit for evaluation
If pain is severe or swelling is present:
- Call us
- Do not wait for it to go away on its own
Related entries
Frequently asked questions
These scenarios show how thresholds shift when structure changes over time under force.