Table: Some Causes and Features of Toothache - Merck Manuals Consumer Version

Some Causes and Features of Toothache

Cause	Common Features*	Tests
Periapical abscess Periapical Abscess A periapical abscess is a collection of pus at the root of a tooth, usually caused by an infection that has spread from a tooth to the surrounding tissues. (See also Overview of Tooth Disorders... read more (a collection of pus around the tooth's root that can cause acute or chronic symptoms)	Pain may have begun recently or be longstanding Constant pain that worsens when chewing or biting Normally, the person can precisely identify the involved tooth Tooth tender when tapped with a metal probe or tongue depressor (percussed) Sometimes visible swelling of the gum over the affected root and painful swelling of the adjacent cheek and/or lip	A dentist's examination†
Apical periodontitis (inflammation of tissues around the tooth's root)	Features similar to those of apical abscess but less severe and without swelling over the affected root	A dentist's examination†
Cavities Cavities Cavities are decayed areas in the teeth, the result of a process that gradually dissolves a tooth’s hard outer surface (enamel) and progresses toward the interior. (See also Overview of Tooth... read more	Pain that Occurs mainly after brushing or after chewing or swallowing hot, cold, or sweet food or drink Is isolated to a single tooth Usually stops when the stimulus is removed Usually a visible cavity or a root surface exposed by gum recession or an abrasion	A dentist's examination†
Fracture of a tooth	Sharp pain when chewing Marked sensitivity to cold	A dentist's examination†
Pericoronitis Gingivitis due to an impacted tooth (pericoronitis) Gingivitis is a mild form of periodontal disease characterized by inflammation of the gums (gingivae). Gingivitis results most often from inadequate brushing and flossing but may result from... read more (usually involving an erupting or partially impacted wisdom tooth)	Constant dull pain, especially when chewing Visible swelling, redness, and sometimes pus around the affected tooth Commonly spasms of the chewing muscles (trismus) may occur and limit opening	A dentist's examination†
Pulpitis Pulpitis Pulpitis is painful inflammation of the tooth pulp, the innermost part of the tooth that contains the nerves and blood supply. (See also Overview of Tooth Disorders.) The most common cause of... read more (inflammation of the tooth pulp)	Pain that occurs without stimulation and/or that lingers for more than a few seconds after stimulation May have difficulty identifying the affected tooth	A dentist's examination†
Sinusitis Sinusitis Sinusitis is inflammation of the sinuses, most commonly caused by a viral or bacterial infection or by an allergy. Some of the most common symptoms of sinusitis are pain, tenderness, nasal congestion... read more	Pain in several upper teeth on one side, especially molars and premolars Sensitivity when chewing and when the upper teeth are tapped (percussed) Often a nasal discharge and tenderness when the sinus is tapped Pain when changing positions, especially lowering the head (as when bending down to tie shoe laces)	A doctor's examination, sometimes with CT of the sinuses A dentist’s examination if no sinusitis is detected
Teething Treatment	Discomfort and fussiness during tooth eruption in young children Commonly drooling and chewing on things (such as the crib rail)	A doctor's examination
* Features include symptoms and the results of the doctor’s examination. Features mentioned are typical but not always present.
† Dental x-rays are usually taken.
CT = computed tomography.