Toothache: First aid

By Mayo Clinic Staff

Tooth decay is the primary cause of toothaches for most children and adults. Bacteria that live in your mouth thrive on the sugars and starches in the food you eat. These bacteria form a sticky plaque that clings to the surface of your teeth.

Acids produced by the bacteria in plaque can eat through the hard, white coating on the outside of your teeth (enamel), creating a cavity. The first sign of decay may be a sensation of pain when you eat something sweet, very cold or very hot.

Other causes of toothache can include:

  • An accumulation of food and debris between your teeth, especially if teeth have spacing between them
  • Infection at the root of the tooth or in the gums
  • Trauma to the tooth, including injury or grinding your teeth
  • Sudden fracture of the tooth or tooth root
  • A split in the tooth that occurs over time
  • Tooth eruption through the gums (teething)
  • Sinus infection that can be felt as pain in the teeth

A toothache often requires some sort of treatment by your dentist.

Until you can see your dentist, try these self-care tips for a toothache:

  • Rinse your mouth with warm water.
  • Use dental floss to remove any food particles or plaque wedged between your teeth.
  • Take an over-the-counter (OTC) pain reliever to dull the ache, but don't place aspirin or another painkiller directly against your gums because it may burn your gum tissue.
  • Sparingly apply an OTC antiseptic containing benzocaine directly to the irritated tooth and gum for temporary relief.
  • Apply oil of cloves (eugenol) on a small piece of cotton directly to the sore tooth and gum to numb the area.
  • If the toothache is caused by trauma to the tooth, apply a cold compress to the outside of your cheek.

Benzocaine has been linked to a rare but serious, sometimes deadly, condition called methemoglobinemia, which decreases the amount of oxygen that the blood can carry. So follow these guidelines:

  • Talk to your health care provider about using an OTC antiseptic containing benzocaine.
  • Don't use benzocaine in children younger than age 2 without supervision from a health care professional.
  • Never use more than the recommended dose of benzocaine.
  • Store products containing benzocaine out of the reach of children.

Call your dentist immediately if you have any of the following with a toothache:

  • Pain that persists for more than a day or two
  • Fever
  • Signs and symptoms of infection, such as swelling, pain when you bite, red gums or a foul-tasting discharge
  • Trouble breathing or swallowing
Nov. 25, 2014