Severe Toothache — Same-Day Assessment
Throbbing or lingering tooth pain needs an exam, not a guess from a web page.
What is happening?
A severe toothache is pain coming from a tooth or the tissue around it. Common sources include decay that has reached the nerve, a crack, an abscess, a lost filling that has exposed dentin, food packed between teeth, or sinus pressure that mimics an upper molar.
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Common symptoms
- Constant throbbing or sharp pain
- Pain that gets worse when you lie down
- Pain on biting
- Hot or cold sensitivity that lingers for minutes
- Pain radiating toward the ear, jaw, or neck
Is it urgent?
Pain that wakes you at night. Pain that does not ease with over-the-counter medicine. Facial swelling with the toothache.
Call (416) 483-0000 →While you are on the way for a toothache
Call us
Tell us the pain started, whether it wakes you, and whether your face is swelling.
Pain relief
Use ibuprofen and/or acetaminophen as the package directs. Do not place aspirin on the gum — it burns the tissue.
Cold, not heat
A cold compress on the outside of the cheek, 15 minutes on and 15 off. Do not put heat on the face, and skip very hot or very cold food.
Common causes
Deep decay reaching the nerve (pulpitis) · A cracked tooth · A dental abscess · A failing or lost filling exposing dentin · Food impaction between teeth · Sinus pressure mimicking an upper molar
How we diagnose it
We examine the tooth, test it with cold and biting, and take an x-ray when that will show the nerve, a crack, or an infection. If a flat x-ray cannot explain the pain, we say so and discuss the next image — we do not treat the symptom as if it were the diagnosis.
How we treat it
Find the source
The visit starts by separating a nerve problem, a crack, an abscess, and a sinus mimic. The treatment follows that finding.
Relieve the cause
That may be a filling, a crown, a root canal, drainage, or an extraction if the tooth cannot be kept. You get a written estimate before non-urgent work starts.
Sedation for this kind of treatment
If the painful tooth needs a root canal or extraction and sitting through it worries you, say so when you call. Local anesthetic numbs the tooth at the visit. Nitrous oxide may be possible the same day. Oral sedation, IV sedation, and general anesthesia are scheduled for a later visit, not started on arrival.
Sedation optionsRelated pages
Good to know
Frequently asked questions
Still have a question? Our team is happy to help over the phone.
(416) 483-0000Can you help if I have severe tooth pain tonight?
Call us. New-patient admissions run from 6 AM to 2 AM. If pain wakes you, does not respond to over-the-counter medicine, or comes with facial swelling, we treat it as same-day.
Should I put aspirin on the gum?
No. Aspirin on the gum burns the tissue. Use pain medicine by mouth, as the label directs, and a cold compress on the cheek.
Will the pain disappear once I arrive?
The aim is to find what is causing the pain and treat that cause so you can get comfortable. We do not promise the pain will vanish before the cause is treated.
Read this as education
These are common patterns, not a diagnosis of your tooth. Your dentist determines the cause during an examination.