Toothache: what's happening, and what to do tonight
Most toothache is one of four things — a cavity reaching the dentine, an inflamed nerve, gum-line irritation, or referred sinus pain. How the pain behaves usually tells you which one. Here's how to read your pattern, what's safe to do tonight, and when it crosses into urgent.
Written and reviewed by an AHPRA-registered dentist.
When toothache is an emergency
Pain on its own is rarely a hospital-ED problem. Pain combined with the signs below means the infection has gone beyond a tooth — see also our wider guide to dental emergencies in Australia.
Call 000 or head to a hospital ED if any of the following are present.
- Facial swelling spreading toward the eye or down the neck
- Fever above 38.5 °C alongside the toothache
- Difficulty swallowing or breathing
- Voice change or muffled speech
- Generally unwell — chills, racing heart, confusion
What's actually behind the pain
The way your toothache behaves tells you a lot about what's going on. Match yours against the patterns below.
Sharp pain on cold, sweet, or biting — settles in seconds
Usually a cavity that's reached the layer beneath the enamel (dentine). The trigger zings the nerve briefly but the pain stops when the trigger does. Caught here it's usually a filling at typical Australian fee ranges. If the cold/hot/sweet zing is the whole story without throbbing, our deeper read on why a tooth zings on cold, hot, or sweet tells you when sensitivity is routine versus the early sign of a cavity.
Constant throbbing, worse lying down
The nerve inside the tooth has become inflamed (pulpitis) — usually because a cavity or crack has reached it. This category needs in-person care within a few days; if swelling appears, escalate sooner and read our signs of a tooth abscess and when antibiotics are not enough guide. Treatment is usually a root canal at typical Australian fees or an extraction at typical Australian fees.
Pain on biting, in a specific tooth
Often a cracked tooth — the crack opens slightly under bite load and aggravates the nerve. Sometimes a high filling that's leaving one cusp catching first. Within-the-week dentist visit. Our broken-or-chipped-tooth severity guide walks through the four kinds of break and which need a crown.
Aching along the gum line, multiple teeth
Less likely a single tooth issue, more likely gum inflammation or sinus referral. Upper back teeth ache during a head cold is a classic sinus pattern. Settles when the sinus clears.
What's safe to do tonight
General guidance, not personal advice. These help you cope while you book in.
- OTC pain relief per the packet — paracetamol and ibuprofen are commonly used.
- Cold compress on the outside of the cheek for 15-minute stretches. Avoid heat — it can encourage swelling to spread if infection is brewing.
- Warm salt-water rinses, a few times a day.
- Soft food on the other side. Avoid very hot, very cold, or very sweet food and drinks — all spike the pain.
- Don't put aspirin or any tablet directly on the gum or tooth. Chemical burn.
- Don't smoke — slows healing and can intensify the throbbing.
These steps help you cope. None of them fix what's causing the pain — that needs a dentist's eye, and in most cases their hands. Use the time these measures buy you to arrange real care.
If you know what you're dealing with
Specific situations behind toothache — each with its own home-care playbook.
Tooth abscess
Throbbing pain plus swelling means infection. When it's urgent, when it's ED.
Broken or chipped tooth
Pain on biting, sharp edge cutting the tongue. Four categories of break.
Wisdom tooth pain
Pain at the back, gum flap inflammation (pericoronitis), home-care playbook.
No dentist nearby?
Rural-access playbook — public dental by state, town-by-town guides for remote Australia, drive-or-wait decisions, online review.
Toothache: common questions
Not sure how urgent yours is?
Send a photo and a short description. An AHPRA-registered Australian dentist replies within 24 hours with a plain-English urgency rating and a referral letter if useful.
Start a case — $25