Why Does a Cavity Hurt? (5 BEST Toothache Home Remedies)
Matt Hannan, DDS
Updated: July 6, 2023
A toothache is one of the most painful things you can experience. But what makes them hurt so much? And what are the best ways to treat a toothache at home? Here are the five best dentist-approved toothache home remedies backed by science to help you get relief fast!Recommended Reading: Cavities | The Ultimate Guide
Why does a cavity hurt?
A cavity forms when tooth decay reaches the tooth’s middle layer, the dentin. The dentin is sensitive to both hot and cold, and acids from food can cause it to hurt. When the tooth decay extends into the tooth’s pulp (the innermost layer of the tooth that contains blood vessels and nerves), the pulp becomes inflamed, and the toothache can become very severe.
What is a cavity?
A cavity is a tooth decay lesion. This type of tooth decay forms when bacteria and food debris combine to form plaque, which then hardens into tartar. The bacteria in plaque produce acids that attack the tooth’s enamel and dentin, causing the tooth to lose minerals and eventually break down.
Related: Learn more about Cavities
Does a cavity spread to other teeth?
A cavity will not automatically spread to other teeth. If plaque is removed regularly through proper oral hygiene practices, tooth decay will not occur, and you will minimize the risk of cavities spreading. However, if cavity-causing bacteria harbors between adjacent teeth for an extended period, tooth decay can affect both teeth. Therefore, you should treat cavities immediately to prevent further damage.
Can a cavity be reversed?
Yes, it can be reversed if the cavity is located in the enamel (outermost layer). This process is called remineralization and occurs when fluoride repairs the weakened enamel surface. However, if the cavity has progressed into the dentin, it will need to be restored by your dentist.
Recommended Reading: Can You Reverse a Cavity? (5 Simple Steps)
Cavity signs & symptoms
The most common symptom of a cavity is tooth pain which occurs when tooth decay breaks through the hard outer layer of the tooth (enamel) and reaches the softer middle layer (dentin). The inner layer (pulp) houses blood vessels and nerves that extend into the dentin.
Other signs & symptoms of cavities include
- Pain when you bite down
- Pain when you eat hot, cold, or sweet foods
- Dark spots on your tooth
- Sensitive teeth
- Spontaneous pain
- Pain that wakes you up during the night
Does cavity pain go away?
Pain tolerance varies between individuals and can be scaled from 1 to 10. The more shallow the cavity, the less it will hurt. In contrast, the deeper the cavity extends towards the pulp (nerve), the higher the pain level. When bacteria reach this inner layer, the tooth will begin to die, and the nerve tissue resorbs.
If the tooth is left untreated for an extended period, the nerve tissue will no longer trigger a pain response. However, if the cavity is not treated, it will grow larger and eventually cause an abscess (a pus-filled pocket).
Why does my cavity hurt at night?
A cavity hurts more at night because blood flow increases when you lay down. Increased blood flow increases pressure within the tiny pulp chamber of the tooth, triggering a pain response. Also, other factors that may distract you from your tooth pain are no more, such as working, cooking, chores, or other activities.
What does pain from a cavity feel like?
As mentioned, pain tolerance can vary between individuals and is often described on a scale from 1 to 10. In addition, cavity pain can come and go or worsen over time.
Cavity pain is commonly described as
- Dull ache
- Pressure pain
- Sharp pain
- Shooting pain
How long does it take for a cavity to reach the nerve?
Cavities progress at variable rates based on many factors, including diet, oral health, and sugar intake frequency. Patients with high cavity risk often have aggressive cavity-causing bacteria, and cavities can advance quickly. However, most cavities take 6-18 months to reach the nerve.
Fluoride treatments can minimize cavity progression and reverse cavities if they are located in the enamel.
How do you know if a cavity has reached the nerve?
The two most common symptoms when a cavity has reached the nerve are spontaneous pain and tooth pain that wakes you up at night. A cavity that has reached the nerve requires root canal treatment to remove the cavity-causing bacteria and infected nerve tissue.
Fluoride treatments can minimize cavity progression and reverse cavities if they are located in the enamel.Related: Learn more about Root Canals
Spontaneous tooth pain – refers to pain that occurs without a painful trigger. For example, tooth pain after drinking something cold is non-spontaneous pain, whereas tooth pain that occurs without drinking, eating, or biting is referred to as spontaneous pain. The pain response is directly due to bacteria irritating the nerve.
Nighttime tooth pain – refers to pain that wakes you up during the night or becomes more intense when lying down as blood flow and pressure increase, leading to increased pressure within the tooth pulp.
Do cavity fillings hurt?
Tooth fillings are required if the cavity has advanced past the enamel and into the dentin (middle layer). Treating the cavity at this stage or earlier is essential to prevent cavity progression into the innermost pulp (nerve) layer.
The dentist can occasionally fill shallow fillings without requiring an anesthetic. If anesthetic is needed, you will feel a quick pinch and squeeze in the tissue. After adequate numbing, cavity fillings will not hurt during treatment; however, you may feel pressure during the procedure.
Why does my jaw hurt after getting a cavity filled?
After filling a cavity, you may experience some pain in your jaw. This is because the dentist had to drill into your tooth to remove the decay and fill the hole. The pain should go away within a day or two. However, if it persists, be sure to contact your dentist.
Also, your jaw joint and related muscles may be sore after keeping your mouth propped open for an extended period. Your dentist may recommend OTC pain medication, intermittent warm or cold pack application, and jaw muscle massages.
Do fillings last forever?
No, unfortunately, fillings do not last forever. On average, fillings last between 7 to 10 years, whereas dental crowns last 15-20 years. However, over time, fillings will wear down and separate from the tooth surface leading to an open margin and possible recurrent decay (decay that forms under an existing filling).
Also, fillings (especially tooth-colored fillings) expand and contract with temperature changes leading to “leakage” – gaps under the existing filling. Amalgam fillings (silver fillings) may fracture or cause teeth to crack because they are placed without bonding material.
Why does my filling hurt days, weeks or months afterward?
The three most common reasons fillings hurt after treatment include tooth trauma, high bite, or ill-fitting restoration.
Tooth trauma – occurs during the cavity-removal process. High-speed and slow-speed burs remove the cavity increasing the tooth temperature. Water spray is applied simultaneously to cool the tooth and prevent nerve tissue irritation. Also, during the filling process, the tooth structure is dried out before bond application and filling placement.
High bite – refers to an elevated filling when biting or chewing. This is the most common reason for post-operative filling pain because it’s challenging to calibrate your bite while you are still numb. In addition, this repeated irritation will bruise the tooth leading to hypersensitivity when chewing or consuming cold beverages.
Ill-fitting restoration – refers to a poorly placed filling with gaps between the filling and tooth surface. These gaps allow cold and hot fluids to interact with the sensitive dentin triggering a pain response. Also, if left untreated, these gaps will harbor bacteria and lead to another cavity.
How to get rid of cavity pain?
Before visiting the dentist, you can manage cavity pain with OTC medications such as Tylenol and Ibuprofen for pain relief. The most effective OTC medication combination is 600 mg Ibupfron and 325 mg Tylenol. Alternate these medications every 4 hours for the most effective pain relief.
If you are still experiencing pain, try one of these toothache home remedies.
Five best toothache home remedies (backed by science)
Aside from OTC medications, home remedies can effectively relieve pain for a throbbing toothache; however, never replace professional dental care with these remedies. Also, only use these home remedies as temporary pain relief to hold you over until your dental appointment. If tooth decay is left untreated, it will lead to more significant pain and tooth infection.
Ice massage therapy
According to a National Institute of Health (NIH) study, ice massage decreased the intensity of dental pain by 50% or more in most patients. In addition, pain reductions produced by ice massage were significantly more effective than only massaging the sore area. The study’s results confirm that ice massage treatment has pain-reducing effects comparable to acupuncture and electrical stimulation. Ice massage is a simple method to alleviate pain associated with toothaches.
Salt water rinse
According to an International Research Journal of Pharmacy and Medical Sciences (IRJPMS) study, patients who gargled with salt water rinse achieved more effective pain relief than those who did not. The survey sample consisted of 74 participants experiencing toothache pain from untreated tooth decay. Salt water rinse has proven to be a safe and effective pain-relief remedy to relieve a toothache.
Herbal dental gel (clove oil + camphor + menthol)
According to the National Institute of Health (NIH) study, alternative herbal medication can effectively relieve a toothache. The herbal dental gel is a unique formulation of three essential oils, clove oil, camphor, and menthol. It can help manage dental pain in many individuals, including geriatrics, busy professionals, and individuals with special needs.
According to a recent Pubmed meta-analysis study, acupressure (acupuncture) can alleviate dental pain caused by a toothache. Sixteen studies were analyzed to confirm acupressure effectiveness; however, questions remain, including the best acupressure technique and how acupressure compares with other pain relief methods such as OTC medications, salt water rinse, and ice massage therapy.
Thyme leaves are primarily used for cooking; however it’s also a tremendous pain-relieving herbal medication to treat toothaches. In addition, thyme has antiseptic and antibacterial properties to reduce unwanted bacteria in the mouth. Thyme oil is potent, so dilute a few drops with water and gargle to alleviate the toothache. You can also apply a few drops of thyme oil onto a cotton ball and place it on the affected area.
Other toothache home remedies
- Hydrogen peroxide rinse
- Cold compress
- Tea tree oil
- Warm water rinse
- Guava mouthwash
- Fresh garlic
- Peppermint tea bag
- Hydrogen peroxide
- Chewing gum
My Experience & Expertise
Healthy bacteria is essential to our overall health, including oral pH and gut health; however, harmful bacteria can lead to severe problems, including toothache. Therefore, tooth decay should be addressed as soon as possible, and never attempt to treat tooth decay outside of a dental practice.
It’s important to remember that home remedies should not replace professional dental care, as untreated cavities can lead to pain, infection, and tooth loss. Also, it would be best to use home remedies as temporary pain relief until your dentist can see you. If you notice signs of infection, including fever, difficulty breathing or swallowing, or your eye is beginning to shut, seek immediate emergency care.
Knowledge is power when cultivating healthy dental habits. The more informed you are, the better positioned you’ll be to prevent avoidable and potentially costly dental procedures for you and your family. Watch for future blog posts, where we’ll continue sharing important information, product reviews and practical advice!
- Melzack R. Relief of dental pain by ice massage of the hand. Can Med Assoc J. 1980.
- Karmawati, A. The Effectiveness of Salt Solution Gargle to Reduce Pain through Monitoring the PUFA Index at Dr. Dradjat Prawiranegara Serang, Banten in 2018. IRJPMS, 2018.
- Kumarswamy A. Multimodal management of dental pain with focus on alternative medicine: A novel herbal dental gel. Contemp Clin Dent. 2016.
- Ernst E, Pittler MH. The effectiveness of acupuncture in treating acute dental pain: a systematic review. Br Dent J. 1998.