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Toothache: What It Means and What to Do

The short answer

A toothache is a symptom, not a diagnosis. The useful information is in what kind of pain it is: a twinge that stops with the cold, a throb that wakes you at 3am, and an ache when you bite are three different problems with three different treatments. Call 6443 9509 and we will work out which. Painkillers at the correct dose in the meantime are sensible, not a delay tactic.

Seen at
Millenia Walk #02-21
Diagnosis
Exam, radiograph, scan
Emergency surcharge
None
Fee
S$218

Go to a hospital emergency department, not to us, if you have swelling that is closing your eye or spreading down your neck, difficulty swallowing or breathing, a fever with facial swelling, bleeding that will not stop, or a jaw injury from a fall or accident. Those need hospital facilities. Everything else on this page, we can help with.

What the pain is telling you

Sharp, brief, with cold or sweetA cavity, a leaking filling, a crack, or exposed root surface. The pulp is still healthy.
Lingers 30 seconds or more after hot or coldPulp inflammation. Often needs root canal treatment, sometimes a deep restoration if caught early.
Throbbing, wakes you at night, worse lying flatA dying or dead pulp. Will not settle on its own.
Tender to bite on one specific toothInfection at the root tip, a crack running into the root, or a high filling.
Dull ache with swelling, bad taste, feverAn abscess. Needs seeing today, and hospital care if the swelling is spreading.
Ache in several teeth on one side, worse on wakingOften clenching or grinding rather than any one tooth. Worth checking before anything is drilled.

This is a guide to what to expect, not a diagnosis. Pain refers between teeth and from the sinus and jaw joint, which is exactly why it needs examining rather than guessing.

Until you can be seen

  1. Take your usual painkiller at the dose on the packet, on schedule rather than waiting for the pain to peak. Tell us what you have taken.

  2. Keep the tooth clean, including the sore area. Brushing it gently will not make it worse and plaque sitting on an inflamed gum will.

  3. Rinse with warm salt water. Avoid very hot, very cold and sugary things on that side.

  4. Sleep propped up. Blood pressure at the tooth is higher lying flat, which is why toothache is worse at night.

  5. Do not put aspirin or clove oil directly on the gum, and do not poke at it with anything. Both cause burns and ulcers we then have to treat as well.

What treatment usually follows

Once we know the cause, the repair is ordinary dentistry: a bonded ceramic onlay where a large part of the tooth has gone, a composite filling where less has, root canal treatment where the pulp is beyond saving, or gum treatment where the problem is around the tooth rather than in it. Occasionally the honest answer is removal and replacement.

What we will not do is start drilling to see what happens. Every fee is published and quoted in writing before treatment beyond settling the pain.

Who you might see

Dr JD Tan →Dr Joanne Ou →Dr Austin Chan →Dr Daniel Teo →Dr Annabelle Tong →

Whoever has the soonest slot. All five are Singapore-registered and speak English and Mandarin.

Related

Emergency dentistry →Cracked or broken tooth →Wisdom teeth →Why teeth wear down →

Questions

How do I stop a toothache at night?

Take your usual painkiller at the correct dose, keep your head raised on an extra pillow, and avoid hot drinks and anything sweet or cold on that side. A cold pack on the outside of the cheek helps for fifteen minutes at a time. None of this treats the cause, and a nerve pain that wakes you at night usually means the pulp is inflamed or dying, which will not resolve on its own.

What kind of pain means I need a root canal?

Pain that lingers for more than a few seconds after hot or cold, throbbing that wakes you, pain that spreads to your ear or jaw, or a tooth that is tender to bite on. Those suggest the pulp is involved. A quick, sharp twinge that stops as soon as the stimulus goes is more often a crack, a leaking filling, or exposed root, and does not necessarily need a root canal.

My tooth hurt badly and now it has stopped. Am I fine?

Not necessarily, and this is the pattern that catches people out. Pain that suddenly stops after a few bad days can mean the nerve has died. The tooth goes quiet, the infection continues in the bone, and it presents weeks later as swelling or an abscess. Get it looked at while it is comfortable.

Can antibiotics fix a toothache?

Rarely, and never on their own. Antibiotics can settle spreading infection to buy time, but the source is inside the tooth and no antibiotic reaches it. Anyone who gives you a course and nothing else has postponed the problem, not treated it. We prescribe them when they are indicated and not as a substitute for treatment.

Does a toothache always mean losing the tooth?

No. Most teeth that hurt can be saved — with a filling, an onlay, or root canal treatment. Extraction is the answer when the tooth is broken below the gum, split vertically through the root, or supported by too little bone to be worth keeping. We will tell you which, and show you why on the screen.

Is a toothache claimable under Medisave?

Ordinary fillings and root canal treatment are not Medisave-claimable; surgical procedures such as a surgical extraction can be. We will tell you what applies in your written quotation rather than guess on the phone.

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