Why Does My Tooth Hurt? Six Common Patterns
Not all toothaches are the same! Depending on the symptoms, toothaches can require different treatments. Understanding these symptoms can help Dr. Henley or Dr. Kelly determine how to help you feel better, faster.
Tooth pain usually comes from decay, a crack, exposed root surfaces, an inflamed or infected nerve, a problem with a filling, or pressure from the sinuses. When the pain starts, what sets it off and how long it lasts all point toward a cause, but the pattern alone can't confirm a diagnosis. Swelling, fever or pain that keeps you up at night should be checked promptly.
Why does my tooth hurt briefly with hot or cold?
A quick zing that fades within a few seconds often comes from exposed dentin. That can happen with gum recession, worn enamel, a small cavity or a filling whose edge has started to leak. Desensitizing toothpaste often helps when the cause is exposed root surface, but it won't fix a cavity or a leaking filling. If the sensitivity keeps coming back, or one tooth stands out, have it examined. Our guide to the causes of tooth sensitivity goes through the possibilities, and foods that trigger sensitive teeth covers what to go easy on in the meantime.
Why is my tooth sensitive after dental treatment?
Fillings, crowns and cleanings can irritate the nerve for a while. Mild sensitivity to temperature after treatment is common and usually settles over days to weeks. Sensitivity that is getting worse, lingers after the cold is gone, or comes with pain on biting should be looked at, because the bite may need adjusting or the nerve may be more irritated than expected. Read more about tooth pain after a filling.
Why does my tooth hurt when I bite or chew?
Pain on biting can come from a cracked tooth, a loose or high filling, decay, or inflammation around the root tip. A crack often causes a sharp pain when you bite down or release, sometimes only on one cusp. This pattern deserves a prompt visit. Depending on the cause, the answer may be a bite adjustment, a crown to hold a cracked tooth together, or root canal treatment if the nerve is involved.
What does lingering pain after hot or cold mean?
Pain that hangs on for more than about 30 seconds after the cold or heat is gone suggests the nerve inside the tooth is inflamed and may not recover. Pain that wakes you up or throbs on its own points the same way. This usually needs root canal treatment or, in some cases, removal of the tooth. Seeing a dentist early gives you more options.
Is severe tooth pain with swelling urgent?
Yes. Constant, severe pain with swelling of the gum or face, a bad taste or tenderness to touch usually means an infection at the root of the tooth, and the nerve may already have died. Treatment depends on the diagnosis and may include draining the infection, root canal treatment or extraction. Antibiotics help in some situations, but they don't remove the source of the infection. Don't wait for a dental infection to settle on its own. See our page on dental emergencies for what to do while you arrange care.
Can sinus pressure feel like a toothache?
It can. The roots of the upper back teeth sit just below the maxillary sinuses, so sinus inflammation can feel like a dull ache in several upper teeth at once, often worse when you bend forward. Our article on sinus infections and tooth pain explains how to tell the difference. An examination and X-rays can show whether a tooth is involved before you treat it as a sinus problem.
When should I go to the emergency room instead?
Trouble breathing or swallowing, swelling that is spreading quickly in the face or neck, or a high fever with facial swelling needs emergency medical care. Call 911 or go to an emergency department rather than waiting for a dental appointment.
Where can I have tooth pain checked in Jacksonville?
Call our office at 904-398-1549 or contact us and tell us when the pain started, what triggers it, how long it lasts and whether there is swelling. When someone is in pain, we try to see them the same day if we can. At the visit, a comprehensive dental examination with the right X-rays connects the pattern you describe with what is actually happening in the tooth.
Sources
American Association of Endodontists. Tooth pain. Accessed October 6, 2026.
American Dental Association, MouthHealthy. Sensitive teeth. Accessed October 6, 2026.
Craig JR, et al. Diagnosing odontogenic sinusitis: an international multidisciplinary consensus statement. Int Forum Allergy Rhinol. 2021;11(8):1235-1248. doi:10.1002/alr.22777 (retrieved via PubMed)
About the author. CJ Henley, DMD, is a general dentist in Jacksonville whose practice focuses on cosmetic and restorative dentistry, dental implants and dental care around head and neck cancer. Meet Dr. Henley.
CJ Henley, DMD, PA · 3675 Hendricks Avenue, Jacksonville, FL 32207 · 904-398-1549
Updated October 2026.
Dr. Henley's Reddit Ask Me Anything (January 2016)
This note was posted in January 2016. That month, Dr. CJ Henley hosted an Ask Me Anything (AMA) thread in Reddit's r/Dentistry community and answered questions from readers about his work and about dentistry.
If you have a question about your own dental care, please contact our office or learn more about Dr. Henley.
About the author. CJ Henley, DMD, is a general dentist in Jacksonville whose practice focuses on cosmetic and restorative dentistry, dental implants and dental care around head and neck cancer. Meet Dr. Henley.
CJ Henley, DMD, PA · 3675 Hendricks Avenue, Jacksonville, FL 32207 · 904-398-1549
Updated October 2026.
Sources
Reddit, r/Dentistry Ask Me Anything thread, January 2016.