Toothache: what to do and when to see a dentist

Why do teeth hurt?

Toothache is a symptom, not a disease. In most cases it means something has reached the dentine or the pulp of the tooth — the inner part where the nerves are — or that the gums and supporting bone are inflamed.

The most common causes we see in our clinics are:

• Tooth decay

  as the cavity deepens, it exposes the dentine and the tooth starts reacting to cold, heat and sweet foods.

• Infection or abscess

  an infection at the root of the tooth causes intense, throbbing pain, sometimes with swelling.

• Gingivitis and periodontitis

  inflamed or receding gums leave the root exposed and sensitive.

• A broken tooth or damaged filling

  even a small fracture can leave the nerve unprotected.

• Tooth sensitivity

  brief, sharp discomfort with cold, hot or acidic foods.

• Wisdom teeth

  when they come through in the wrong position or remain partly covered by the gum.

What can you do right away to ease the pain at home?

While you wait for your appointment, there are simple, safe measures that help keep the discomfort under control:

• —Rinse with warm salt water (a teaspoon of salt in a glass of water) to help clean the area and reduce inflammation.
• —Apply a cold compress to the outside of your face, in 15–20 minute intervals, to reduce swelling.
• —Take an over-the-counter painkiller, such as paracetamol or ibuprofen, always following the instructions on the packaging and the advice of your doctor or pharmacist.
• —Floss gently to remove any food debris that may be pressing on the gum.
• —Keep your head elevated when lying down — lying completely flat increases blood pressure in the area and can intensify the pain.

When is it urgent to see a dentist?

Severe pain, fever, swelling or trauma needs urgent advice: call the clinic before coming. Difficulty breathing, speaking or swallowing, or heavy bleeding that will not stop, needs immediate medical help through 112.

What should you avoid doing when you have toothache?

Some common habits make things worse or mask the problem without solving it:

• —Do not place aspirin (or any tablet) directly on the tooth or gum — it can burn the tissues.
• —Do not apply heat to your face: heat can speed up the spread of an infection.
• —Do not take antibiotics on your own initiative — only a dentist or doctor can assess whether they are needed.
• —Do not ignore pain that has disappeared on its own: when the pain from an infected tooth suddenly stops, it may mean the nerve has died — but the infection is still progressing.

How is toothache treated at the clinic?

Treatment always depends on the cause, so the first step is an assessment appointment with a clinical examination and, where needed, an X-ray.

If the cause is decay, the tooth is treated and restored. If the infection has already reached the nerve, the usual solution is root canal treatment (endodontics), which removes the infected tissue and allows you to keep your natural tooth. In cases of gum disease, treatment involves a deep professional clean and ongoing periodontal care.

We see patients in Almada, Fernão Ferro and Baixa da Banheira, Monday to Saturday, 10:00–13:00 and 14:00–19:00. Call before coming: the team assesses urgency and confirms the earliest available appointment.

• When a tooth can be preserved

How can you prevent toothache?

The vast majority of toothache episodes stem from preventable problems. Prevention rests on three habits:

• —Brush your teeth at least twice a day with fluoride toothpaste and floss daily.
• —Have a professional dental cleaning and a check-up regularly — these are the appointments where cavities are caught before they start to hurt.
• —Don't put off treating small cavities, persistent sensitivity or bleeding gums.

The most common questions

Does toothache go away on its own?

Rarely. Toothache is almost always a sign of an active problem — decay, infection or inflammation — that keeps progressing even if the pain eases temporarily. If the pain suddenly disappears, the cause hasn't: book an appointment anyway.

Can I take antibiotics on my own for toothache?

No. Antibiotics are only indicated in specific situations and require a prescription. Taking them without an assessment can mask the infection, delay the right treatment and contribute to antibiotic resistance. Treating the cause — not just the symptoms — is what resolves the pain.

How long can I wait with toothache before seeing a dentist?

If pain lasts more than 1–2 days, book an appointment. With swelling or fever, call for advice and urgent assessment. Difficulty breathing, speaking or swallowing needs immediate medical help: call 112.

Why does toothache get worse at night?

When you lie down, the horizontal position increases blood flow to the head and the pressure on the inflamed area, intensifying the pain. There are also fewer distractions at night, which makes the pain more noticeable. Sleeping with your head slightly elevated can help.

Where can I get urgent dental care near Almada, Seixal or Moita?

Fábrica do Sorriso has three clinics on the south bank of the Tagus (Margem Sul) — Almada, Fernão Ferro and Baixa da Banheira — which see urgent toothache cases Monday to Saturday, from 10:00 to 13:00 and 14:00 to 19:00. We also welcome patients from Seixal, Corroios, Sesimbra, Moita, Barreiro and surrounding areas.