Is toothache an emergency? It depends on your other symptoms. Toothache with spreading swelling, fever, or trouble swallowing or breathing needs a hospital now. Severe, throbbing or night-time pain needs a dentist today, while mild, short-lived sensitivity can usually wait for an appointment this week.
Use the traffic-light guide below to decide what to do next. For knocked-out teeth, bleeding and other injuries, see our dental emergency guide.
Is toothache an emergency? Use the traffic-light guide
Red: go to hospital now
Call 000 or go to your nearest hospital emergency department if you have toothache with any of these:
- difficulty breathing or swallowing, or you can’t swallow your own saliva
- swelling spreading to the eye, neck or floor of the mouth (under the tongue)
- fever, chills or feeling very unwell alongside facial swelling
- bleeding that won’t stop after 15–20 minutes of firm pressure
- a possible broken jaw after an injury
- a knock to the head with loss of consciousness, vomiting or confusion
These can be signs of a spreading infection or a serious injury that needs hospital care first. Once you’re safe, a dentist can treat the tooth.
Amber: see a dentist today
These signs suggest the nerve is badly inflamed or there is an infection. Call a dentist as early in the day as you can if you have:
- severe or throbbing pain that doesn’t settle with over-the-counter pain relief
- pain that wakes you at night or starts on its own
- pain to hot or cold that lingers after the food or drink is gone
- pain when biting, or a tooth that feels raised or loose
- gum or facial swelling that isn’t spreading quickly, a pimple on the gum or a bad taste
- toothache after an injury, or a cracked or broken tooth
- a knocked-out adult tooth, which ideally needs a dentist within 30 minutes
We aim to see urgent problems as soon as possible, often on the same day. Find out how our same-day emergency dentist appointments work, or call our emergency dentist in North Sydney.
Green: book an appointment this week
- brief, sharp sensitivity to cold or sweet that stops as soon as the trigger is gone
- a dull ache that comes and goes and is easing
- mild tenderness after a new filling or a clean
- a sore gum from food stuck between teeth
- a lost filling or small chip with little or no pain
Green doesn’t mean ignore it. Early sensitivity is often a sign of decay or a worn filling, and finding it early usually means simpler treatment. If green symptoms get worse, treat them as amber.
What your toothache might be telling you
Short, sharp pain to cold
This is often exposed dentine from gum recession, worn enamel or early decay. The nerve is usually still healthy, and a filling, a toothpaste for sensitive teeth or another simple treatment may help.
Lingering or throbbing pain
Pain that lingers after hot or cold, throbs, or keeps you awake often means the nerve (pulp) is inflamed beyond the point where it can recover. The usual options are root canal therapy to save the tooth or, in some cases, removing it.
Pain on biting, with or without swelling
This may point to a dental abscess, an infection at the root tip or in the gum, or a cracked tooth. An abscess needs prompt treatment to drain the infection and deal with its source.
Pain that suddenly stops
If a bad toothache suddenly disappears, the nerve may have died. The infection can still be there and may flare up later, so the tooth still needs checking.
What to do while you wait
- Rinse with warm salty water and gently floss around the tooth in case food is trapped.
- Take over-the-counter pain relief such as paracetamol or ibuprofen, taken as directed on the pack, if it’s safe for you.
- Hold a cold pack wrapped in a cloth on the outside of your cheek for 10–15 minutes at a time.
- Sleep with your head slightly raised.
- Avoid very hot, cold or sugary food and drinks, and chew on the other side.
Don’t put aspirin on the gum, don’t use heat packs on your face, and don’t take antibiotics unless a dentist or doctor has prescribed them. Antibiotics don’t treat the inside of the tooth, which is where most toothache starts.
Toothache after hours
North Sydney Dentistry is open Monday to Friday, 9am to 6pm. Outside those hours:
- for any red-flag symptoms, call 000 or go to your nearest emergency department
- if you’re unsure whether you need to be seen tonight, call healthdirect on 1800 022 222 for 24/7 nurse advice
- for amber or green problems you can manage at home, follow the steps above and call us when we open
What happens at an urgent toothache appointment?
Your dentist will ask about your pain, check your medical history, examine the tooth and usually take an X-ray. The first goal is to find the cause and relieve pain, for example by removing decay and placing a temporary filling, starting root canal treatment or draining an infection. Your dentist will explain longer-term options, likely costs and any risks before going further. See our price guide for more on fees.
Frequently asked questions
Is toothache an emergency if there’s no swelling?
It can be. Severe, throbbing pain or pain that wakes you at night should be seen by a dentist the same day, even without swelling. Mild sensitivity that settles quickly can usually wait a few days.
Can I go to hospital for a toothache?
Go to hospital for toothache with spreading swelling, fever, or difficulty breathing or swallowing. Hospitals can manage these serious symptoms, but you will usually still need a dentist to treat the tooth itself.
Why does my toothache get worse at night?
Lying down can increase pressure in an inflamed tooth, and there are fewer distractions. Pain that wakes you is a sign to see a dentist soon.
Should I wait for a toothache to go away?
Waiting is rarely a good idea. Even if the pain eases, the cause is usually still there, and pain that suddenly stops can mean the nerve has died. Book an appointment to find the cause.
Need help now?
North Sydney Dentistry is at Level 1, Suite 102/71 Walker St, North Sydney, a two-minute walk from North Sydney station. We’re open Monday to Friday, 9am to 6pm, and keep time aside for urgent problems where we can. Call (02) 8090 1108 or book online.
This article is general information only and is not a substitute for advice from your own dentist or doctor. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.