A toothache that disappears and then returns can be confusing. One day your tooth hurts when you chew, and the next day you feel almost nothing. It can be tempting to assume the problem has fixed itself.
Unfortunately, tooth pain that comes and goes does not always mean the underlying problem is gone.
Intermittent tooth pain can be caused by tooth decay, a cracked tooth, irritated dental pulp, gum problems, grinding, or an infection that is developing gradually. Sometimes the pain temporarily subsides because the irritation changes—not because the underlying condition has been resolved.
Dr. Alamdeep Brar, DDS, is listed by Emergency Dental Service as an emergency dental provider at Bright Choice Dental Sicklerville LCP in Sicklerville, New Jersey. The practice listing specifically notes that its patient-care team is available by phone 24/7 to help schedule an emergency appointment within 24 hours.
Why Does Tooth Pain Come and Go?
Tooth pain can fluctuate because different dental problems affect the nerves and surrounding tissues in different ways.
For example, early decay may cause occasional sensitivity, while inflammation inside the tooth can produce pain that comes and goes. A cracked tooth may hurt only when you bite a certain way.
Common causes include:
- Tooth decay
- Cracked or fractured teeth
- Inflamed or infected dental pulp
- Dental abscesses
- Gum disease
- Teeth grinding or clenching
- Problems with fillings or crowns
- Dental trauma
The American Dental Association notes that acute dental pain can arise from conditions affecting both the hard tissues of teeth and the surrounding soft tissues, including cavities and gum disease.
1. A Cavity May Be Getting Worse
A cavity doesn’t necessarily cause constant pain from the beginning.
Early decay may produce little or no discomfort. As decay progresses deeper into the tooth, you may begin noticing sensitivity or occasional pain when eating something sweet, hot, or cold.
Eventually, decay can reach the pulp and cause much more significant pain.
That’s why a tooth that hurts occasionally shouldn’t automatically be ignored simply because the pain isn’t constant.
2. A Cracked Tooth Can Cause Intermittent Pain
A cracked tooth can be particularly unpredictable.
You may experience pain only when biting on a particular part of the tooth. Sometimes the pain occurs when you release your bite rather than when you initially bite down.
Other possible symptoms include:
- Sharp pain while chewing
- Sensitivity to cold
- Pain that comes and goes
- A feeling that one tooth is different from the others
Some cracks are difficult to see without a dental examination.
If the pain started after biting something hard or following an injury, arrange a dental evaluation.
3. The Nerve Inside the Tooth May Be Inflamed
The pulp inside a tooth contains nerves and blood vessels.
Deep decay, cracks, trauma, or repeated dental procedures can irritate this tissue. Depending on the stage of the problem, the pain may be occasional at first and become more persistent later.
If inflammation progresses, the tooth may become painful without an obvious trigger.
In some cases, the pulp can eventually lose its vitality while infection develops around the root.
A decrease in pain does not necessarily mean the tooth is healing.
4. An Infection Can Develop Gradually
A dental infection can sometimes begin with relatively mild or intermittent symptoms.
As bacteria move deeper into a damaged or decayed tooth, inflammation can develop around the root.
You may eventually notice:
- Throbbing pain
- Pain when biting
- Gum swelling
- Facial swelling
- A bad taste
- Pus or drainage
- Fever
A suspected dental infection should be evaluated promptly rather than managed indefinitely with temporary pain relief.
The ADA recommends definitive dental treatment for many conditions causing acute dental pain rather than using pain medication as a substitute for treating the underlying problem.
5. Gum Problems Can Cause Recurring Pain
Not all tooth pain actually comes from the tooth.
Inflamed or infected gums can become tender around individual teeth or larger areas of the mouth.
You may notice:
- Bleeding when brushing
- Red or swollen gums
- Tenderness
- Persistent bad breath
- Pain while chewing
If gum symptoms keep returning, a dental examination can help determine whether plaque buildup, gum disease, or another problem is responsible.
6. Teeth Grinding Can Make a Tooth Hurt Occasionally
Clenching and grinding can put repeated pressure on teeth and the tissues that support them.
You may notice pain:
- When waking up
- After periods of stress
- When chewing
- In several teeth at once
Grinding can also contribute to tooth wear and cracks, which may create additional dental problems over time.
When Does On-and-Off Tooth Pain Become an Emergency?
Not every intermittent toothache requires emergency treatment.
However, seek Emergency Dental Care if your tooth pain becomes severe, rapidly worsens, or is accompanied by:
- Significant facial or gum swelling
- A dental abscess
- Pus or drainage
- Fever or feeling unwell
- A severely broken or cracked tooth
- Significant dental trauma
- Uncontrolled bleeding
- Pain that makes it difficult to eat or sleep
The ADA identifies uncontrolled bleeding and infections with swelling that may compromise the airway among conditions requiring immediate attention.
If facial or neck swelling makes breathing or swallowing difficult, seek immediate emergency medical care.
What Should You Do When Tooth Pain Comes and Goes?
Don’t repeatedly wait for the pain to disappear.
Instead:
Pay attention to the trigger. Does it happen when you bite, eat something cold, drink something hot, or wake up?
Avoid chewing on the painful side. This can reduce irritation while you arrange an examination.
Maintain normal oral hygiene. Continue brushing and cleaning between your teeth gently.
Don’t place aspirin directly on your tooth or gums. It can irritate the surrounding tissue.
Schedule a dental examination. A dentist may need to examine the tooth, test its vitality, check your bite, and take X-rays to determine the cause.
Pain medication can provide temporary relief when appropriate, but it doesn’t repair a cracked tooth, remove decay, or eliminate the source of an infection. Current ADA guidance supports non-opioid analgesics as first-line options for managing acute dental pain when definitive treatment isn’t immediately available.
What Happens During an Emergency Dental Visit?
An emergency dental evaluation generally begins by identifying the source and severity of the pain.
The dentist may:
- Review your symptoms and dental history.
- Examine the painful tooth and surrounding gums.
- Check your bite and tenderness.
- Test the tooth’s response to temperature or other stimuli.
- Take dental X-rays when necessary.
- Determine whether immediate treatment is needed.
Treatment depends on the underlying cause. A cavity may require a filling, while a severely damaged or infected tooth may require more extensive treatment. A cracked tooth may need to be restored or, depending on the severity, treated with a crown or other dental procedure. If an infection is present, the dentist will determine the appropriate treatment based on the tooth and surrounding tissues.
Don’t Ignore Tooth Pain Just Because It Goes Away
Tooth pain that comes and goes can be an early warning sign of a dental problem. Even if the pain temporarily disappears, the underlying cause may still be present.
If your tooth pain keeps returning, becomes more severe, or is accompanied by swelling, fever, drainage, or significant sensitivity, don’t wait for it to become an emergency.
Dr. Alamdeep Brar, DDS and the patient-care team at Bright Choice Dental Sicklerville LCP can help evaluate urgent dental concerns and determine the appropriate next step.
If you are experiencing a dental emergency, contact an emergency dental provider as soon as possible rather than relying on temporary pain relief alone.
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