Why does my tooth hurt when I drink something cold?

Usually because of sensitive teeth or an irritated nerve, and the best clue is how long the pain lasts. A healthy tooth feels cold for only a second or two after the cold is gone (AAE).

A short, sharp twinge that fades within seconds is commonly linked with sensitive teeth (dentin hypersensitivity). Dentin, the layer under the enamel, gets exposed when gums pull back or enamel wears away. Cold, sweet or sour things, cold air and brushing can set it off (Liu 2020, ADA).
Brief pain from cold or sweet things in a tooth with decay or a worn filling is commonly linked with reversible pulpitis. The nerve is irritated but can recover once a dentist fixes the cause (AAE, Cleveland Clinic).
Pain that lingers after the cold is gone is the classic sign of irreversible pulpitis. The American Association of Endodontists (AAE) says pain lasting more than about 30 seconds after hot or cold means the pulp is likely damaged for good. Root canal treatment is usually needed to save the tooth.

Sources differ on the exact cut-off: one review allows up to 20 seconds for reversible pulpitis (Liu 2020), while the AAE says a couple of seconds. So the tool asks "a few seconds" or "30 seconds or more", not an exact time. Thirty seconds isn't a hard line, either: the AAE's own case examples include irreversible pulpitis with pain lingering 8 to 12 seconds. If your pain lasts longer than a few seconds, see a dentist even if it's under 30. For simple sensitivity, a toothpaste for sensitive teeth and a soft brush often help (ADA, AAE). See a dentist if it doesn't improve, because decay and cracks can feel the same.

Why does hot food or drink make my tooth hurt?

Heat is more often a warning sign than cold. Cleveland Clinic notes that reversible pulpitis usually doesn't react to heat, while a tooth with irreversible pulpitis stays sore after heat, cold or sweets for more than a few seconds. Sensitivity to heat and cold is also a sign of an abscess at the root tip, along with a throbbing ache and pain on biting. A cracked tooth can react to temperature too (AAE). If heat hurts and the pain lingers, see a dentist within a few days.

Why does my tooth hurt when I bite down?

Pain on biting points away from simple sensitivity:

Pattern	Commonly linked with
Sharp pain as you chew or let go of the bite, which comes and goes	A cracked tooth (AAE)
Constant ache, tooth tender to touch, maybe swelling	An abscess or inflamed root tip (AAE, NHS)
Dull ache that's worse on biting, with a swollen gum	A gum (periodontal) abscess (Liu 2020)
Sore to bite on a new filling	A filling that hits first when you bite (Liu 2020)
Pain at the very back, with a swollen gum flap	Pericoronitis around a wisdom tooth (Cleveland Clinic)

A dentist tells these apart with a bite test, tapping, a cold test and X-rays. With a crack, an early diagnosis gives the best chance of saving the tooth (AAE).

Why does my tooth throb at night?

Throbbing that keeps you awake, or gets worse when you lie down, is commonly linked with irreversible pulpitis. The AAE notes that this pain can start on its own, can seem to come from another tooth, and may get worse when you lie down or bend over. Over-the-counter painkillers often don't help much. If you also have swelling, a bad taste or a fever, an infection is more likely: see a dentist today (NHS).

Night-time jaw pain is different. Clenching or grinding in your sleep can cause a jaw ache, or a headache or face pain that's worse in the morning (Cleveland Clinic, NHS). And sometimes the pain isn't from a tooth at all. Toothache is a symptom of sinusitis (NHS), and sinus pressure is often felt as a dull ache in the upper back teeth (Cleveland Clinic, AAE).

When is toothache an emergency?

Call 911 or go to the ER if you have toothache with any of these. The tool checks them first, every time:

Swelling that makes it hard to breathe, swallow or speak
Swelling spreading to your eye or neck, or an eye that won't open
A fever or feeling very unwell together with dental swelling

See a dentist today if painkillers don't control the pain, or you have swelling, a bad taste or pus (NHS, SDCEP). A dental abscess won't go away on its own (NHS). Otherwise, the NHS says to see a dentist if toothache lasts more than 2 days. For a broken tooth, an injury or other problems, use the Dental Emergency Checker.

Pain relief while you wait

The ADA's 2024 guideline for people aged 12 and older recommends an anti-inflammatory painkiller (an NSAID such as ibuprofen or naproxen) first, alone or with acetaminophen (paracetamol). If you can't take NSAIDs, acetaminophen alone is the usual choice.

Follow the label, and don't take more than it says.
Ask a pharmacist first if you have stomach, kidney, heart or liver problems, take blood thinners, are pregnant, or are buying for a child or teen.
Children under 16 should not take aspirin (NHS). Never put aspirin on the gum, because it can burn (ADA).

Pain relief buys time, but most toothaches need a dentist to fix the cause.

How this tool works

Warning signs come first. If you tick any, the result is an emergency, whatever else you pick.
Each answer adds points to the causes it's commonly linked with (table below). A hallmark sign scores up to 5. A minus means a source says that sign is not typical, such as lingering pain for sensitive teeth.
Two causes need a matching history. Dry socket is only listed after an extraction in the last 14 days, and sensitivity after dental work only after a filling, crown or cleaning in the last 4 weeks.
Ranking. 8 or more points is a strong match, 5 to 7 a good match and 2 to 4 possible. Causes under 2 points aren't shown. Ties list the more serious cause first.
Urgency uses the four levels of the Dental Emergency Checker. Pain that painkillers don't control, swelling, a bad taste, or pain getting worse days after an extraction means today. Lingering, night or biting pain, a hole in the tooth, or a serious cause at the top means within a few days.
Swelling after an extraction. Some swelling in the first 3 days is expected, so on its own it doesn't mean today. From day 4 it does: swelling that gets worse after day 3 should be checked (Cleveland Clinic, NHS), and the tool can't tell whether yours is still growing. The 0–1, 2–3 and 4–5 day choices match the Dental Emergency Checker's.

Cause	Points from your answers
Abscess	face swelling +4, biting +3, tender to touch +3, gum swelling +3, hurts on its own +2, bad taste or pus +2, heat +1, hole or broken filling +1
Dry socket	extraction 2–3 days ago +4, extraction 4–5 days ago +4, getting worse 2–5 days after extraction +3, hurts on its own +2, extraction 6–14 days ago +2, bad taste or pus +2, extraction 0–1 days ago +1
Irreversible pulpitis	lingers 30 s or more +5, heat +3, hurts on its own +3, night or lying down +3, cold +2, sweet +1, biting +1, tender to touch +1, several teeth +1, older filling or crown +1, hole or broken filling +1, painkillers don't help +1, gone in seconds −2
Pericoronitis	wisdom tooth area +4, gum swelling +3, biting +2, face swelling +2, bad taste or pus +2, hurts on its own +1, bleeding gums +1
Cracked tooth	letting go of a bite +4, biting +3, cold +1, heat +1, sweet +1, hurts on its own +1, tender to touch +1, older filling or crown +1, clenching +1, on and off for weeks +1
Gum problem	bleeding gums +4, gum swelling +3, biting +2, bad taste or pus +2, receding gums +2, hurts on its own +1
Reversible pulpitis	cold +3, gone in seconds +3, hole or broken filling +3, sweet +2, filling or crown in last 4 weeks +1, older filling or crown +1, hurts on its own −2, lingers 30 s or more −2
After dental work	filling or crown in last 4 weeks +5, cleaning in last 4 weeks +3, cold +2, heat +1, biting +1
Sinus	sinus symptoms +4, upper back teeth +3, upper teeth ache together +3, hurts on its own +1, several teeth +1, lower back teeth −2
TMD/clenching	jaw clicks +4, morning jaw ache +3, clenching +3, biting +1, hurts on its own +1, upper back teeth +1, several teeth +1, upper teeth ache together +1
Sensitive teeth	cold +3, gone in seconds +3, receding gums +3, sweet +2, cleaning in last 4 weeks +2, heat +1, clenching +1, on and off for weeks +1, hole or broken filling −1, hurts on its own −2, lingers 30 s or more −3

Its limits. The points are our own weighting of what the sources describe, not a tested scoring system. The tool can't see, test or X-ray your tooth, and more than one cause can happen at once. "Commonly linked with" describes what a pattern often means, not what you have. Your answers stay in your browser, and Copy link saves only the options you picked.

Frequently asked questions

What does it mean if tooth pain lingers after something cold?

A healthy tooth feels cold for only a second or two (AAE). Pain that lingers after the cold is gone, typically for more than 30 seconds, is the classic sign of irreversible pulpitis: the AAE says the pulp is likely damaged for good, and root canal treatment is often needed. See a dentist within a few days, or today if painkillers don't control it.

Can a toothache go away on its own?

Some can. Sensitivity after a filling is usually temporary: the AAE suggests waiting 2 to 4 weeks before having it checked. Sensitive teeth often get better with a toothpaste for sensitive teeth. Others can't: a dental abscess won't go away on its own (NHS), and irreversible pulpitis can't heal. The NHS says to see a dentist if toothache lasts more than 2 days.

How can I tell if I have a cracked tooth?

You can't be sure at home. A crack often causes sharp pain when you chew, sometimes as you let go of the bite, and the tooth may react to hot or cold. The pain can come and go (AAE). A dentist can find it with a bite test, a dye or a bright light shone through the tooth (Cleveland Clinic). Early care gives the best chance of saving the tooth.

Can a sinus infection make my teeth hurt?

Yes. Toothache is a known symptom of sinusitis (NHS), and sinus pressure is often felt in the upper back teeth (Cleveland Clinic), sometimes several at once. If the tooth pain stays after the sinus symptoms clear, see a dentist: an infected upper tooth can also spread into the sinus (Cleveland Clinic).

Is it normal for a tooth to be sensitive after a filling?

Often, yes. Recent dental work can irritate the nerve for a while (AAE). The AAE suggests waiting 2 to 4 weeks and seeing your dentist if the pain stays or gets worse. If it hurts to bite on the new filling, it may sit a little high, which your dentist can adjust.

Why does my tooth hurt more when I lie down?

Pain that gets worse lying down or bending over is commonly linked with irreversible pulpitis, an inflamed nerve that can't heal (AAE). This kind of pain may also start on its own and keep you awake, and painkillers often don't help much. See a dentist soon. If you also have swelling, a bad taste or a fever, go today.

Sources

American Association of Endodontists. Tooth Pain. Accessed October 26, 2026.
American Association of Endodontists. Cracked Teeth. Accessed October 26, 2026.
American Association of Endodontists. ENDODONTICS: Colleagues for Excellence. Endodontic Diagnosis. Fall 2013. Accessed October 26, 2026.
Liu XX, Tenenbaum HC, Wilder RS, Quock R, Hewlett ER, Ren YF. BMC Oral Health 2020;20:220. Pathogenesis, diagnosis and management of dentin hypersensitivity: an evidence-based overview for dental practitioners. 2020. Full text checked through Europe PMC. Accessed October 26, 2026.
American Dental Association (MouthHealthy). Sensitive Teeth - Heat and Cold Sensitivity. Accessed October 26, 2026.
American Dental Association (MouthHealthy). Top 10 Dental Symptoms. Accessed October 26, 2026.
NHS. Toothache. reviewed July 1, 2024. Accessed October 26, 2026.
NHS. Dental abscess. reviewed March 18, 2026. Accessed October 26, 2026.
NHS. Gum disease. reviewed April 20, 2026. Accessed October 26, 2026.
NHS. Sinusitis (sinus infection). reviewed January 31, 2024. Accessed October 26, 2026.
NHS. Temporomandibular disorder (TMD). reviewed June 20, 2023. Accessed October 26, 2026.
NHS. Teeth grinding (bruxism). reviewed April 8, 2026. Accessed October 26, 2026.
Cleveland Clinic. Pulpitis: Types, Symptoms & Treatment. updated July 18, 2022. Accessed October 26, 2026.
Cleveland Clinic. Cracked Tooth (Fractured Tooth). updated April 29, 2024. Accessed October 26, 2026.
Cleveland Clinic. Periapical Abscess: Symptoms, Diagnosis & Treatment. updated July 29, 2026. Accessed October 26, 2026.
Cleveland Clinic. Sensitive Teeth: Causes, Treatment & Prevention. updated July 3, 2025. Accessed October 26, 2026.
Cleveland Clinic. Sinus Pressure: Causes and How To Find Relief. updated February 9, 2023. Accessed October 26, 2026.
Cleveland Clinic. Temporomandibular Joint (TMJ) Disorders. updated July 22, 2025. Accessed October 26, 2026.
Cleveland Clinic. Bruxism (Teeth Grinding). updated December 18, 2023. Accessed October 26, 2026.
Cleveland Clinic. Pericoronitis: Symptoms, Causes & Treatment. updated April 20, 2026. Accessed October 26, 2026.
Cleveland Clinic. Dry Socket: Symptoms, Causes & Treatment. updated May 5, 2025. Accessed October 26, 2026.
Cochrane (Daly BJM et al.). What treatments can be used to prevent and treat alveolar osteitis (dry socket)?. 2022. Accessed October 26, 2026.
Cleveland Clinic. Wisdom Teeth Removal: Procedure & Recovery. 2026. Accessed October 26, 2026.
NHS. Wisdom tooth removal (Recovering from wisdom tooth removal). reviewed June 12, 2024. Accessed October 26, 2026.
John K, Pepper T. StatPearls (NCBI Bookshelf). Cracked Tooth Syndrome. 2024. Accessed October 26, 2026.
Blake A, Tuttle T, McKinney R. StatPearls (NCBI Bookshelf). Apical Periodontitis. 2023. Accessed October 26, 2026.
Yousefi Y, Meldrum J, Jan AH. StatPearls (NCBI Bookshelf). Periodontal Abscess. 2023. Accessed October 26, 2026.
Kwon G, Serra M. StatPearls (NCBI Bookshelf). Pericoronitis. 2022. Accessed October 26, 2026.
Maini K, Dua A. StatPearls (NCBI Bookshelf). Temporomandibular Syndrome. 2023. Accessed October 26, 2026.
American Dental Association. What Constitutes a Dental Emergency?. updated March 30, 2021. Accessed October 26, 2026.
Scottish Dental Clinical Effectiveness Programme (SDCEP). Management of Acute Dental Problems: Quick Reference Guide for healthcare professionals. 2013. Paraphrased; flowcharts not reproduced. Accessed October 26, 2026.
American Dental Association (MouthHealthy). Dental Emergency - What if I break a Tooth. Accessed October 26, 2026.
Carrasco-Labra A, et al. Journal of the American Dental Association 2024;155(2):102-117. Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in adolescents, adults, and older adults. 2024. Accessed October 26, 2026.
American Dental Association. Oral Analgesics for Acute Dental Pain. updated February 2, 2024. Accessed October 26, 2026.

Last reviewed October 26, 2026 by the Dental Health Time editorial team, against the sources above. How we review.