When a discolored tooth also hurts, feels sensitive or smells unpleasant

Use the symptom pattern to judge urgency

Brief sensitivity to cold can come from exposed dentin, recession, wear or a small cavity. Pain that lingers after heat or cold, wakes you at night, occurs without a trigger or worsens when biting raises concern for deeper inflammation, infection or a crack.

Bad breath is commonly associated with tongue coating, gum disease, dry mouth and trapped food. When it occurs with one painful tooth, drainage, swelling or a foul taste, a localized dental infection must be considered.

• Call a dentist promptly for spontaneous or persistent tooth pain.
• Seek same-day advice for facial swelling, pus, fever or difficulty opening the mouth.
• Go to urgent or emergency care for trouble breathing or swallowing, rapidly spreading swelling, or swelling near the eye.
• Have a loose or injured permanent tooth assessed as soon as possible.

What you can do while awaiting care

Gently brush the area and clean between the teeth to remove trapped food, but do not dig into a cavity with sharp objects. Rinsing with warm salt water can soothe irritated tissues temporarily; it does not eliminate decay or an abscess.

If over-the-counter pain relievers are safe for you, use them according to the Drug Facts label. Your medical conditions, pregnancy status, allergies and other medicines can affect which option is appropriate, so ask a pharmacist or clinician if uncertain.

• Avoid very hot, cold or sugary foods if they trigger pain.
• Keep your head elevated if throbbing worsens when lying down.
• Use a cold pack on the outside of the cheek for injury-related swelling.
• Never place aspirin on the gum; it can burn tissue.
• Do not use leftover antibiotics or delay treatment because pain temporarily stops.

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How decay is actually treated

Treatment depends on depth. An early non-cavitated area may be managed with fluoride, plaque control and changes in sugar exposure while a dentist monitors whether the lesion arrests. Once a hole has formed, a filling is commonly needed because brushing cannot regrow the lost shape.

If decay or trauma reaches the pulp, root canal treatment may be needed to retain the tooth. A tooth that cannot be restored may require extraction, followed by a discussion of replacement options.

• Fluoride supports remineralization of early weakened enamel.
• A filling replaces tooth structure lost to a limited cavity.
• A crown can protect a substantially weakened tooth.
• Root canal treatment addresses infected or irreversibly inflamed pulp.
• Antibiotics may be used for selected spreading infections but do not repair the tooth.

Sensitivity needs a cause-based plan

For exposed dentin without untreated disease, desensitizing toothpaste and concentrated fluoride applied by a dentist can reduce sensitivity. Gum recession, erosion, grinding and forceful brushing may also need to be addressed to keep symptoms from returning.

A supplement or probiotic should not be used to self-treat sharp pain or presumed decay. No oral supplement can fill a cavity, stabilize a fracture or drain an abscess.

• Use a soft brush with light pressure.
• Spit out fluoride toothpaste after brushing rather than immediately rinsing it away.
• Limit frequent acidic drinks and avoid brushing immediately after an acid exposure.
• Request an examination if sensitivity is localized, worsening or prolonged.

Frequently Asked Questions