Dr. Silberman often gets asked the question: “Do I apply heat or cold to a toothache?” Watch our one-minute video to discover the answer:
Should you apply heat or cold to a toothache?
ALMOST NEVER APPLY HEAT to your face when experiencing a toothache. If you have an infection the heat may draw that infection out causing more swelling. Apply COLD! If you are experiencing a severe toothache the best thing is ice water in the mouth. You may have gasses trapped in your tooth. If you keep ice cold water in your mouth, the gasses will contract and pain either lessens or ceases.
“Inflammation is the body’s natural response to any infection. Heat increases inflammation. Ice helps to relieve inflammation.” —Dr. Paul Silberman, Dentist in Waldorf
What to do if you have tooth pain
- Get to your dentist as soon as possible.
- Putting it off will make it worse.
- Even if the pain eases, the underlying cause for the pain is still present and you will wind up experiencing pain again.
There are many reasons you may have a toothache. It can occur even if you have seen a dentist regularly. If you have a toothache and have not seen a dentist for a long time, do not be intimidated. Just go to a dentist as soon as possible if experiencing pain. Never worry about telling a dentist that you have not seen anyone for dental treatment for a long time. Your dental office must be a judgment-free zone. What is important is how you can start to achieve dental health now, not what you did or did not do in the past.
Are you experiencing tooth pain right now?
Call The Silberman Dental Group
Editor’s note: This post was originally published in July 2014 and has been revamped for comprehensiveness and timeliness.
I recently had two root canals. #’s 18 And 19. Both of which were broken and chipped. A week later I went in for temporary crowns. After one week the pain along my lower jaw from one side to the other was, on a scale of 1-10, at a ten! I recently went back to the dentist to have my bite adjusted. After 5 days, I still experienced pain, at a 10! I was not prescribed antibiotics or pain reliever. I called the dentist yesterday and insisted they give me antibiotics Incase there was bacteria within the teeth that went infected. Should the dentist, during my initial visit prescribed an antibiotic? I could have avoided all this pain!
Sylvia, I am sorry for this terrible dental experience you went through. You asked, “Should the dentist have, during my initial visit, prescribed an antibiotic?” This is very controversial.
I always prescribe antibiotics at the time I diagnose the need for root canal therapy and the patients never have post-operative pain. That is not what is taught in dental schools today. The treatment you received is considered the standard of care today, and unfortunately, the result you received occurs in one out of five patients. From my point of view, if the ratio was 1:5,000 or even 1:500, I might consider that approach. But because I know that one out of five is going to suffer, I pre-medicate with antibiotics. The downside is that some will have an allergic reaction to the antibiotic. I always tell the patient that if a rash or difficulty breathing develops, stop the medication and call me.
There is also concern about over-prescribing antibiotics and patients developing resistant strains of bacteria. While a valid concern, I still weigh that against what you had to go through. It’s not like I am suggesting antibiotics for the treatment of the common cold. If a tooth requires root canal therapy, bacteria are present. I want to reduce the number of bacteria before treatment. I want to “take the bees out of the hive before I stick my hand in it.” But I am in the minority. I hope that answers your question.
Call your dentist and tell them that it is an emergency. Stress that you are in pain and cannot take it. Normally, they will fit you in regardless if there is a wait list. If that doesn’t work ask your dentist for a pain reliever –they may be able to prescribe something that is stronger than you are taking. Furthermore, if the tooth is impacted (which yours sounds like) they give you meds to relieve the swelling in order that they will be able to facilitate the extraction. If worst comes to worst perhaps call a different dentist. Normally, the ER cannot do anything for you.
Hello GoToothache! Thanks for the helpful tips. We agree that if you are in pain, you should call your dentist. They will either be able to fit you in for an appointment or offer advice on easing the pain.
My face is so swollen because of my toothache..I never in my life had this..not even when I’ve had some of my teeth.pulled..I’m 61 diabetic and can’t stand this pain…
If you can’t get in to see a dentist, go to an emergency room or Urgent Care Center. You need to be put on antibiotics to control the swelling. As a diabetic you know that the healing response is always more difficult. It is very important that you do not apply heat to your face as this will dramatically increase the swelling. It is OK to apply cold compresses. You can take Tylenol 500 mg (2 extra strength) along with Motrin (two 200 mg) every 8 hours. Or when you get your antibiotic prescription you might be able to get a stronger pain medication prescribed too.
I took advil or tynenol with cold water. My orthodontist suggested try rinsng your mouth with salt water. It will get better as your teeth align.
Rinse with warm salt water, Infection in your mouth can spread quickly. Do not use alcohol as this causes inflammation to your gums making it worse.
Hi Deborah! Thanks for sharing. Warm salt water rinses are an easy and effective way of preventing the spread of infections
If your old its all good, if not then be sure to lay of acid drinks and candy. And don’t brush your teeth right after eating these, wait at least an hour
Why does it hurt so much worse when I quit using cold water. Will it eventually stop hurting like that or will I have no choice but to try to withstand the pain when stopping the use of cold water. It hurts so bad when I stop using cold water I can barely talk. It like no pain I’ve ever had
There is an infection in your tooth. The bacteria (germs) in the infection give of a byproduct of gas. The gas can’t escape and is trapped inside the tooth. Applying cold to gas makes it contract and takes pressure off the nerve which stops the pain. A dentist can numb the tooth and open it to allow the gas to escape which will stop 80% of the pain. You can save the tooth with root canal therapy or have it extracted. I hope that answer helps.
Hello Robert! Thank you for commenting. We believe everyone, regardless of age, should be aware of sugary and acidic drinks or foods.
And great tip on waiting to brush! It is proven that you should wait to brush after having acid in your mouth or else it can further damage your enamel.
I have a visable abscess in my mouth and the pain is killing me. I have antibiotics, but is there anything I can do to alleviate the pain a little until I can get to the dentist Wednesday
Sorry you are going through this. The abscess tells me that there is no “feeling” in at least one root of the tooth. The pain is coming from the infection outside the tooth or from one of the other roots that still have feeling. A quick remedy is to hold Ice Water in your mouth in the area of the affected tooth. It should take away the pain for a while and can be continually reapplied as needed. Once the antibiotic kicks in, the frequency of the need for ice water should decrease. Hopefully, the other teeth are not sensitive to cold or this becomes a trade-off.
The reason ice water helps is because the bacteria inside the tooth give off a bi-product of gas. The gas is trapped and has no way to escape. When gas is heated it expands. Your body heat may be enough to cause it to expand and put pressure on the nerves causing the pain. The ice water gets the gas to contract and remove the pressure from the nerves. You may have to keep ice water on the night stand next to the bed if the pain wakes you. Take a swig and hold it around the tooth, then swallow and go back to sleep.
Where are you located?
I hope this helps. Good luck!
I am having a tooth pulled tomorrow that has had a root canal in the past. My face is super swollen and draining out of my nose. I am on antibiotics. Can I apply a warm wet wash cloth to help the abscess drain?
Do not apply heat to your face. It will draw the infection to the surface and create severe swelling. It is OK to apply cold compresses. You should not have tooth infection drainage from the nose. There should not be communication between the sinus and oral cavities. Be sure you tell the surgeon at the time of the extraction that this has been your experience. It may be necessary to apply a membrane that will separate the extraction site from the sinus to create proper healing.
I had a tooth pulled a year ago. This week I have developed an incredible throbbing pain on the gum in the tooth extraction site. What could this be?
There are a few possibilities. If part of the extracted tooth was left behind, it is possible that your body is still healing and pushing the fractured piece to the surface. Essentially, you are “teething” as the fragment pushes out through the gum. Another possibility is that a neighboring tooth is acting up and it’s very difficult to determine exactly where the pain is coming from. If you are having any sensitivity to cold, hot or pressure, the problem is likely another tooth. In any event, you should see a dentist to have the site x-rayed and evaluated. I hope that helps.
Thanks for the tip Dr. Silberman. It is indeed interesting to note that heat can actually cause inflammation in your tooth, since warm saline water is considered a useful home remedy to tackle infections. Rather it is the hot spicy foods which can cause gum inflammation.
Warm saline rinses are a good home remedy for minor gum swelling. An abscessed tooth is a different story. It is best not to apply heat externally as it will draw the infection to the outer surface and potentially cause severe swelling. If the abscess is draining in the mouth next to the tooth, it is again OK to use warm saline to help with the draining process. No External Heat.