Severe Toothache Treatment London

A severe toothache is one of the most common reasons patients seek emergency dental care. The pain can be constant or intermittent, sharp or throbbing, and may radiate to the jaw, ear, or head. While over-the-counter painkillers may provide temporary relief, a toothache that persists or worsens requires professional assessment to identify the cause and prevent complications.

Common causes of severe toothache

• Dental decay (caries) — decay that has reached the inner nerve of the tooth, causing inflammation and pain
• Dental abscess — a bacterial infection at the root tip or in the gum, often causing swelling and throbbing pain
• Cracked or fractured tooth — a crack through the tooth may expose the nerve, especially when biting
• Failed filling or crown — a previous restoration that has broken down, allowing bacteria to reach the tooth
• Gum disease (periodontitis) — advanced gum infection causing pain, swelling, and bone loss around teeth
• Impacted wisdom tooth — a wisdom tooth pressing against adjacent teeth or trapped under the gum
• Referred pain — in some cases, pain felt in a tooth may originate from sinuses, the jaw joint (TMJ), or nearby structures

What to expect at your emergency appointment

When you attend for a severe toothache, your dentist will conduct a focused clinical examination, including visual inspection and gentle testing of the affected tooth. X-rays may be taken if clinically indicated. Based on the findings, your dentist will explain the diagnosis, discuss treatment options (including risks, benefits, and alternatives), and provide a written treatment plan with costs before any work proceeds.

Treatment options for severe toothache

Treatment depends on the underlying cause:

• Fillings — for teeth with decay that has not yet reached the nerve
• Root canal treatment — to remove infected nerve tissue and save the tooth (from £347.50 for members)
• Extraction — when the tooth cannot be predictably saved
• Abscess drainage — incision and drainage where a collection of pus is present
• Antibiotics — prescribed where clinically indicated for spreading infection (not a substitute for dental treatment)
• Temporary dressing — to stabilise a tooth until definitive treatment can be arranged

Risks and important information

As with any dental treatment, there are risks to be aware of. These are discussed with you before treatment and informed consent is obtained. Possible risks include: post-treatment sensitivity, the need for further treatment (such as a crown after root canal), the possibility that a tooth cannot be saved despite treatment, and temporary discomfort during recovery. Not all emergency visits result in immediate definitive treatment — some cases are stabilised and planned treatment arranged for a follow-up visit.

When to seek emergency care for a toothache

You should seek urgent dental care if you experience:

• Severe pain not controlled by over-the-counter painkillers
• Facial swelling, especially if spreading or affecting the eye or throat
• Fever alongside dental pain
• Difficulty swallowing or opening your mouth
• Pain that has been worsening over several days
• Bleeding or discharge from the gum around a tooth

If you experience difficulty breathing or severe facial swelling affecting your airway, attend your nearest hospital A&E department immediately.

While you wait for your appointment

If you are waiting for an emergency appointment, over-the-counter painkillers such as ibuprofen (if suitable for you) and paracetamol may help manage pain temporarily. Avoid very hot or cold foods and drinks. Do not place aspirin directly on the gum. A cold compress on the outside of the cheek may help reduce swelling. This is general guidance — always follow your dentist's or pharmacist's advice.

Toothache treatment cost breakdown

The initial emergency exam costs £30 for new patients (£95 standard, £47.50 for SPMD members). X-rays are £20 (£10 members) if clinically needed. Further treatment costs depend on the diagnosis — common treatment costs at our clinic include: