If you have tooth pain, you will probably head to the dentist. And there’s a good chance you have something like a cavity, infection or gum disease and your dentist can treat you.
But what if your dentist says your teeth look fine? What could be causing your pain? You might feel worried and frustrated.
The truth is: it’s not always problems in your teeth that trigger toothaches. Conditions that affect your nerves, sinuses or jaw can also cause dental pain. Knowing the difference can help you get the right care and relief.
If dental causes have been ruled out, it might be time to get a second opinion from a medical provider.
Dental pain vs. non-dental pain: What’s the difference?
Khalid Alsherbini, MD, an epilepsy and neurology specialist with Banner - University Medicine, said, “A typical toothache comes and goes. It gets worse when the tooth is exposed to hot or cold foods or drinks, or by chewing or biting with that tooth.” You may also see swelling or redness in your gums.
Dental pain is caused by something that can be treated, like decay, periodontal (gum) disease or a cracked or injured tooth. The pain goes away after the dentist treats what was causing it.
“Tooth pain that’s not dental is more constant, throbbing and usually not limited to one tooth. It can affect the whole jaw or the side of the face,” Dr. Alsherbini said. It can be severe, sharp, burning or electric-like.
This facial pain may flare when you brush your teeth, talk or eat and may even happen with exposure to air. Plus, dental treatment doesn’t help. “The vast majority of people with facial pain usually visit the dentist before seeing a neurologist,” Dr. Alsherbini said.
If your dentist rules out common causes like cavities, cracked teeth or infections, it’s time to look into other possibilities.
Common non-dental causes of tooth pain
If it’s not a dental problem that’s causing your pain, what could it be? A few different things can trigger tooth or facial pain.
Nerve-related conditions
One of the most common culprits is trigeminal neuralgia. This disorder affects a major facial nerve called the trigeminal nerve. It can cause sudden, severe jolts of pain that feel like a dental emergency, even though your teeth are healthy.
Other nerve conditions could also be blamed. Glossopharyngeal neuralgia can cause sharp pain in the throat, tongue or jaw when swallowing, speaking or yawning. And lingering pain after shingles may also trigger tooth-like pain.
Sinus and nasal conditions
The roots of your upper teeth sit close to your sinus cavities. When you have a sinus infection or chronic sinusitis, pressure in these spaces can cause toothaches. If your pain gets worse when you’re congested or when you bend forward, your sinuses may be causing it.
Jaw and joint problems
Temporomandibular joint (TMJ) disorders can cause pain that radiates into the teeth. The TMJ is the joint that connects your lower jaw to your skull. It allows you to move your mouth. Grinding your teeth, clenching your jaw or stress can make TMJ disorders worse.
Other medical causes
Sometimes, tooth pain may be caused by another condition that you feel in your jaw, like:
- Ear infections
- Cluster headaches
- Heart-related issues
That’s why it’s important not to ignore unusual or long-lasting pain.
When to see a dentist vs a doctor
“It’s hard to differentiate early,” Dr. Alsherbini said. Your first step should almost always be your dentist. They can rule out common dental issues such as cavities, abscesses or gum disease.
But it may be time to see a health care provider such as a neurologist or ear, nose and throat (ENT) specialist if your tooth pain:
- Is still there after dental treatment
- Feels shocking, stabbing or burning
- Spreads to other parts of your face
- Is triggered by light touch, speaking or brushing your teeth
- Comes with headaches
- Starts suddenly
- Is severe
Getting the right diagnosis and relief
“A dentist will usually do an X-ray and examine your teeth and joint,” Dr. Alsherbini said. If those don’t show any signs of problems, you may need to see a neurologist or ENT doctor for tooth pain diagnosis.
A medical provider may recommend further testing, such as an MRI or sinus scan, to look for nerve or sinus-related causes.
“Sometimes we need a special MRI to look at the facial nerve, trigeminal nerve or glossopharyngeal nerve to make sure there is no mass or compression. And sometimes we evaluate for multiple sclerosis or demyelinating disease,” Dr. Alsherbini said.
Getting the right diagnosis is key. Ignoring the pain can make it worse. If you don’t get a diagnosis, or if your scans come up clear and your provider can’t find the cause, get a second opinion.
Treatment options for non-dental tooth pain, which can include medication or surgery, can help you get back to your everyday activities without pain.
How Banner Health can help
At Banner Health, we understand how frustrating it can be to hear “nothing’s wrong” when you’re in pain. Our neurologists, ENT specialists and pain management teams work together to uncover the cause of non-dental tooth pain and find treatment options
If you’re dealing with tooth pain and your dentist says nothing is wrong with your teeth, reach out to one of our expert providers today.
