Tooth Pain That Comes and Goes: When to See a Dentist Immediately

Key Takeaways

• Intermittent tooth pain often signals underlying dental issues such as mild decay, cracked teeth, or gum recession — even if it disappears quickly.
• Random pain throughout the day may be linked to hidden factors like bruxism, sinus infections, or psychological stress.
• Knowing the difference between nerve-related pain and surface sensitivity is essential — nerve pain typically lingers and may require root canal therapy.
• Untreated cavities, old fillings, gum recession, or clenching often cause recurring pain. These conditions worsen if left untreated.
• Red flags that require immediate dental care include swelling, fever, shooting pain, and persistent sensitivity to hot or cold temperatures.
• Long-term solutions for nerve-related pain include fillings, root canals, crowns, or extractions, depending on the severity and the tooth's structure.
• Dentists use systematic diagnostic steps such as visual exams, X-rays, percussion tests, and thermal sensitivity checks to identify the root cause.
• Quick relief at home may include saltwater rinses, OTC medications, or cold compresses — but these are temporary and do not replace professional care.

What does it mean when tooth pain comes and goes?

You’re biting into something cold or crunchy, and suddenly, there's a sharp jolt of pain — but then it vanishes. Moments later, everything feels normal. Sound familiar? This is known as intermittent tooth pain, and it's a sign that shouldn’t be ignored.

What Is Intermittent Tooth Pain?

Intermittent tooth pain refers to discomfort that appears and disappears, rather than being a constant sensation. It may occur during specific activities, such as chewing, or after exposure to extreme temperatures, including heat or cold. It also strikes randomly, only to fade within seconds or minutes.

This type of pain doesn’t always scream “emergency,” but it often signals that something underlying is developing, possibly without being noticed. Identifying why the pain is coming and going is essential to prevent it from becoming chronic or more severe.

Common Triggers

Several everyday actions can trigger this kind of tooth pain:

• Biting or chewing, especially with hard foods
• Drinking cold or hot beverages
• Eating sweet or acidic foods
• Clenching or grinding your teeth (bruxism)

Each of these triggers stresses the tooth structure and may reveal underlying issues.

Potential Causes

Cracked Tooth Syndrome (CTS)

A hairline crack in the tooth, often invisible on X-rays, may cause pain when pressure is applied during biting. This pain usually disappears once pressure is released, which explains the intermittent nature.

Mild Tooth Decay

In its early stages, decay may irritate the dentin layer without reaching the nerve. This can cause brief sensitivity to temperature or sugar, but no lingering pain.

Worn Fillings or Dental Work

Over time, dental restorations can shift, crack, or lose their seal. This can expose parts of the tooth or nerve, triggering sporadic pain.

Gum Recession

When gums pull back from the teeth, they expose sensitive root surfaces, which react to hot, cold, or touch. Pain may not be constant, but it flares up in response to these stimuli.

Dr. James C.H. Ko DDS adds:
"Patients often ignore fleeting discomfort, but we always advise that any recurring tooth pain — no matter how minor — is a reason to get evaluated. Prevention is always easier than correction."

What You Should Do

If you experience pain that comes and goes, don’t wait until it becomes unbearable. A dental assessment can catch the issue early. Early diagnostics and advanced imaging can often detect problems before they become more severe.

Why do my teeth hurt randomly throughout the day?

Tooth pain that hits out of nowhere — and then disappears — is one of the most frustrating sensations to experience. It can disrupt your work, your meals, or your sleep. But what’s behind these unexpected flare-ups?

The truth is, random tooth pain often isn’t random at all. It usually stems from subtle, chronic issues that aren’t always easy to spot without a professional exam.

Under-the-Radar Causes of Tooth Pain

Bruxism (Teeth Grinding)

One of the leading causes of seemingly random tooth pain is bruxism — the unconscious grinding or clenching of teeth, especially during sleep. Over time, this can wear down enamel, stress your jaw, and even crack teeth.

• Pain is often dull and spreads across multiple teeth.
• You might also notice morning jaw tension or headache.s

Sinus Infections

Believe it or not, tooth pain — especially in the upper molars — can originate in your sinuses. When sinuses become inflamed due to infection or allergies, they can press against dental nerves.

• Pain often worsens when bending forward or lying down.
• It may feel like multiple teeth are affected.

Gum Disease (Gingivitis or Periodontitis)

Chronic inflammation from untreated gum disease can irritate nerves and cause shifting in tooth alignment, both of which can trigger intermittent pain.

• Look out for bleeding gums, bad breath, and a receding gumline.

Psychological Stress

Stress doesn’t just affect your mind — it manifests in the body, often through clenched jaws or grinding. People under chronic stress may experience episodic dental pain without even realizing the root cause is behavioural.

When It's Not Just "Random"

Dr. Rob Eisen notes:
"Tooth pain that seems spontaneous is often a delayed reaction to micro-damage building up over time. Identifying stressors — physical or emotional — can help us find the underlying source."

What You Can Do

Until you can get an appointment, you can:

• Keep a journal of when the pain occurs and what might trigger it
• Use a nightguard if you suspect bruxism.
• Avoid chewing on hard food.s
• Try a warm compress or a sinus rinse if the symptoms match those of sinus pressure.

Could it be a tooth nerve problem or something else?

Sometimes, tooth pain is a simple matter of sensitivity. Other times, it means the nerve inside your tooth is inflamed or damaged — something that won’t heal on its own. So how can you tell the difference?

Nerve Pain vs. Surface Sensitivity

It’s important to distinguish between surface-level sensitivity and deep nerve pain. They may feel similar at first, but are very different in cause and treatment.

Here’s a comparison to make it easier to spot:

Symptom	Surface Sensitivity	Nerve-Related Pain
Duration of Pain	Brief (seconds)	Lingering (minutes or hours)
Triggered by	Cold, sweet, or acidic foods	Hot foods, pressure, spontaneous pain
Type of Pain	Sharp, short burst	Throbbing, pulsating, dull ache
Location	Often easy to pinpoint	May feel like it radiates
Treatment	Desensitizing toothpaste, fluoride	Root canal, extraction, antibiotics

Signs of Nerve Exposure or Pulpitis

Pulpitis is the inflammation of the dental pulp — the tissue inside your tooth that contains nerves and blood vessels. It may be reversible in early stages, but it becomes more dangerous once it reaches the inner nerve chamber.

Watch out for:

• Lingering pain after hot or cold exposure
• Pain that worsens at night or when lying down
• Pain triggered by chewing or tapping the tooth
• Swelling, bad taste, or fever (in severe cases)

What are the most common causes of recurring tooth pain?

Tooth pain that keeps returning is never just a nuisance — it’s a signal. When discomfort comes and goes regularly, it typically indicates a structural or biological issue that remains unresolved. Let’s walk through the most frequent causes.

1. Untreated Cavities (Dental Caries)

Tooth decay remains one of the leading causes of recurring pain. As enamel wears down, the inner layers become exposed and sensitive to heat, cold, or pressure.

• Pain may be sharp or dull, depending on severity.
• Cavities often start painlessly but grow worse if left untreated.

The Canadian Dental Association notes that cavities are most common among patients who delay preventive care.

2. Gum Recession

When gums pull away from the teeth, dentin and root surfaces — which are not protected by enamel — become exposed. This causes heightened sensitivity to temperature and pressure.

• Often seen in older adults or those with aggressive brushing habits.
• Linked to gum disease or trauma

3. Teeth Clenching or Grinding

Chronic bruxism causes microfractures and enamel wear. This leads to stress on the teeth and periodontal ligaments, resulting in pain that often intensifies during periods of stress or sleep.

• You may not realize you grind your teeth until a dentist points it out.
• Pain is often diffuse across multiple teeth.

4. Failing or Old Fillings

As fillings age, they can pull away from the tooth, crack, or decay underneath — allowing bacteria to re-enter. This creates a new site of irritation and decay.

• Sensitivity near previously treated teeth
• Pain when biting down or with temperature changes

5. Exposed Dentin

When enamel is worn or missing, the dentin layer becomes vulnerable. Since dentin contains microscopic tubules that connect to the nerve, even mild triggers can cause pain.

• Often worsens with acidic or cold foods.
• May feel like a sharp, fleeting zap

If you’re dealing with repeat pain, don’t tough it out. Schedule a comprehensive assessment at North York Smile Centre to prevent the cycle from escalating into a crisis.

When should you go to the dentist for tooth pain?

Not all toothaches need urgent care — but some absolutely do. Knowing when to wait and when to act can prevent long-term complications.

Red Flags That Require Immediate Attention

• Severe or shooting pain that doesn’t go away
• Swelling in the face or jaw
• Fever and chills — potential signs of infection
• Bleeding gums not linked to brushing
• Pain when biting down
• Persistent sensitivity to hot or cold (especially if it lingers)

When to Call the Dentist

• Track the symptoms
  • When does the pain happen?
  • What triggers it — food, cold air, pressure?
• Check for visible issues.
  • Cracks, broken fillings, or gum inflammation
• Look for systemic signs
  • Swelling, fever, fatigue = possible infection
• Try conservative care (but only if symptoms are mild)
  • Saltwater rinse, OTC pain relief, gentle brushing
• Call your dentist if symptoms worsen or last more than 1–2 days

What is the best long-term solution for nerve-related tooth pain?

When tooth pain involves the nerve, temporary fixes won't do. The underlying tissue, called the pulp, can become infected, inflamed, or die entirely. Long-term relief depends on removing the source of the pain while preserving as much of the tooth structure as possible.

Let’s break down the best treatment options:

Treatment Option	When It’s Needed	Pros	Limitations
Filling	When decay is superficial and hasn't reached the pulp	Quick, minimally invasive	Not effective for deep nerve issues
Root Canal	When pulp is infected or inflamed	Saves the natural tooth	Requires crown placement afterward
Crown Placement	When the structure is weakened by decay or after a root canal	Protects the tooth, restores function	May require multiple appointments
Extraction	When the tooth is beyond saving or causing infection	Removes the problem completely	Tooth loss requires a replacement option (implant, bridge)

What’s the Bottom Line?

• Root canal therapy is often the gold standard when nerve pain stems from pulp infection or irreversible inflammation.
• Fillings work only in early cases where the nerve hasn’t been affected.
• Crowns are typically needed to reinforce teeth after root canals or large restorations.
• Extraction is only recommended when the tooth can’t be saved — usually due to fracture below the gumline or severe infection.

If you’re dealing with persistent or throbbing tooth pain, book an endodontic evaluation at North York Smile Centre. Getting to the root of nerve pain isn’t just about comfort — it’s about saving your smile.

How do dentists diagnose the root cause of your toothache?

If you've ever had a dental appointment for tooth pain, you’ve probably experienced a variety of tests and tools. But what exactly are dentists looking for? The process isn’t guesswork — it’s a systematic series of assessments that help pinpoint the exact issue.

Here’s a step-by-step breakdown of how dentists diagnose toothaches:

1. Visual Examination

The first step is always a thorough visual and tactile inspection. The dentist will:

• Check for visible signs of decay or cracks
• Assess your gums for inflammation or recession.
• Look for worn enamel, missing fillings, or fractures.

At this stage, lighting, magnification, and sometimes dyes are used to highlight subtle damage.

2. Percussion and Pressure Testing

Next comes the percussion test, where a tool is used to tap the tooth and gently check for tenderness. The dentist might also ask you to bite down on a stick or a rubber tool.

• Release pain may indicate a cracked tooth.
• Sensitivity to tapping could signal inflamed ligaments or nerve involvement.

3. Cold and Heat Sensitivity Test

To evaluate nerve health, dentists often apply hot or cold stimuli:

• Short, sharp pain usually indicates surface-level sensitivity
• Lingering pain may suggest pulpitis or nerve inflammation.

4. X-rays and Imaging

When visual checks don’t tell the whole story, X-rays become essential. Dentists use them to:

• Detect hidden decay between teeth
• Identify abscesses or bone loss.
• Examine old fillings or root canals for failure.

What’s the final takeaway on intermittent tooth pain and dental care?

Tooth pain isn’t always constant — but even fleeting discomfort is a message. It’s your body alerting you to an issue before it becomes a serious problem. Understanding the warning signs and acting early can save you pain, money, and even your tooth.

Here’s a summary of everything we’ve covered:

Cause	Description	Relief Options	Professional Treatment
Cracked Tooth	Pain with biting, intermittent sensitivity	Avoid hard foods, cold compress	Crown, bonding, root canal if deep
Cavities	Sensitivity to sugar, heat, and cold	Fluoride rinse, desensitizing paste	Filling or inlay
Gum Recession	Exposed roots, cold/hot sensitivity	Soft-bristled brush, toothpaste for sensitivity	Gum graft, fluoride varnish
Nerve Inflammation (Pulpitis)	Throbbing, spontaneous or heat-triggered pain	OTC meds, avoid hot drinks	Root canal therapy
Bruxism	Dull aches, jaw tension, worn enamel	Nightguard, jaw exercises	Occlusal adjustment, Botox (in some cases)

Final Tips

• Keep a symptom journal: Note when pain occurs, what triggers it, and how long it lasts.
• Don’t self-diagnose: Use home remedies cautiously, but don’t delay professional care.
• Book a complete dental checkup at North York Smile Centre: We offer comprehensive diagnostics, emergency care, and long-term solutions.

When in doubt, remember this: Tooth pain is never just in your head.