Toothache — what to do, when to call.

Toothaches come in different flavors, and the kind of pain you have usually tells us what’s wrong. A sharp twinge from cold or sweet foods that fades in a few seconds often points to a cavity or exposed root surface. A dull constant ache that builds over hours can suggest an inflamed pulp — the nerve and blood vessel inside the tooth. Throbbing pain that wakes you up, or pain plus visible swelling, usually means infection and needs urgent treatment.

What you can do before we see you

Rinse your mouth gently with warm salt water — about a teaspoon of salt in eight ounces of warm water. It won’t fix the underlying problem, but it cleans the area and often eases the pressure briefly. An over-the-counter pain reliever — ibuprofen if you can tolerate it, acetaminophen otherwise — helps most moderate tooth pain.

A cold compress against the outside of your face can dull the ache. Avoid putting heat on the area, and avoid putting aspirin directly on the gum — it can chemically burn the tissue. Floss around the painful tooth gently, in case there’s a piece of food trapped between teeth that’s creating pressure. (More often than people expect, that’s the entire cause.)

When to call

Call us at 540-337-6004 if any of the following apply:

• The pain has lasted more than 24 hours
• The pain wakes you up at night or keeps you from eating
• You can see or feel swelling around the tooth or in your face
• You notice a pimple-like bump on the gum near the tooth
• The tooth feels loose or has changed position
• You have a fever along with the tooth pain

What we’ll do

When you come in, Dr. Agrawal will examine the tooth, take a small X-ray if needed, and identify the source of the pain. From there, the path forward depends on the cause. A simple cavity gets filled the same day. An inflamed nerve typically needs root canal therapy — performed in our office, comfortably, with sedation available. An infection gets drained and antibiotics started immediately, with follow-up treatment scheduled to address whatever caused it.

Whatever we find, you’ll leave with a clear plan and significant relief. Most toothaches can be resolved in one or two visits.