(02) 9569 3378 / (02) 9560 9371 51 Garners Ave, Marrickville, NSW 2204, Australia

There are various degrees of toothache so how do you know when it is time to visit the dentist?

To answer this question let’s first try to quantify the pain levels and we use 3 bands to do this:

Pain is occasional and when it occurs you may rate it 1-2 out of 10. Sometimes you are unsure which tooth is causing the problem.

You would probably rate this at 4-5/10.  It may be infrequent but the pain is a little more intense. Hot or cold food and drink will often cause sharp pain when they touch the tooth.  However it comes and goes and the pain may be relieved with analgesics

Rated 8-10/10. The pain is very severe and disrupts your daily routine. It may have kept you up all night. The pain is unrelenting, it comes in waves and there is not much you can take to stop the pain.

Ok, so now you have a good idea how to rank your pain level, let’s have a look at what causes the pain.

Mild discomfort

  • Tooth decay
  • Weak areas of the tooth lacking calcium
  • Sensitive exposed roots from receded gums
  • Crack in tooth

Moderate pain

  • Deeper tooth brush abrasion
  • More severe tooth decay or a deeper crack in the tooth, particularly if the tooth has a large silver coloured filling
  • Food-packing between teeth due to gaps, broken fillings/chipped teeth
    Acidic foods

Severe pain

  • Dying nerve in the tooth
  • Gross amounts of decay close to the nerve
  • Large cavity
  • Old large metal filling that is leaking, or close to the nerve
  • Chronic gum disease

Now before I ask you the big question, which is, at what level do you think you should address the problem let me add one other factor.

Sometimes patients believe the pain they are experiencing is due to a tooth problem, when in reality it may be associated with Jaw Pain.

What Is Jaw Pain?

Jaw pain can be a sign of something as common as a toothache — or even something as serious as a heart attack. Your jawbone, also called a mandible, connects to your skull at a pair of joints known as the temporomandibular joints, or TMJs. These joints are just in front of your ears, and they let you open and close your mouth.

Your jaw also holds your teeth and gums, which can be sensitive to heat, cold, or pressure. They also can get infected if you don’t keep them clean.


Temporomandibular joints, or TMJs is one of the most common reasons for jaw pain. About 1 in 8 people may have a TMJ disorder. It’s more common among women.

Can I have a Serious Dental Issue and Feel no Pain?

The short answer to this is yes, you definitely can have a variety of dental cavities, cracks and other issues but experience no pain, until the issue becomes serious.

For example, some abscesses are painless. Painless abscesses often still show identifiable symptoms such as gums and cheeks that are swollen. But if the abscess occurs in a tooth that has undergone root canal treatment, there may be no absolutely no pain because the nerve is already dead.

When you take into consideration that you may not feel any pain with many dental or oral conditions, until they become serious, you can see that making the right choice about when to see your dentist, is quite a complicated decision and that is why so many people get it wrong.

about when to see your dentist, is quite a complicated decision and that is why so many people get it wrong.

Our first advice is, attending your dentist for your regular dental check-up is the best way to ensure none of the issues above become a problem for you. That is because we will pick up most issues at a very early stage, when you can easily do something about it. This is the best and cheapest way to maintain good oral health, but with the best intensions in the world, things don’t always go to plan, something like Covid comes along and we miss our regular check-up.

If you are experiencing an issue then the next step is:


  • Book a dental examination to look for obvious cavities/exposed nerves/inspection of gums
  • X-rays to detect hidden cavities between teeth
  • Tooth tapping test to see if the infection has spread into the jaw bone
  • CO2 ice test to determine if the nerve has died

Our Final Recommendation

Early onset of any discomfort should be a warning that action is needed. Even if you experience mild symptoms, then please contact us and make an appointment. Why? Because the problem may be solved by simple measures such as doing a small filling, or applying a paste over the exposed nerves.

However, if further symptoms occur whenever you subject the teeth to temperature, then fillings may or may not fix the problem as it may be too late. (another reason to get in early).

Here is a summary:

Mild discomfort
Action may be as simple as removing decay with a small filling or applying a de-sensitizing material over exposed nerves.

Moderate pain
Removing decay/crack with a filling, but may require an onlay, or crown.

Severe pain

  • Root canal therapy if you choose to keep the tooth
  • Extracting the tooth if you don’t want root canal (B the way, root canals are not as painful as many people think).
  • As the treatment for conditions that produce severe pain are often more extensive they are also more expensive. To help you make the right choice that may save your tooth, such as root canal treatment, we do offer dental finance plans that enable you to spread the cost and get the work you need done, when you need it.

If Ignored

The two words most patients hate to hear.

Extraction or Root canal therapy. These are the only options in cases of severe tooth infection.

These are more complicated treatments that could be avoided by early detection and treatment of the problem. For example, removing a tooth and having a replacement tooth (a dental implant) in the future is a more expensive option to treating the early onset symptoms.

If a crack remains untreated, and the tooth splits in half, the tooth cannot be saved, so extraction is the only treatment option.

So now, you have more information, we hope it helps you to make the right decision about when to visit us / your dentist. Whatever you decide, please don’t leave it until it becomes a serious issue and causes you to lose your tooth / teeth.