Common symptoms
- • Pain that lingers for minutes after hot or cold, especially hot
- • Throbbing pain that starts on its own without a trigger
- • Pain that wakes you at night or is worse lying flat
- • Difficulty identifying exactly which tooth hurts
- • Temporary relief from holding cold water in the mouth
Likely causes
- • Deep decay reaching the pulp
- • A cracked tooth allowing bacteria into the nerve
- • Repeated or very deep dental treatment on the same tooth
- • Trauma to the tooth, sometimes years earlier
- • Untreated reversible pulpitis progressing
What can help tonight
- • Take pain relief as directed on the packet, if it is safe for you
- • Keep your head slightly raised when sleeping
- • Avoid hot drinks, which often make this pain worse
- • Keep cleaning the area gently to prevent infection
- • Arrange treatment promptly — this type of pain does not settle by itself
This is general information, not a diagnosis. Always follow the advice given to you by your dentist.
When it's an emergency
- • Facial swelling spreading towards your eye or neck
- • Difficulty breathing or swallowing
- • High temperature with severe pain and feeling very unwell
If any of these apply to you, call 999 or attend A&E now. Outside these signs, NHS 111 can advise out of hours.
What a ToothAid dentist can do online
A dentist can recognise this pain pattern over video, check for signs of spreading infection, and give you an evidence-based plan for getting through the next 24 to 48 hours. Antibiotics do not relieve pulpitis, so they will only be prescribed where there is genuine infection.
What needs in-person treatment
Irreversible pulpitis is treated by removing the inflamed nerve — root canal treatment — or by extracting the tooth. Both require an in-person appointment, and ToothAid can refer you to a participating practice for urgent assessment.
Frequently asked questions
Will painkillers be enough until I'm seen?
They can take the edge off, but pulpitis pain is often poorly controlled by tablets alone. Treatment is what reliably stops it.
Why do antibiotics not help?
The pain comes from pressure inside an inflamed nerve, not from a spreading infection. Antibiotics cannot reach or relieve it.
Can the tooth be saved?
Often yes, with root canal treatment, provided enough healthy tooth structure remains. Your dentist will assess this in person.
Why does hot water make it worse and cold make it better?
This is a classic sign of an irreversibly inflamed nerve, and it is a useful detail to tell your dentist.