See someone urgently if
- Facial swelling, particularly if it is closing the eye or spreading under the jaw or into the neck
- Difficulty swallowing, opening the mouth, or breathing
- Fever alongside a painful tooth
- Pain that started after a blow to the face
- A tooth that has become noticeably loose in an adult
Otherwise, book in the normal way. Call +91 83036 12717.
What causes it
Decay reaching the pulp
The commonest cause by a wide margin. Once bacteria breach the enamel and dentine and reach the pulp, the tissue inflames inside a rigid chamber that cannot expand, and the pressure produces the characteristic deep, throbbing ache. This is also why it worsens when you lie down: blood pressure in the head rises slightly and the chamber has no room for it.
A cracked tooth
Distinctive because the pain comes on biting and often spikes as you release the bite rather than as you press down. Cracks can be invisible on an X-ray and are frequently missed for months. A cracked tooth left alone tends to split further until it cannot be saved.
An abscess at the root tip
The tooth may feel raised, tender to touch, and sore to bite on. There may be a small pimple on the gum that discharges and relieves the pressure temporarily. The relief is not recovery; the infection is simply draining.
Gum problems and food impaction
Food wedged between two teeth presses on the gum and causes a persistent dull ache that resolves the moment it is removed. Gum infection around a tooth produces a different, more diffuse soreness than pulp pain.
A wisdom tooth pushing through
Pain at the very back of the jaw, often with a flap of swollen gum over a partly erupted tooth that traps food and becomes infected. This is pericoronitis and it recurs until the tooth is either fully through or removed.
Sinus pressure
The roots of the upper back teeth sit close to the sinus floor. Sinusitis can make several upper teeth ache at once, and the clue is that all of them hurt rather than one, and it worsens when you bend forward.
What helps before you are seen
Take a painkiller you know you tolerate
Paracetamol or ibuprofen at standard doses, taken on schedule rather than waiting for the pain to peak, works better than intermittent dosing. Do not exceed the labelled dose.
Keep your head elevated
Pulpal pain characteristically worsens when horizontal. Propping up on extra pillows genuinely helps you get through the night.
Warm salt water rinses
Half a teaspoon in a glass of warm water, several times a day. It helps most where the problem is gum inflammation or food impaction, less so for pulp pain.
Cold on the cheek, not heat
A cold pack outside the cheek helps some pulpal pain. Avoid applying heat to a swollen face, which encourages infection to spread.
Do not put aspirin against the gum
It burns the soft tissue and does nothing for the tooth. This remains a surprisingly common piece of household advice and it causes a chemical ulcer.
Do not start antibiotics on your own
Pain from an inflamed pulp does not respond to antibiotics, because the tissue involved has lost its blood supply and the drug cannot reach it. Self-prescribing delays the treatment that works and adds to resistance.
How it is treated
Diagnosis first
An examination plus an X-ray establishes whether the pulp is involved, whether there is an abscess at the root tip, and whether the tooth is restorable. Pain location is unreliable, because pulp pain refers along the jaw and patients frequently point at the wrong tooth.
Filling, where the pulp is still healthy
If decay has not reached the nerve, removing it and restoring the tooth resolves the pain. Fillings cost roughly ₹500 to ₹3,000 in Lucknow depending on size and material.
Root canal, where the pulp is inflamed or dead
The pulp is removed, the canals disinfected and sealed, and the tooth restored. This is what saves a tooth that would otherwise be extracted. Root canal treatment costs ₹3,000 to ₹12,000 in Lucknow, plus the crown that a back tooth needs afterwards.
Drainage, where there is an abscess
Pressure has to be released before anything else helps. This is done through the tooth or through the gum, and it produces immediate relief.
Extraction, where the tooth cannot be saved
A tooth split below the gum or with too little structure left is removed. Extraction costs ₹500 to ₹5,000 depending on difficulty, and the gap then needs planning for.
Toothache: common questions
Why does my toothache get worse at night?
Lying down raises blood pressure in the head slightly, and an inflamed pulp is sealed inside a rigid chamber that cannot accommodate the extra pressure. There are also fewer distractions at night. Sleeping propped up on extra pillows genuinely reduces it.
Will a toothache go away on its own?
The pain often does; the problem does not. When a pulp finishes dying, the pain stops because the nerve is dead, and patients read this as recovery. The infection then progresses silently towards an abscess. Pain that disappears without treatment is a reason to be seen sooner, not later.
How much does treating a toothache cost in Lucknow?
It depends entirely on the cause. A filling runs ₹500 to ₹3,000, a root canal ₹3,000 to ₹12,000 plus a crown, and an extraction ₹500 to ₹5,000. An examination and X-ray, at roughly ₹200 to ₹1,200, is what establishes which of those you need.
Can I take antibiotics for a toothache?
Not on your own. Antibiotics do not relieve pain from an inflamed pulp, because the affected tissue no longer has a blood supply for the drug to reach. They have a role only in spreading infection, and taking them without treating the tooth delays the fix.
When is a toothache an emergency?
When there is facial swelling, especially spreading towards the eye, under the jaw or into the neck, or difficulty swallowing, opening the mouth or breathing, or fever with rapidly increasing swelling. Those signs mean infection is tracking through tissue planes and need same-day medical care.
Medically reviewed
Reviewed by Dr. Dhanya Saxena, BDS, MHA, FMC, FAOI, oro-dental surgeon and aesthetic physician at Redefine Dental and Facial Aesthetic, Indira Nagar, Lucknow. Dental Council registration 20935. Last reviewed 30 August 2026.
This page is general information, not a diagnosis. Prices are prevailing Lucknow market ranges, not a quotation. If you have facial swelling, difficulty swallowing or difficulty breathing, seek emergency medical care rather than a routine appointment.