Toothache That Will Not Go Away? 7 Causes and When to See a Lagos Dentist

Toothache is one of the most disruptive forms of pain — it interrupts sleep, makes eating miserable, and can radiate into your jaw, ear, and head. But not all toothaches are the same, and understanding what’s causing yours determines whether you need emergency care today or a routine appointment next week. Here are the 7 most common causes Lagos dentists see.

1. Tooth Decay (Cavity)

The most common cause of toothache in Lagos. Bacteria in the mouth break down sugars, producing acid that erodes the outer enamel layer. As decay progresses deeper into the tooth, it reaches the dentine — which contains nerve-carrying tubules — producing sensitivity and pain. Left longer, decay reaches the pulp (nerve), causing severe spontaneous pain.

When to go: If the pain is sharp when you eat or drink cold, sweet, or hot foods — see a dentist within days to weeks. If the pain is throbbing, spontaneous (starts without a trigger), or wakes you at night — go urgently.

2. Cracked or Fractured Tooth

Teeth crack from biting hard foods, teeth grinding, large old fillings that weaken the tooth structure, or trauma. A crack that extends to the nerve causes sharp pain when biting that may “release” when you stop biting. Cracks are often invisible on X-rays and require clinical examination.

When to go: Any cracked tooth should be evaluated promptly — cracks can propagate and split the tooth entirely, converting a treatable situation into an extraction.

3. Gum Disease (Periodontitis)

Advanced gum disease causes deep pockets of infection around tooth roots — these can be very painful, especially when pressed or during chewing. Gum disease pain is often dull and aching rather than sharp, and associated with bleeding gums, bad breath, and loose teeth.

4. Dental Abscess

An abscess is a localised collection of pus — either at the root tip (periapical abscess) or in the gum tissue (periodontal abscess). It causes severe, throbbing pain that often worsens with hot food or drink and may be associated with facial swelling, fever, and a bad taste in the mouth.

5. Exposed Tooth Root (Gum Recession)

When gum tissue recedes — from aggressive brushing, gum disease, or ageing — the tooth root becomes exposed. Unlike the crown, the root has no protective enamel layer. The result is intense sensitivity to cold air, cold water, and acidic foods. The pain is sharp and brief rather than the lingering ache of decay or abscess.

Desensitising toothpaste helps manage symptoms; a dentist can apply fluoride varnish or bonding agent to exposed surfaces for more significant relief.

6. Impacted Wisdom Teeth

Wisdom teeth (third molars) often don’t have enough space to erupt fully — especially in Nigerians, where the jaw tends to be smaller relative to tooth size. A partially erupted wisdom tooth creates a flap of gum tissue (operculum) that traps food and bacteria, causing pain, swelling, and infection (pericoronitis). This is one of the most common causes of acute toothache in Lagos patients aged 18–35.

Impacted wisdom teeth causing recurrent pain, infection, or damage to adjacent teeth are typically recommended for extraction.

7. Referred Pain (Not Always the Tooth You Think)

Dental pain notoriously refers — a problem in an upper molar can cause pain that feels like it’s in the lower jaw, or even the ear. Sinus infections, temporomandibular joint (TMJ) disorders, and tension headaches can all produce pain that feels like toothache. Only a proper examination can confirm the source.

When to Go to a Lagos Dentist Immediately

• Severe pain not controlled by standard pain relief
• Swelling in your face, jaw, or neck
• Fever alongside toothache
• Pain that radiates to your ear, jaw, or neck
• Toothache that wakes you from sleep
• Difficulty swallowing or opening your mouth