Are you feeling pain in your molar teeth? Molar pain can be associated with other inconvenient symptoms, such as pain with exposure to hot or cold or when biting down, gum swelling, bad breath, and more. Molar tooth pain causes range from tooth abnormalities, such as cavities, to gum disease and infection. Read below to learn more about molar pain and when to talk to your doctor.
6 most common cause(s)
Molar pain explained
Adults typically have 32 permanent teeth. Twelve of these are molar teeth, which are at the back of the mouth. The four teeth at the very back (one on each side at the top and bottom) appear last, in the late teens and early 20s, and are often called "wisdom teeth." Molar teeth have mostly flat tops and are used to grind food. Pain in molar teeth can be caused by any of the processes that affect other teeth. In addition, molar teeth are particularly prone to certain painful conditions because of their position far back in the mouth.
Common accompanying symptoms of molar tooth pain
Symptoms that can be associated with molar tooth pain include:
- Pain with exposure to hot or cold
- Pain when biting down
- Gum swelling and pain
- Bad breath
- Tooth discoloration
- Bad tasting discharge
- Loose teeth
What causes pain in the molar teeth?
Causes of molar tooth pain are described below, including tooth abnormalities, gum disease, and infection.
Tooth abnormalities
Molar tooth pain can be related to the following tooth abnormalities.
- Cavities: Debris that forms on the surfaces of teeth over the course of the day can host bacteria. Any acid produced by bacteria creates holes in the teeth over time. Molar teeth are particularly prone to cavities because their location in the back of the mouth makes them difficult to clean effectively.
- Fracture: An acute injury, biting down on hard foods, or gradual damage over time can cause a crack to develop. This results in pain if the crack extends deep into the tooth.
- Inflammation of the pulp: Either a deep cavity or an injury to the tooth can cause damage and inflammation of the pulp, the deepest part of the tooth. This results in pain with hot and cold foods and with chewing.
- Impacted tooth: Sometimes there is not enough space for a wisdom tooth to completely grow out of the gum. It may grow at an angle, damaging other teeth and contributing to infections and cavities.
Gum disease
Gum disease can lead to damage and molar tooth pain.
- Loose tooth: In severe gum disease the gums erode away from the teeth. The teeth become loose, resulting in pain during chewing.
- Inflamed gum flap: The flap of gum covering an erupting wisdom tooth often becomes inflamed and painful.
Infection
Molar tooth pain can also be caused by infections.
- Local infection: Inflammation of the gum over a wisdom tooth or the pulp of a tooth can progress to a bacterial infection.
- Spreading infection: Without proper treatment, a local infection can spread, causing extensive swelling and pain. An infection in a molar tooth is particularly likely to cause a severe infection because it is located in the back of the mouth near the airway and other important structures.
- Sinusitis: An infection of the sinuses can cause referred pain to the upper molar teeth.
This list does not constitute medical advice and may not accurately represent what you have.
Acute viral sinusitis
Acute viral sinusitis, also called viral rhinosinusitis or "sinus infection," occurs when viruses take hold and multiply in the sinus cavities of the face.
It is most often caused by the same viruses that cause the common cold and spreads the same way, through an infected person's coughing or sneezing.
Because children have small, underdeveloped sinuses, this illness is far more common in adults.
Symptoms include clear nasal discharge (not greenish or yellowish,) fever, and pain if facial sinuses are pressed.
If there is rash, severe fatigue, or neurologic symptoms (seizures, loss of sensation, weakness, or partial paralysis,) see a medical provider to rule out more serious conditions.
Diagnosis can usually be made through history and examination alone.
Antibiotics only work against bacteria and cannot help against a viral illness. Therefore, treatment consists of rest, fluids, and fever/pain reducers such as ibuprofen. (Do not give aspirin to children.) Symptoms of viral sinusitis last for about seven to ten days. As with the common cold, the best prevention is frequent and thorough handwashing.
Rarity: Common
Top Symptoms: headache, cough, sinusitis symptoms, sore throat, congestion
Symptoms that always occur with acute viral sinusitis: sinusitis symptoms
Symptoms that never occur with acute viral sinusitis: being severely ill
Urgency: Self-treatment
Tooth abscess (infection)
A tooth abscess is a collection of infected material (pus) in the center of a tooth. It is due to a bacterial infection.
You should seek dental care within 24 hours. The diagnosis is made based on your history, an exam, and an x-ray of the mouth. If the abscess is affecting your breathing, it's considered a medical emergency and you should seek emergency care. Treatment involves incision and drainage of the abscess in addition to antibiotics.
Rarity: Uncommon
Top Symptoms: severe jaw or tooth pain, swollen jaw, jaw stiffness, tooth pain that gets worse with hot, cold, or sweet beverages, warm and red jaw swelling
Symptoms that always occur with tooth abscess (infection): severe jaw or tooth pain
Urgency: Primary care doctor
Temporomandibular joint (TMJ) dysfunction disorder
Temporomandibular joint (TMJ) dysfunction disorder refers to long-term pain and dysfunction in the TMJ, the joint that connects the upper and lower jawbones.
The TMJ is a complex joint with complicated movements and is subject to strain and injury. Symptoms may come and go for no apparent reason. Misalignment of the teeth and jaw, and tooth grinding, are no longer believed to be a cause. Women seem to be more susceptible than men.
TMJ disorder has three types:
- Pain or discomfort in the muscles controlling the TMJ.
- Dislocation or injury to the jawbone.
- Arthritis of the TMJ.
Diagnosis is made through patient history, physical examination, and imaging. The goal is to rule out other causes such as sinus infection or facial nerve damage.
Due to the difficulty of diagnosing TMJ disorder, treatment begins with conservative methods that do not permanently change the jaw or teeth. Ice packs, soft foods, gentle stretching of the jaw muscles, and reducing stress are all encouraged. Short-term pain medications may be used. Splints, Botox, implants, and surgery are not recommended.
Rarity: Common
Top Symptoms: dizziness, pain, restricted movement, and clicking sounds from jaw, history of headaches, jaw pain, pain in the back of the neck
Symptoms that always occur with temporomandibular joint (tmj) dysfunction disorder: pain, restricted movement, and clicking sounds from jaw
Urgency: Primary care doctor
Infected wisdom tooth (pericoronitis)
Pericoronitis of the 3rd molar is an infection of the gums surrounding the 3rd molar (wisdom tooth). It almost never happens to normal teeth because wisdom teeth take a long time to break the gums (erupt). It's believed that once the wisdom tooth breaks the surface of the gums, the bacteria in the mouth get into the gums at that spot and cause an infection. This is also worsened by food particles that build up in the area.
You should go immediately to your dentist, or, if they are not available, go to the nearest urgent care center. There, the dentist/doctor will clean the area, drain any pus, and write for an antibiotic mouth rinse. Penicillin is reserved for severe cases. A follow-up with a dentist is required to see if you need to get the tooth pulled.
Gingivitis
Gingivitis is the infection of the gums surrounding the teeth. It is caused by plaque and/or tartar that has built up on your teeth. Plaque is a sticky layer of gunk made by food particles, mucus, and bacteria. After a while, plaque hardens to become tartar (or calculus). Plaque and tartar at the bottom of the teeth causes the gums to become irritated and infected.
You should go to the nearest dentist in the next few weeks. There, the dentist or dental hygenist will clean your teeth, getting rid of that nasty plaque/tartar. Once cleaned, you should rinse your mouth twice-a-day with chlorhexidine 0.12% oral rinse (PerioGard) or half-strength hydrogen peroxide. Flossing and brushing your teeth are also essential.
Dental cavity
Dental cavities are bacterial infections of the tooth. The bacteria produce acid that breaks down the tooth.
You should visit your dentist within the next 24 hours. Once a toothache presents, the tooth might already be in big trouble, and it needs attention right away.
Acute bacterial sinusitis
Acute bacterial sinusitis, also called bacterial rhinosinusitis or "sinus infection," has symptoms much like viral rhinosinusitis but a different treatment.
Any sinusitis usually begins with common cold viruses. Sometimes a secondary bacterial infection takes hold. Like cold viruses, these bacteria can be inhaled after an infected person coughs or sneezes.
Anyone with viral sinusitis, upper-respiratory allergy, nasal passage abnormality, lung illness, or a weakened immune system is more prone to bacterial sinusitis.
Symptoms include thick yellowish or greenish nasal discharge; one-sided pain in the upper jaw or teeth; one-sided sinus pain and pressure; fatigue; fever; and symptoms that get worse after first improving.
See a doctor right away for severe headache, high fever, stiff neck, or vision changes. These can indicate a medical emergency.
Diagnosis is made with a simple examination in the doctor's office.
Bacterial sinusitis can be treated with antibiotics, but this is not always necessary.
Often rest, fluids, and over-the-counter pain relievers and decongestants are enough.
Prevention is done through good lifestyle and hygiene to keep the immune system strong.
Rarity: Common
Top Symptoms: fatigue, headache, cough, sinusitis symptoms, muscle aches
Symptoms that always occur with acute bacterial sinusitis: sinusitis symptoms
Symptoms that never occur with acute bacterial sinusitis: clear runny nose, being severely ill
Urgency: Primary care doctor
At-home and professional treatment for a molar tooth ache
Most causes of molar tooth pain are not an emergency. However, infections that start with a tooth and spread to other structures can be dangerous, even life-threatening, and require urgent evaluation. In addition, quick treatment may be necessary to save a broken tooth.
At-home treatments
A few home treatments can help with molar tooth pain, such as the following.
- Toothpaste for sensitivity: If you experience molar tooth pain with brushing or with hot and cold foods, try using a toothpaste formulated for sensitivity.
- Ice or a compress: Try placing a cold compress on your cheek over the affected tooth.
- Warm water rinse: Warmth can also help relieve tooth pain.
- Pain medication: NSAIDs such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) can help relieve pain.
When to see a doctor
In some cases, even if emergency treatment isn't necessary, you may need medical evaluation and treatment. Make an appointment with your dentist if you have:
- Tooth pain when consuming hot and cold food and liquids
- A loose tooth
- Constant tooth pain lasting more than two days
- Swollen, painful gums around a tooth
Molar tooth pain treatment quiz
Take a quiz to find out how to treat your symptoms.
Medical treatments
Your dentist may prescribe one or more of the following treatments, depending on the cause of your molar tooth pain:
- Filling a cavity: This can prevent further damage.
- Fluoride treatment: This helps prevent the progression of cavities.
- Rootcanal: This is where the pulp of the tooth is removed and the resulting space is filled.
- Antibiotics for an infection
- Removal of a tooth
When molar tooth pain is an emergency
You should seek medical attention promptly if you experience:
- Difficulty breathing, speaking, or opening your mouth
- Facial swelling
- Fever
- Swollen lymph nodes
- Discharge with a foul taste
- A piece of a tooth broken off
- Bleeding from a tooth
FAQs about molar tooth pain
Why do wisdom teeth have to get removed?
Wisdom teeth are the molars at the very back of the mouth. Often there is not enough space for wisdom teeth to fully emerge from the gum. As a result, they may grow at odd angles and damage other teeth. In addition, the gum covering partially erupted teeth is prone to infection and trapping of food particles. Partially or fully erupted wisdom teeth are prone to developing cavities because they are difficult to clean and floss. Wisdom teeth are removed when they are causing problems such as pain, infection, and negative effects on surrounding teeth.
Can sinusitis cause molar teeth to hurt?
Allergic inflammation or infection of the sinuses can cause tooth pain. The upper molars are most likely to hurt since they are located close to the sinuses. Unlike other causes of tooth pain, which are restricted to the tooth affected by a particular process like a cavity, the pain associated with sinusitis will be felt in multiple teeth.
How can I prevent painful cavities in my molar teeth?
Unfortunately, molar teeth can be difficult to brush and floss due to their position in the back of the mouth. Brush at least twice a day and visit the dentist regularly for professional cleanings. Avoiding sugary and sticky foods will also help prevent cavities from developing. If you have a particularly high risk of cavities, your dentist may prescribe antibacterial or fluoride treatments.
Why does one of my molar teeth hurt when I have cold or hot food and liquids?
Pain with exposure to hot and cold indicates pulpitis, meaning inflammation of the pulp (the deepest part of the tooth). There may be damage due to a deep cavity or tooth trauma. Depending on the severity of pulpitis, the pain may immediately disappear after exposure to temperature extremes or may persist. It is important to seek treatment so that further damage can be prevented.
How do I know if my painful molar tooth is infected?
Molar tooth pain can be due to a developing infection within the tooth itself or the surrounding structures. An infection causes constant, severe tooth pain. As an untreated infection spreads, other signs like swelling and discharge may be present. In the most severe case where a tooth infection spreads through the mouth, fever, difficulty opening the mouth, and difficulty breathing will occur, requiring emergency treatment.
Questions your doctor may ask about molar tooth pain
- Were you hit or injured anywhere on your face? If so, where?
- Has your dentist or significant other ever told you that you grind your teeth in your sleep?
- Any fever today or during the last week?
- Do you have a cough?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
- Tooth pain. American Association of Endodontists. AAE Link
- Fukuda KI. Diagnosis and treatment of abnormal dental pain. Journal of Dental Anesthesia and Pain Medicine. 2016;16(1):1-8. NCBI Link
- Gingivitis and Periodontitis: Overview. In: Informed Health Online [Internet]. Cologne, GY: Institute for Quality and Efficiency in Health Care (IQWiG); 2006. NCBI Link
- Li X, Kolltveit KM, Tronstad L, Olsen I. Systemic disease caused by oral infection. Clinical Microbiology Reviews. 2000;13(4):547-558. NCBI Link