Toothache That Spreads to the Ear, Jaw or Head: What It Means

A toothache that spreads to the ear, jaw or head is usually down to how the nerves of the face share their pathways. Pain that starts in one tooth can be felt somewhere else, which is called referred pain. Common dental causes include an abscess, decay, a wisdom tooth, a cracked tooth, and grinding or strain in the jaw joint. Other problems, such as sinus trouble, an ear complaint or a migraine, can also feel like toothache.

No article can tell you which of these applies to you. A clinician has to examine you, usually with an X ray, to find the source. What this guide can do is explain the likely causes, what you can sensibly do today, what a dentist will check, and which warning signs mean you should not wait.

Key takeaways

• Pain from a tooth can be felt in the ear, jaw, temple or head, and pain from elsewhere can feel as if it comes from a tooth.
• The NHS says to see a dentist if toothache lasts more than 2 days, or if you have a swollen cheek or jaw, a high temperature or pain when you bite.
• Dental causes include an abscess, decay, a wisdom tooth, a cracked tooth and grinding. Non dental causes include sinusitis, ear problems, migraine and facial nerve pain.
• Swelling that makes it hard to breathe, swallow or speak needs A&E or 999. So does chest pain that spreads to the arms, neck or jaw.
• Only an examination can say what is behind your pain. Do not wait for it to settle if it is getting worse.

Why can a toothache be felt in the ear, jaw or head?

Referred pain means pain that you feel in a different place from where it starts. The nerves that carry feeling from the teeth, jaws, face and ear are closely connected, so the brain can find it hard to tell exactly where a signal comes from. A tooth that is inflamed or infected may therefore feel as though the ear, the jaw or the temple hurts instead of, or as well as, the tooth.

According to the NHS, pain from the jaw joint can be felt "around your jaw, ear and temple", and the NHS earache page lists a dental abscess among the causes of earache that comes with toothache. That is the same pattern many people describe: an aching ear, but no sign of anything wrong in the ear itself. We cover this in more detail in why TMJ pain is often confused with toothache.

Referred pain also works the other way. Pain that starts in the sinuses, the jaw muscles or a facial nerve can be felt in the teeth. This is why a dentist looks at the whole picture rather than only the tooth that hurts most.

Common dental causes of toothache that spreads

The NHS lists the causes of toothache as tooth decay, a dental abscess, a cracked or damaged tooth, a loose or broken filling, infection, problems with braces, gum disease and grinding your teeth. Several of these are known to produce pain that travels.

Dental abscess

A dental abscess is a collection of pus caused by infection, usually at the root of a tooth or in the gum. According to the NHS, symptoms include intense toothache or pain in your gums, a swollen face or jaw, a high temperature, swollen glands on each side of your neck, and difficulty opening your mouth and chewing food. Pain from an abscess is often throbbing, and it can spread towards the ear or jaw on the same side. Our post on tooth abscesses explains when swelling needs care the same day.

An abscess does not go away without treatment, and the NHS advises asking for an urgent dentist appointment or help from NHS 111 if you think you have one. If you want to understand how we approach this, see our page on a dental abscess.

Decay and a damaged filling

Decay that has reached the inner part of the tooth, where the nerve sits, can cause an ache that is hard to pin down. Early on, you may feel sensitivity to hot, cold or sweet things. As the nerve becomes inflamed, the pain can become constant or throbbing and may be felt in the jaw or the side of the head. A loose or broken filling can expose the same area.

If a dentist finds that the nerve is infected, one option is root canal treatment, which removes the infected tissue from inside the tooth. Whether that is suitable, or whether another approach is better, depends on the tooth and what the X ray shows.

Wisdom teeth

Wisdom teeth usually start to come through in the teens or early twenties, though the NHS says they can cause problems at any age. If there is not enough room, a wisdom tooth may only partly emerge or may sit at an angle. The NHS lists possible effects including pain and swelling, gum infection (pericoronitis), food getting stuck, decay, gum disease, a cyst and a dental abscess.

Because the wisdom teeth sit at the back of the jaw, close to the jaw joint and the muscles used for chewing, pain from them is often felt in the jaw and ear. If this sounds familiar, our page on impacted wisdom teeth explains how we see patients with this problem.

A cracked tooth

A crack can be very fine and hard to see. People often describe a sharp pain when they bite down, or a pain that comes and goes with hot and cold. The NHS lists a cracked or damaged tooth as a cause of toothache, and pain on biting is one of the signs it says should prompt a visit to a dentist. If the crack lets bacteria reach the nerve, the discomfort can build up and spread.

A tooth that has chipped or broken needs to be looked at soon, as there are options for a cracked or broken tooth that depend on how deep the damage goes.

Grinding and the jaw joint

Clenching or grinding your teeth, often during sleep, can strain the muscles and the joint that connects your lower jaw to your skull. According to the NHS, temporomandibular disorder (TMD) can cause pain around the jaw, ear and temple, headaches around the temples, clicking or popping sounds, and difficulty opening the mouth fully. It lists teeth grinding, wear and tear of the joint, a blow to the head or face, stress and an uneven bite among the causes.

This kind of pain can mimic toothache, particularly in the back teeth, even when the teeth themselves are healthy. The NHS suggests seeing a dentist if teeth grinding might be an issue. Where grinding is a factor, a dentist may talk through a night guard, and the fee for a night guard is shown on our fee list.

Non dental causes that can feel like toothache

Sometimes the teeth are fine and the pain is coming from somewhere else. The NHS pages below are the sources for each of these. None of this is a diagnosis, and a dentist or doctor needs to examine you.

Sinus problems

The upper back teeth sit close to the sinuses, so a blocked or inflamed sinus can feel like an ache in several teeth at once, often alongside a stuffy nose or pressure around the cheeks. The NHS says to see a GP if sinusitis symptoms do not improve after 7 days of treatment from a pharmacy or GP. A dentist can still be useful here, because ruling out a tooth is part of the answer.

Ear problems

The NHS says most earaches get better on their own, but to get medical help if they do not improve within 2 to 3 days. It advises an urgent GP appointment or NHS 111 if earache comes with swelling around the ear, fluid coming from the ear, hearing loss or a change in hearing, or if you become generally unwell. It also tells you not to put anything inside your ear, such as cotton buds.

Migraine and facial nerve pain

Migraine is usually described as a throbbing headache, often on one side of the head. The NHS migraine page does not link it to tooth pain, but people sometimes search for answers about their teeth when the real source is a headache. If a facial pain is sharp, shooting and triggered by light touch, washing the face or brushing your teeth, the NHS says to see a GP, particularly if painkillers do not help and a dentist has ruled out any dental causes.

Chest and heart symptoms

This one is rare, but it matters because the stakes are high. The NHS heart attack page says chest pain may spread to the arm, neck and jaw, and that you should call 999 if you have chest pain that feels tight or like squeezing, or chest pain that is spreading to your arms, neck or jaw. If your jaw or tooth pain comes with chest pain, do not wait for a dental appointment. Call 999 and do not drive yourself.

What to do today

If you have a toothache that is spreading, there are sensible steps you can take while you arrange to be seen. They help with comfort. They do not treat the cause.

• Contact a dentist. The NHS says to see a dentist if toothache lasts more than 2 days or does not settle with painkillers, and not to go to your GP for dental treatment, because they cannot provide it.
• Use over the counter pain relief. The NHS suggests painkillers such as paracetamol or ibuprofen, and a pain relief gel for your mouth. Follow the packet instructions, and check with a pharmacist if you have a health condition, are pregnant or take other medicines.
• Rinse with salt water. The NHS suggests rinsing your mouth with salt water.
• Choose soft food. The NHS suggests foods such as yoghurt or scrambled eggs, and avoiding anything very sweet, hot or cold.
• Keep the area clean. Brush gently around the sore tooth rather than avoiding it altogether.
• If you suspect grinding, relax the jaw. The NHS TMD advice includes keeping your teeth apart when you are not eating and not clenching.

If you cannot get an emergency dental appointment, the NHS says to call 111 or use 111 online for advice.

What the dentist checks

The aim of the visit is to find out where the pain is really coming from. A dentist will usually start by asking about the pain: when it started, what sets it off, whether it is sharp or dull, constant or occasional, and whether it wakes you at night. They will also ask about your health and any medicines.

Then comes the examination. The dentist will look at the teeth, gums, tongue and cheeks, tap or test individual teeth, check how your teeth bite together, and feel the jaw muscles and joint. Our dental examination includes a bite and jaw joint assessment and X rays, and the dentist explains what they find and what the options are.

An X ray can show decay between teeth, infection at a root, a wisdom tooth that is partly through, or bone changes that cannot be seen with the eye. If the teeth look healthy, the dentist may suggest that your doctor looks at the sinuses, ear, jaw joint or a facial nerve. That is a useful result, not a failed visit, because it narrows down the cause.

If you are in pain and want to be seen quickly, our emergency appointment is available with same day slots. The fee list shows the emergency appointment, including a prescription and periapical X rays, at £99, and the dentist gives you the fee for any further treatment after assessment.

When to get urgent help

Some symptoms should not wait for a routine appointment. This is the NHS wording, and it applies in England.

• Call NHS 111 (or use 111 online) if you cannot get an emergency dental appointment, or you are not sure what to do.
• Go to A&E if the area around your eye or your neck is swollen, or if swelling is making it difficult to breathe, swallow or speak. The NHS says to call 999 and ask for an ambulance if you need to go to A&E, and not to drive yourself.
• Call 999 or go to A&E if you are finding it hard to breathe, speak or swallow, have a lot of swelling in your mouth, are finding it hard to open your mouth, or have a swollen or painful eye. This is the NHS abscess guidance.
• Call 999 for chest pain that feels tight or like squeezing, or that spreads to the arms, neck or jaw.
• Call 999 for a sudden, extremely painful headache, or for weakness on one side of the face, trouble speaking or loss of vision. These come from the NHS migraine page.
• Ask for an urgent dentist appointment or NHS 111 if you have a swollen face or jaw, a high temperature or swollen glands in your neck along with the toothache.

None of this replaces advice from a clinician who can see you.

If your toothache is spreading and you would like a clinician to look at it, you can book an emergency appointment or a new patient examination at our Maida Vale clinic, and the dentist will explain what they find before anything is done.

Toothache that spreads FAQs

Can a toothache really cause ear pain?

Yes, it can. The nerves that supply the teeth, jaw and ear are closely linked, so pain from a tooth can be felt in the ear. The NHS earache page lists a dental abscess among the causes of earache with toothache. A dentist or doctor needs to examine you to say what is behind your own pain.

Why does my toothache spread to my jaw?

Pain from an inflamed or infected tooth can travel along nearby nerves to the jaw. Wisdom teeth, abscesses and a cracked tooth are among the causes the NHS lists. Jaw joint problems can also feel like toothache, so it is worth having both checked.

Can a toothache cause a headache?

It can. Pain from the teeth and jaw can be felt around the temples, and the NHS lists headaches around the temples among the symptoms of a jaw joint disorder. Headaches also have many non dental causes, such as migraine, so a clinician has to assess you.

Is it a toothache or a sinus problem?

The two can feel alike, particularly in the upper back teeth. The NHS lists pain and tenderness around the cheeks, eyes or forehead as sinusitis symptoms, and toothache as another. A dentist can check your teeth first, and if they are healthy you can speak to a pharmacist or GP.

How long should I wait before seeing a dentist?

The NHS says to see a dentist if toothache lasts more than 2 days, or if it does not go away with painkillers. Do not wait if you have swelling, a high temperature, pain when you bite or a bad taste in your mouth. Swelling that affects breathing or swallowing is an emergency.

Could my jaw and ear pain be from grinding my teeth?

It could be. The NHS says teeth grinding is one cause of temporomandibular disorder, which can cause pain around the jaw, ear and temple. Only an examination can say whether grinding is involved in your case, and a dentist can look for signs of wear on your teeth.

Can toothache be a sign of a heart problem?

Rarely. The NHS says that chest pain can spread to the arm, neck and jaw, and that chest pain spreading to the arms, neck or jaw needs a 999 call. If your jaw pain comes with chest pain, do not wait for a dental appointment.

What will a dentist do about toothache that spreads?

They will ask about the pain, examine your teeth, gums, bite and jaw, and usually take an X ray. They will explain what they find and the options for treatment, and they will tell you if the cause seems to lie outside your mouth. The dentist gives you the fee after assessment.