Clinical information notice
This page contains general dental information and does not claim a completed named medical review. See our editorial and medical review policy.
This page provides general information only and is not a substitute for dental or medical advice. If you have facial swelling, a fever, or difficulty swallowing alongside tooth pain, seek emergency care or call 999.
Quick Answer
Call NHS 111 (dial 111) — they provide dental advice 24/7 and can refer you to an NHS emergency dentist at no upfront cost. For temporary relief while waiting: ibuprofen (if safe for you), clove oil applied to the tooth, and a cold compress on the jaw. These reduce pain; they do not treat the cause. If you also have facial swelling, a fever, or difficulty swallowing, go to A&E — do not wait for a dental appointment.
If you have facial swelling, fever above 38°C, difficulty swallowing or breathing: call 999 or go to A&E immediately. These can be signs of a spreading dental abscess that requires emergency medical care — do not wait for a dentist.
Key Takeaways
- Severe toothache usually means the nerve inside the tooth is inflamed or dying — temporary pain relief helps, but dental treatment is needed to stop the problem progressing.
- Call NHS 111 (dial 111) for urgent dental advice; they can refer you to an NHS emergency dental service at no upfront cost, 24 hours a day.
- If you have facial swelling, fever or difficulty swallowing alongside toothache, go to A&E — these can be signs of an abscess spreading into soft tissue.
- Temporary measures (clove oil, ibuprofen, cold compress) reduce discomfort. They are not a treatment and do not prevent the problem getting worse.
- The most common causes — pulpitis, abscess, cracked tooth — all require professional diagnosis. Waiting makes them worse and more expensive to treat.
When Is Severe Toothache a Medical Emergency?
Toothache alone — even severe toothache — is an urgent dental problem rather than a medical emergency in most cases. However, these symptoms alongside tooth pain require emergency care immediately:
- Facial or jaw swelling that is expanding
- Fever above 38°C / 100.4°F
- Difficulty swallowing or a feeling of throat tightness
- Difficulty breathing
- Swelling spreading into the neck
These are signs of a dental abscess that has spread beyond the tooth — a medical emergency requiring A&E attendance or a 999 call. For more detail, see the tooth abscess guide.
Common Causes of Severe Tooth Pain
Severe, persistent toothache is almost always caused by one of these:
- Irreversible pulpitis
- Inflammation of the pulp (the living tissue inside the tooth) caused by deep decay, a crack, or trauma. The nerve is dying. Pain is usually severe, spontaneous, and lingers after the trigger (hot, cold, biting) is removed. Requires root canal or extraction.
- Dental abscess
- A bacterial infection creating a pocket of pus at or around the root tip. Pain is typically severe and throbbing, often constant, and may be accompanied by swelling or a bad taste. Requires drainage and root canal or extraction.
- Cracked or fractured tooth
- A crack in the tooth structure — from biting something hard, old fillings under stress, or grinding — can expose the nerve. Pain is often a sharp stab on biting that immediately releases. May require a crown or extraction depending on the extent.
- Lost or broken filling with exposed nerve
- Exposed dentine or nerve is acutely sensitive to temperature, sweet food, and air. Can escalate to pulpitis if left. Requires a new filling at minimum.
What to Do Right Now: NHS 111
Call NHS 111 (dial 111) or use 111.nhs.uk. The service is available 24 hours a day, 7 days a week. NHS 111 can:
- Provide immediate telephone dental advice from a dental nurse or clinician
- Triage your symptoms to establish urgency
- Refer you to an NHS urgent dental care centre (UDCC) or emergency dental service in your area
- In some cases, arrange emergency prescriptions for antibiotics if an infection is suspected
You do not need to be registered with a dentist to access NHS 111 dental services. The referral to an emergency dental appointment is free to access; NHS band charges apply for treatment (Band 1 £27.90, Band 2 £76.60, Band 3 £306.80, from April 2026 in England), unless you are exempt.
Temporary Pain Relief (What Works, What Doesn't)
Use these to manage discomfort while waiting for dental treatment — not instead of it:
- Ibuprofen + paracetamol combined — most effective over-the-counter option for dental pain. Take both if neither is contraindicated for you; they work via different pathways. Do not exceed stated doses.
- Clove oil (eugenol) — apply a small amount to the affected tooth with a cotton bud. Provides mild topical anaesthetic relief. Not suitable for large quantities on gum tissue.
- Cold compress on the outside of the cheek — reduces swelling and numbs the area. Apply for 15–20 minutes at a time.
- Avoid temperature extremes and sweet foods — these trigger pain in most dental causes and inflame already-irritated nerve tissue.
If pain relief is not adequately controlling symptoms, or if symptoms are worsening, call NHS 111 and seek care sooner rather than later.
NHS Emergency Dental Services
NHS Urgent Dental Care Centres (UDCCs) provide same-day or next-day treatment for patients in acute dental pain, including those not registered with a practice. Access is via NHS 111 referral. They can perform:
- Examination and diagnosis
- Extractions of teeth causing acute pain
- Opening a tooth to relieve pressure from a dying pulp
- Temporary dressings and fillings
- Antibiotics for spreading infection
Emergency treatment is stabilising, not final. Root canal, permanent crown, or replacement if the tooth is extracted are arranged as follow-up.
Finding an NHS Dentist Accepting New Patients
For non-emergency NHS treatment once the acute pain is resolved, you will want to register with an NHS practice. Options:
- NHS.uk — Find a Dentist — search for practices accepting new adult patients in your postcode
- Community Dental Services (CDS) — NHS dental services for patients who cannot access a standard practice; ask your GP or local council how to refer
- University dental schools — treat patients at reduced cost under supervised qualified dentists
See the full guide: Can't Find an NHS Dentist — step-by-step options.
Private Emergency Dentist: What It Costs
If you cannot access NHS care and need to see a dentist today, a private emergency appointment typically costs:
- Emergency consultation fee: £80–£250 (examination + X-ray)
- Extraction: £150–£300 on top
- Temporary dressing or filling: £80–£200 on top
- Root canal (front tooth): £500–£700 + crown £800–£1,000
Always confirm what the emergency fee covers before attending — some practices include a simple extraction in the emergency charge; others do not.
Treating the Underlying Cause
The cause determines the treatment. In most cases of severe toothache:
- Pulpitis / dying nerve: Root canal saves the tooth. Without it, the tooth progresses to abscess and eventual extraction.
- Abscess: Emergency drainage, then root canal (to save the tooth) or extraction. See tooth abscess guide for full guidance.
- Cracked tooth: Crown if the crack has not reached the root. Extraction if the crack goes below the gum line.
- Lost filling: New filling. If decay beneath has reached the nerve, root canal is needed first.
UK vs Turkey Cost Comparison
For the treatments most commonly needed after severe toothache:
| Cause | Treatment | NHS | UK Private | Turkey |
|---|---|---|---|---|
| Pulpitis (nerve inflammation from decay or crack) | Root canal + crown | £306.80 (Band 3) | £1,300–£2,500 | £330–£580 |
| Dental abscess | Emergency drainage + root canal or extraction | Free (NHS 111) + Band 2/3 | £80–£350 emergency + treatment | Varies |
| Cracked tooth | Crown or extraction | £306.80 (Band 3) | £800–£1,500 | £130–£280 |
| Broken or lost filling (exposed nerve) | Replacement filling | £76.60 (Band 2) | £80–£200 | £60–£120 |
NHS charges from April 2026 (England). Turkey prices are at partner clinics; flights and hotel are additional (typically £300–£600 for a 3–5 day trip). 0% representative APR finance from around £10/month over 36 months is available for treatment booked through this site, subject to eligibility.