Intermittent Toothache (Pain That Comes and Goes)
An intermittent toothache is discomfort that appears, settles, and then returns again days or weeks later. Because the pain is not constant, many people are unsure whether it signals a real dental issue or something that can be ignored.
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While not all intermittent tooth pain indicates a serious problem, it often reflects a tooth or surrounding structure that is under stress and responding only when triggered.
Why Tooth Pain Can Be Intermittent
An intermittent toothache occurs when a tooth or surrounding tissue reacts only when certain conditions are present. Unlike constant pain, which is easier to recognise as a problem, intermittent discomfort often depends on triggers rather than time.
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Teeth do not behave like muscles or skin. Dental nerves respond to stimulation, such as temperature changes or pressure, and may remain quiet when those triggers are absent. This is why discomfort can seem to “come and go,” even though the underlying cause has not fully resolved.
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Common triggers for intermittent tooth pain include cold or hot drinks, chewing or biting pressure, discomfort when pressure is released after biting, teeth grinding or clenching (especially at night), and changes in sinus pressure affecting the upper teeth.
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Because these triggers are not constant, the pain may disappear for days or even weeks before returning. This pattern often leads people to delay assessment, assuming the issue has settled, when in reality the tooth is responding only when stimulated.
Common Causes of Intermittent Toothache
An intermittent toothache can arise from several different dental or surrounding conditions. In many cases, discomfort appears only when the tooth is stressed, stimulated, or inflamed to a certain threshold.
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Possible causes of tooth pain that comes and goes include early tooth decay that has not yet reached constant nerve irritation, small cracks or weakened tooth structure that flex under pressure, and gum inflammation that exposes sensitive root surfaces. Teeth with large fillings or crowns may also become intermittently uncomfortable as forces are transmitted differently through the tooth.
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In some situations, intermittent pain may be related to jaw clenching or grinding, sinus congestion affecting upper teeth, or a tooth nerve that is irritated but not yet irreversibly inflamed. Because these conditions can overlap, symptoms alone do not always point to a single cause.
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This is why intermittent tooth pain often feels confusing, the tooth may seem normal most of the time, yet respond suddenly when triggered.
Why Intermittent Tooth Pain May Change Over Time
Intermittent toothache does not always remain intermittent. While symptoms may settle temporarily, the underlying cause often continues to progress quietly beneath the surface.
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In the early stages of irritation or inflammation, a tooth may only respond when exposed to certain triggers, such as temperature changes or pressure. As these triggers become more frequent or the tooth’s ability to adapt decreases, discomfort may start to last longer or occur more easily.
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This change does not necessarily happen suddenly. Some people notice that episodes become closer together, that the pain lingers slightly longer after a trigger, or that the tooth begins reacting to situations that previously caused no discomfort.
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Because these changes can be gradual, it is common for intermittent tooth pain to be overlooked until the symptoms become more persistent. Understanding this pattern helps explain why a tooth that “seemed fine” for weeks can later become more noticeable.
When Intermittent Toothache Should Be Checked
Although intermittent toothache does not always indicate an urgent problem, there are situations where an assessment can help prevent further complications. Because the pain is not constant, timing and pattern often matter more than intensity.
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It is generally advisable to have the tooth checked if the discomfort keeps returning in the same area, becomes easier to trigger, or starts lasting longer once it appears. Pain that occurs during chewing or biting, or that is felt when pressure is released, can also suggest that the tooth is under mechanical stress rather than simple sensitivity.
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Lingering discomfort after cold exposure, a feeling of pressure, or the presence of swelling or a bad taste may indicate that the tooth or surrounding tissues are no longer settling fully between episodes. Teeth with large fillings, crowns, or a history of dental work may also warrant closer attention when intermittent pain develops.
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An examination at this stage is often about clarification rather than treatment. Identifying what is triggering the symptoms can help determine whether monitoring, preventive care, or further management is appropriate.
How Dentists Assess Intermittent Tooth Pain
When a toothache is intermittent, assessment focuses less on how strong the pain feels and more on when and how it occurs. Understanding the pattern of discomfort helps narrow down which structures may be involved.
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During a dental visit, the dentist may ask about what triggers the pain, how long it lasts, and whether it feels sharp, dull, or pressure-related. Simple tests, such as checking the tooth’s response to cold, gentle pressure, or biting, can provide useful information about how the tooth is reacting.
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Bite alignment and existing dental work may also be reviewed, particularly if the tooth has a large filling or crown. In some cases, X-rays are used to assess the surrounding bone and root area, especially when symptoms have been recurring.
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Because intermittent tooth pain can have overlapping causes, the goal of assessment is often to identify whether the tooth is stable, irritated, or showing signs that closer monitoring or treatment may be needed.
Can Intermittent Toothache Lead to Root Canal Treatment?
In some situations, intermittent toothache may be related to irritation or inflammation within the tooth. When the dental nerve is able to recover between episodes, discomfort may remain occasional rather than constant.
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If inflammation inside the tooth progresses and becomes irreversible, treatment such as root canal therapy may be discussed as an option to relieve symptoms and preserve the tooth. However, not all cases of intermittent tooth pain involve the tooth nerve, and many can be managed with monitoring, adjustments, or preventive care when identified early.
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The presence of intermittent pain alone does not determine whether root canal treatment is needed. Decisions are based on a combination of symptoms, examination findings, and imaging, rather than on pain pattern alone.
Frequently Asked Questions (FAQs)
Is intermittent toothache serious?
Intermittent toothache is not always serious, but it should not be ignored if it keeps returning. Pain that comes and goes often reflects a tooth that reacts only when triggered, rather than one that is constantly inflamed. An assessment can help determine whether the tooth is stable or whether closer monitoring is advisable.
Can I wait if the pain goes away?
If the discomfort settles and does not return, monitoring may be reasonable. However, when the same tooth repeatedly becomes uncomfortable, even after long pain-free periods, it is usually helpful to have it checked. Dental issues do not always progress in a straight line, and early clarification can prevent unnecessary discomfort later.
Why does it hurt only when I bite or drink something cold?
Biting and cold exposure place stress on a tooth in different ways. When a tooth has become more sensitive, even normal pressure or temperature changes can trigger discomfort. Once the pressure is released or the cold stimulus is removed, the sensation may settle, making the pain feel intermittent rather than constant.
Got a question?
If you’re experiencing tooth discomfort that comes and goes and are unsure what’s triggering it, a discussion can help clarify whether the tooth needs monitoring or further assessment.
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WhatsApp us to ask a question or check whether an appointment is appropriate.
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You may reach us by:
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Email: info@ppdental.com.sg
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Phone: +65 6904 8482
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WhatsApp:
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If you send a message, it can be helpful to mention when the discomfort tends to occur, such as with cold drinks or during brushing.
Book an Appointment
If you would like an in-clinic assessment, you can book an appointment at a time that suits you. This allows the dentist to evaluate what may be triggering the intermittent discomfort and advise on the appropriate next steps.