Common Signs That a Tooth Needs Dental Assessment

Teeth do not always give clear warnings. Some problems cause obvious pain; others develop quietly until they are more difficult to treat. Knowing which signs deserve attention helps you seek care at the right time.

The short answer

See a dentist promptly for persistent or worsening tooth pain, sensitivity that lingers, pain on biting, swelling, a tooth that has darkened, bleeding or receding gums, loose teeth in adults, or broken teeth and fillings. Seek urgent medical care for swelling that affects breathing, swallowing or the eye.

Signs worth having checked

Sensitivity that lingers

Brief sensitivity to cold that disappears immediately is common and often due to exposed dentine. Sensitivity that lingers for more than a few seconds after the cold is removed can indicate pulp inflammation.

Pain on biting

Pain when biting down or releasing can indicate a cracked tooth, a high filling or infection at the root.

Spontaneous or night-time toothache

Pain that comes on by itself, throbs or wakes you at night often indicates inflammation of the pulp and needs prompt assessment.

Swelling or a gum "pimple"

A swelling on the gum, or a small bump that releases fluid, often indicates an abscess.

A tooth that has changed colour

A tooth that darkens, especially after a knock, may have a damaged or dead pulp.

Bleeding gums

Gums that bleed when brushing are a common sign of gum inflammation (gingivitis). Untreated, this can progress to periodontitis, which affects the bone supporting teeth. See the NHS guide to gum disease.

Receding gums

Gums pulling back can expose roots, cause sensitivity and indicate gum disease or brushing too hard.

Loose teeth in adults

Adult teeth should not move. Looseness can indicate advanced gum disease, infection or trauma.

Broken teeth or fillings

Even if painless, a broken tooth or filling can trap food and allow decay. See What to Do If You Chip or Break a Tooth.

Persistent bad breath or bad taste

This can be caused by gum disease, decay or infection.

Changes in the soft tissues

Ulcers that do not heal within about two weeks, white or red patches, or lumps in the mouth should be examined.

When it is urgent

Contact a dentist the same day if possible for:

• Severe pain not controlled by over-the-counter pain relief
• Facial swelling
• A knocked-out permanent tooth
• Significant bleeding after an extraction

Go to a hospital emergency department immediately if swelling affects breathing, swallowing or the eye, or if you have a high fever with facial swelling.

Problems that may not cause symptoms

Early decay, gum disease and infections at the tips of roots often cause no pain. This is one reason regular check-ups are important. See Why Regular Dental Checkups Matter.

What to tell your dentist

• When symptoms started and whether they are getting worse
• What triggers them (hot, cold, sweet, biting)
• How long pain lasts
• Any swelling, fever or recent injury
• Medications you take

Conclusion

Early assessment usually means simpler, less costly treatment. If you notice any of these signs, book an assessment or, for urgent problems, see our emergency dental care page.