Tooth Pain That
Comes and Goes
Intermittent tooth pain is rarely random — it follows a trigger pattern, and the underlying cause is almost always progressive. Here's what each type of on-and-off pain actually signals, how urgently you need care, and what treatment involves.
In This Article
Why Tooth Pain Comes and Goes — The Real Explanation
Tooth pain comes and goes because it follows a trigger-response pattern — the pain appears when the tooth is stimulated (by temperature, pressure, or biting force) and fades when that stimulus is removed. The underlying cause remains. What changes over time isn't whether the tooth hurts — it's how easily it's triggered and how long the pain lasts after the trigger stops. Intermittent pain that needs a hard bite to start becomes constant pain that no longer needs any trigger at all.
The most common patient mistake with tooth pain that comes and goes is using the disappearance of pain as evidence that the problem resolved. It didn't. Cavities don't heal. Cracks don't seal. Nerve inflammation doesn't reverse without treatment. Pain fades temporarily because the inflammation eases, the nerve stimulus has been removed, or — in the most serious cases — because the nerve has died entirely.
That last scenario is worth understanding clearly: a tooth that hurt severely and then suddenly stopped hurting is not a good sign. When the nerve dies, it can no longer send pain signals. The infection, however, continues spreading into the surrounding bone. The silence is not recovery — it's the loss of the warning system.
Pain Patterns and What They Mean
The most useful information about intermittent tooth pain isn't just that it's there — it's when it's there, how long it lasts, and what makes it stop. These details narrow down the cause more accurately than the intensity of pain alone.
Sharp pain when biting or chewing — then gone
Schedule within 1–2 weeksThis is the classic presentation of a cracked tooth or a failing filling or crown. The crack or gap in the tooth structure flexes under biting force, irritating the dentin or nerve — then relaxes when pressure is released. Because the crack doesn't stay open at rest, there's no constant pain between bites.
Cracked teeth are notoriously hard to diagnose visually. They often don't show on X-rays. Your dentist may use a bite stick, transillumination (shining light through the tooth), or dye staining to locate the crack. Early cracks are treated with a crown that holds the tooth together and stops the flexing. If the crack has reached the pulp, a root canal is needed before the crown.
Likely treatment: Filling ($125–$175) if the crack is shallow · Crown ($950) if extensive · Root canal + crown ($1,900) if pulp involvedBrief cold sensitivity — fades within 10 seconds
Schedule within 2–3 weeksBrief cold sensitivity points to exposed dentin — the sensitive inner layer of the tooth that sits beneath the enamel. Dentin exposure happens from tooth decay (cavity), enamel erosion from acid, gum recession, or aggressive brushing. When dentin tubules are exposed, cold fluid moves through them and stimulates the nerve — but only while the cold is present.
This is typically the earliest stage of a problem. At this point, a filling resolves decay-related sensitivity. Gum-recession sensitivity may be managed with desensitizing treatments. The important thing is that brief cold sensitivity at this stage is far better than the next stage — which is when it starts to linger.
Likely treatment: Filling ($125–$175) if cavities present · Desensitizing treatment if recession-relatedCold sensitivity that lingers 30+ seconds after stimulus
See dentist within a few daysLingering cold sensitivity is a critical distinction from brief cold sensitivity. When pain continues well after the cold stimulus ends, it indicates pulpitis — inflammation inside the tooth's pulp (the nerve and blood vessel tissue at the core of the tooth). The pulp is reacting not just to the cold itself, but to its own internal inflammatory state.
Early reversible pulpitis can sometimes be resolved by removing the irritant (deep decay, a cracked filling). But moderate to advanced pulpitis — where cold sensitivity lingers for a minute or more — typically requires a root canal to remove the inflamed pulp tissue and seal the tooth. The longer this type of pain is left untreated, the more likely irreversible nerve damage becomes.
Likely treatment: Root canal ($750–$950) + crown ($950) if pulpitis has become irreversibleDull ache that comes and goes — no clear trigger
Schedule within 1–2 weeksA dull, wandering ache without a clear trigger is often caused by bruxism (teeth grinding) or TMJ (jaw joint) issues. Grinding creates diffuse stress across multiple teeth and the jaw muscles — the ache appears after grinding episodes (often overnight) and fades during the day. Sinus pressure from allergies or a sinus infection can also cause this pattern, particularly in the upper back teeth which sit directly below the maxillary sinuses.
Early-stage gum disease (periodontitis) can also cause dull intermittent aching, particularly if combined with gum recession. A dental exam with X-rays will differentiate between these causes — treatment varies significantly depending on which is found.
Likely treatment: Night guard for bruxism · Deep cleaning for gum disease · Sinus management if sinus-relatedThrobbing that comes in waves — worse at night
See dentist same day or next morningThrobbing that comes in waves — especially pain that wakes you at night — strongly suggests advanced pulpitis or early abscess formation. The throbbing corresponds to the heartbeat-driven pressure changes inside the infected or inflamed pulp. Lying down intensifies it because increased blood pressure in the head amplifies pressure in the inflamed tissue.
This is not intermittent pain in the "comes and goes between triggers" sense — it's pain cycling in intensity. An emergency dental evaluation is warranted. A root canal to remove the infected pulp is almost certainly needed. If an abscess has formed, antibiotics may be prescribed before or alongside treatment.
Likely treatment: Root canal ($750–$950) + possible antibiotics · Emergency appointment recommendedSevere pain that suddenly stops completely
⚠ See dentist today — do not waitThis pattern is uniquely dangerous because it feels like good news and is the opposite. When severe tooth pain stops suddenly without any treatment, it almost always means the nerve has died. The pulp tissue has become necrotic — it can no longer send pain signals. The infection, however, has not resolved. It is still active in the surrounding tissue and bone, and now progressing without any warning system.
A dead tooth with spreading infection can develop into a dental abscess, cause bone loss, and in rare cases spread to surrounding structures including the jaw, neck, and beyond. The silence is misleading. An emergency evaluation is critical even when the pain has completely stopped — particularly if it was recently severe.
Likely treatment: Root canal ($750–$950) + crown — or extraction ($250) if tooth is not restorableHow Intermittent Pain Progresses Over Time
Understanding the typical progression of dental pain helps clarify why waiting is usually the worse outcome. These stages are not fixed — some teeth move through them slowly over months, others rapidly within weeks. But the direction is almost always one-way without treatment.
Occasional sensitivity — triggered only by specific stimuli
Brief sharp pain from cold or sweet foods. Resolves within seconds. The tooth structure is compromised (early decay, crack, or enamel wear) but the nerve is not yet involved. At this stage: a filling or desensitizing treatment is usually all that's needed. Lowest cost, least invasive window.
More frequent sensitivity — lingers after the trigger
Cold sensitivity now persists for 30 seconds or longer. The nerve (pulp) is now inflamed — pulpitis has begun. Spontaneous dull aching may start between triggers. At this stage: a root canal is often necessary. Still a good outcome if treated promptly — the tooth can be saved.
Throbbing pain — coming in waves, waking at night
Rhythmic throbbing indicates advanced pulpitis or early abscess. Ibuprofen may not fully control the pain. An emergency dental appointment is appropriate. Root canal treatment is almost certainly needed. An abscess may require antibiotics before or concurrent with treatment.
Pain stops — nerve has died, infection spreads silently
The pain signal disappears, but the infection is now in the bone. Swelling, fever, and spreading facial infection are possible outcomes. The tooth may still be saveable with a root canal, but the window narrows. Extraction followed by an implant may become necessary. This is the most expensive, most invasive outcome — and the most preventable.
Quick Symptom Checker
Match your pain pattern to the most likely cause and urgency level.
When to Act — and How Urgently
Not every instance of intermittent tooth pain requires a same-day visit. But all of it warrants a dental appointment — the question is timing.
Treatments & Published Prices
The right treatment for intermittent tooth pain depends entirely on how far the underlying problem has progressed. Below are the most common interventions — listed from least to most intensive — with Best Dental's published prices so you know your out-of-pocket before you arrive.
Tooth-Colored Filling
Dental Crown
Root Canal
Root Canal + Crown
Tooth Extraction
Emergency Exam + Treatment
*PPO estimates assume standard 50% coverage for major procedures after deductible. Best Dental verifies your specific benefits before treatment begins. 0% financing available via Cherry or CareCredit on approved credit.
Home Relief While You Wait
These measures can reduce intermittent tooth pain while you wait for your appointment. They manage symptoms — they do not stop decay, heal a crack, or reverse nerve inflammation.
Alternate Ibuprofen + Acetaminophen
400mg ibuprofen and 500mg acetaminophen alternated every 3 hours (not at the same time) provides stronger combined relief than either alone. Take with food.
Clove Oil on the Tooth
Apply a small amount of clove oil (eugenol) directly to the painful tooth with a cotton ball. The same active ingredient used in emergency dental sedatives — temporary but effective numbing.
Salt Water Rinse
½ tsp salt in 8 oz warm water — rinse gently for 30 seconds. Reduces bacterial load around the tooth and soothes inflamed gum tissue. Don't swish aggressively.
Cold Compress — Outside Only
Apply ice wrapped in cloth to the outside of the cheek for 15 on / 10 off. Reduces inflammation. Never apply cold directly to the tooth — this will worsen cold sensitivity.
Keep Head Elevated When Sleeping
Lying flat increases blood pressure in the head, amplifying throbbing. An extra pillow reduces nighttime pain significantly for patients with pulpitis.
Avoid Triggers You've Identified
If you know cold drinks or biting on the left side triggers your pain, avoid both until your appointment. Don't test the tooth — each trigger episode adds stress to already-irritated tissue.
Frequently Asked Questions
Tooth pain comes and goes because it follows a trigger-response pattern. Pain appears when the tooth is stimulated — by biting, cold, heat, or pressure — and fades when the stimulus is removed. The tooth responds to each trigger and then quiets until the next one. The underlying cause (decay, crack, nerve inflammation) doesn't disappear between episodes — it's just not being stimulated at that moment. Over time, as the condition progresses, the triggers needed to produce pain become easier and easier to hit, and the recovery between episodes shortens.
Pain from minor gum irritation — a piece of food lodged in the gum, temporary sensitivity from aggressive brushing — can resolve on its own in a day or two. But pain from tooth decay, a cracked tooth, or pulp inflammation does not resolve without treatment. Most importantly: if a tooth was severely painful for several days and then the pain stopped abruptly without any treatment, this is a warning sign, not good news. It almost always means the nerve has died. The infection continues spreading into the surrounding bone with no pain signal remaining to warn you. A dental evaluation is critical even when the pain has stopped.
This distinction matters clinically. Brief cold sensitivity — pain that resolves within 10 seconds of the cold being removed — indicates exposed dentin, typically from a cavity or gum recession. The nerve is irritated by the cold stimulus but not yet inflamed. Lingering cold sensitivity — pain that continues 30 seconds, a minute, or longer after the cold is gone — indicates pulpitis, meaning the nerve tissue inside the tooth is actively inflamed. Lingering cold sensitivity often requires a root canal; brief cold sensitivity may be resolved with a filling. The difference in treatment — and cost — is significant, which is why catching this early matters.
Pain on biting that's localized to one side or one specific spot on the tooth is a strong indicator of a cracked tooth or a failing filling. The structure is compromised at one point — that point experiences stress when bite force hits it from a specific angle. A dentist can use a bite stick (a small device you bite down on) to isolate exactly which cusp or area of the tooth is causing the pain. Depending on how deep the crack or damage extends, treatment may range from a crown to a root canal and crown combined.
Yes. Throbbing pain that comes in waves — where the pain pulses with intensity — is a sign of advanced pulp inflammation or an early abscess. The throbbing corresponds to heartbeat-driven pressure changes inside the inflamed or infected tissue. It almost always requires a root canal to remove the infected pulp. If it's accompanied by swelling, fever, or waking you from sleep repeatedly, it should be treated as a dental emergency and evaluated the same day. Best Dental offers same-day emergency appointments — call (281) 215-3065.
Diagnosing intermittent tooth pain requires more investigation than constant pain because the tooth may look and feel normal at the time of the exam. Your dentist will take X-rays (to check for decay, bone loss, and infection), perform a cold test (applying cold to each tooth to check for lingering sensitivity), do a percussion test (tapping teeth to check for abscess-related tenderness), and may perform a bite test using a bite stick to localize cracked tooth pain. Transillumination (shining a light through the tooth) and dye testing can reveal cracks invisible to the naked eye and X-rays. Giving your dentist a precise description of when the pain occurs, how long it lasts, and what makes it stop or worsen significantly speeds up diagnosis.
Yes. Bruxism (grinding or clenching) is a very common cause of diffuse intermittent tooth pain — particularly dull aching in the morning, generalized jaw soreness, and sensitivity across multiple teeth simultaneously. Grinding creates cumulative stress on enamel and can accelerate crack formation, cause referred pain in jaw muscles, and sensitize the pulp over time. A custom night guard reduces the grinding load significantly. If you already have intermittent pain and grind at night, that combination warrants an evaluation — both to assess whether any existing damage is present and to prevent further progression.
A root canal is the right treatment when the pain is caused by pulp inflammation (pulpitis) or infection — not for all intermittent pain. If your intermittent pain is caused by a small cavity, a filling resolves it. If it's caused by a cracked tooth, a crown resolves it. If it's caused by bruxism, a night guard may be sufficient. The distinction is whether the nerve tissue inside the tooth is affected. Lingering cold sensitivity, throbbing that comes in waves, pain after the tooth is no longer stimulated, or severe pain that has stopped abruptly all suggest pulp involvement — those situations typically require a root canal. Brief sensitivity from triggers that stops immediately often doesn't. A dental exam with cold testing determines this definitively.
Get Treatment at Best Dental — Richmond, TX
Depending on what's causing your intermittent tooth pain, treatment at Best Dental will follow one of three paths — each with published prices, same-day availability for urgent cases, and most PPO insurance accepted.
Tooth Pain Coming and Going?
Don't wait for it to become constant. Same-day appointments available. Published prices on every treatment — extraction $250, filling $125–$175, root canal $750–$950. Most PPO insurance accepted. Serving Richmond, Katy, Sugar Land, and Rosenberg.
