A Toothache Without a Cavity

Pain in a tooth is commonly linked in the minds of many with a dental cavity. Yet the complexities of the inside of a tooth and its connections with surrounding tissues make tooth pain without a cavity a common finding. Understanding the possible causes can eliminate confusion caused this condition occurs.


According to an article published in the Australian Dental Journal, accidents around home and school account for most injuries to permanent teeth. Some of these injuries require immediate attention due to the tooth being fractured. In other instances, the visible portion of the tooth is not harmed and no dental treatment is sought. However, the soft tissue on the inside of the tooth may have been injured. This leads to inflammation and possibly infection that causes pain until the diseased tissue is removed from the tooth.

Cracked Tooth

A crack or chip in a tooth creates a pathway for bacteria to gain access to the nerve tissue on the inside of a tooth according to the American Association of Endodontists. This causes inflammation of this tiny amount of tissue. Because it is trapped within the hard structures of the tooth, there is no room for it to swell and prevent pain from developing. This leads to a severe toothache as pressure is increasingly exerted on sensitive nerve fibers.

Sinus Infection

The back teeth of the upper jaw are in close proximity to the maxillary sinuses. Some of these roots protrude into the sinus cavity. This is the reason that sinusitis patients often complain of achy teeth in their upper jaw according to the American Academy of Otolaryngology 2. A correct diagnosis is critical in this instance to prevent unnecessary dental treatment from being performed.


The dental pulp on the inside of the tooth and the periodontal ligament on the outside of the root contain cells that can be triggered to start dissolving the hard tooth structures. This is known as internal or external resorption. This can be the result of such medical conditions as scleroderma, according to the Scleroderma Foundation. Dental trauma is another possible cause. It is possible that this process will begin for no apparent reason. When it continues untreated it may cause a toothache without a cavity being detected in the tooth.

Medical Condition

A toothache must be addressed immediately not only for maintenance of good oral health but because it may be the manifestation of a more serious underlying medical condition. According to the Yale Medical School an angina attack may be confused with a toothache.


Regular dental checkups can help prevent toothaches from occurring. Further dental and medical complications can be minimized by seeking the appropriate care when any pain around the oral cavity develops.