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Tooth Pain That Comes and Goes: What It Means & When to Seek Help

If you’ve experienced tooth pain that mysteriously appears and then disappears just as quickly, you’re not alone. This frustrating type of intermittent dental discomfort is actually one of the most common complaints patients bring to our Boston practice. While it might be tempting to dismiss pain that “goes away on its own,” I’m here to tell you that this on-again, off-again discomfort is rarely something you should ignore.

As a board-certified prosthodontist and Professor at Tufts University School of Dental Medicine, I’ve seen countless patients who waited too long to address intermittent tooth pain, only to face more complex and costly treatments down the road. The truth is that tooth pain that comes and goes often signals underlying dental issues that are in their early stages—which means they’re also in their most treatable stages.

In this comprehensive guide, I’ll explain what might be causing your intermittent tooth pain, why it behaves the way it does, and most importantly, what you should do about it.

Why Intermittent Tooth Pain Is Different (And Deceptive)

Unlike constant, throbbing pain that sends you running to the dentist immediately, intermittent tooth pain is elusive. It appears when triggered by specific stimuli—a sip of cold water, a bite of something sweet, or pressure while chewing—and then fades away, sometimes for hours or even days.

This unpredictable nature makes intermittent pain particularly deceptive. Many patients convince themselves that if the pain goes away, the problem has resolved itself. Unfortunately, this is rarely the case. In my experience spanning degrees from both the University of Freiburg and Tufts University, I can tell you with certainty that tooth pain that comes and goes always indicates an underlying problem—whether it’s a brewing infection, structural damage, or tissue irritation.

The intermittent nature simply means that the condition hasn’t progressed to the point of constant discomfort yet. But without intervention, it almost certainly will.

Common Causes of Tooth Pain That Comes and Goes

1. Tooth Sensitivity: The Leading Culprit

Tooth sensitivity is one of the most common reasons for intermittent dental pain. This condition occurs when the protective enamel layer of your teeth wears down, or when gum recession exposes the underlying dentin or even the tooth roots.

Dentin contains thousands of microscopic tubules that connect directly to the nerve center of your tooth. When exposed to external stimuli—hot coffee, cold ice cream, sweet desserts, or acidic foods—these tubules allow sensations to reach the nerve quickly, resulting in those sharp, brief jolts of pain that characterize sensitivity.

What causes enamel erosion and gum recession?

The good news is that sensitivity-related pain is highly treatable. In early stages, switching to a desensitizing toothpaste containing fluoride can actually help remineralize minor areas of enamel loss. For more advanced cases, we offer professional treatments at The Face Dental Group, including fluoride varnishes, dental bonding to cover exposed roots, or even gum grafting procedures when recession is significant.

2. Cavities and Tooth Decay

Tooth decay affects approximately 90% of adults worldwide at some point in their lives, making it one of the most prevalent chronic diseases. What many people don’t realize is that cavities often announce themselves with intermittent pain long before they cause constant discomfort.

In the early stages, a cavity erodes through your tooth’s enamel layer. Once it reaches the dentin beneath—which is much softer and more sensitive—you’ll start experiencing intermittent sharp or throbbing pain, particularly when consuming sweets, hot foods, or cold beverages. The pain occurs because these stimuli reach the sensitive dentin and irritate the nerve tissue deeper within the tooth.

Here’s what makes cavity-related pain particularly tricky: it may start so mildly that you barely notice it. You might feel a slight twinge when drinking something cold, but then nothing for days. This pattern can continue for weeks or months as the decay slowly progresses deeper into the tooth structure. By the time the pain becomes constant, the decay has likely reached the pulp (nerve chamber), requiring more extensive treatment like a root canal.

This is precisely why I always tell my patients in Boston: don’t wait for pain to become unbearable. Regular dental examinations can catch cavities in their earliest stages, often before any pain develops at all.

3. Cracked or Fractured Teeth

Cracked teeth are masters of disguise. Unlike a completely broken tooth that’s immediately obvious, small cracks—sometimes invisible even on X-rays—can cause unpredictable, intermittent pain that’s difficult to pinpoint.

The pain occurs because the crack opens slightly when you bite down or when temperature changes cause the tooth structure to expand or contract. This opening allows stimuli to reach the sensitive inner layers of the tooth or even irritate the nerve directly. When the pressure releases or the temperature normalizes, the crack closes, and the pain disappears.

Common causes of cracked teeth include:

Diagnosing cracked teeth requires specialized expertise, which is where my training in prosthodontics becomes particularly valuable. We use specialized lighting, magnification, and advanced imaging to identify cracks that might otherwise go undetected. Treatment depends on the crack’s severity and can range from simple bonding to crowns, or in severe cases, extraction and replacement with dental implants.

4. Gum Disease (Periodontal Disease)

Gum disease affects nearly 50% of American adults over age 30, yet many don’t realize they have it until it’s quite advanced. One of the earlier warning signs is intermittent tooth pain or sensitivity, particularly when eating, brushing, or flossing.

As periodontal disease progresses, inflammation causes the gums to pull away from the teeth, forming pockets where bacteria accumulate. This recession exposes the tooth roots, which lack the protective enamel covering found on the crown portions of teeth. The result is heightened sensitivity and intermittent pain triggered by temperature, pressure, or bacterial irritation.

In more advanced stages, the infection can cause throbbing pain similar to an abscess, but unlike an abscess, the discomfort may come and go depending on the level of inflammation at any given time.

At The Face Dental Group, our periodontal specialists can assess gum health and create a treatment plan to stop disease progression. Early intervention with improved hygiene and professional cleanings can often reverse gingivitis (early-stage gum disease) before it advances to more serious periodontitis requiring surgical intervention.

5. Bruxism (Teeth Grinding and Clenching)

Many of my patients are surprised to learn they grind their teeth, especially since bruxism often occurs during sleep. This unconscious habit can cause significant dental damage over time, including enamel wear, micro-fractures, and chronic muscle strain—all of which can produce intermittent tooth pain.

Bruxism-related pain typically manifests as:

The intermittent nature of grinding-related pain makes sense when you consider that the damage accumulates gradually. You might grind more heavily on some nights than others, or certain activities (like chewing tough foods) might stress already-compromised teeth, triggering temporary pain.

Treatment for bruxism often involves a custom-fabricated night guard to protect your teeth during sleep, along with stress management techniques and, in some cases, addressing bite alignment issues. With my background in prosthodontics and full mouth rehabilitation, I frequently help patients who’ve experienced significant damage from long-term grinding restore both function and comfort to their smiles.

6. Sinus Infections and Sinus Pressure

Here’s something that surprises many patients: not all “tooth pain” actually originates from your teeth. The roots of your upper back teeth sit very close to your maxillary sinuses. When these sinuses become inflamed or infected, the pressure can mimic tooth pain remarkably well.

Sinus-related tooth pain typically:

If you’re experiencing these symptoms in our Boston practice area, especially during cold and flu season or allergy periods, we’ll carefully evaluate whether your tooth pain might actually be sinus-related before recommending dental treatment.

7. Other Potential Causes

Several other conditions can cause intermittent tooth pain, including:

When Should You See a Dentist?

Given my years of experience in dental education and clinical practice, my answer to this question is straightforward: if you’re experiencing tooth pain that comes and goes, you should schedule a dental evaluation—even if the pain seems minor or infrequent.

Here’s why early intervention matters: nearly all the conditions that cause intermittent tooth pain will progress if left untreated. A small cavity becomes a large one requiring a crown instead of a simple filling. Minor sensitivity from early enamel loss becomes severe sensitivity requiring more complex treatment. A small crack becomes a fractured tooth requiring extraction.

You should definitely schedule an appointment if:

At The Face Dental Group, we use advanced diagnostic technology including digital X-rays, intraoral cameras, and 3D imaging when necessary to identify problems that might not be visible during a standard visual examination. This comprehensive approach, combined with my specialized training in prosthodontics and implantology, allows us to accurately diagnose the source of your pain and create an effective treatment plan.

What to Expect During Your Evaluation

When you visit our Boston practice for intermittent tooth pain, we’ll conduct a thorough examination that typically includes:

This comprehensive evaluation allows us to pinpoint the exact cause of your discomfort and recommend the most appropriate, conservative treatment.

Treatment Options Based on Diagnosis

The beauty of catching dental problems early—when they’re still causing intermittent rather than constant pain—is that treatment is typically more conservative, less invasive, and more affordable.

Depending on your specific diagnosis, treatment might include:

With my expertise in digital dentistry, cosmetic dentistry, and advanced procedures like All-on-4 dental implants, I can offer comprehensive solutions even for complex cases where intermittent pain has been ignored for too long and significant damage has occurred.

Home Care While Waiting for Your Appointment

If you’re experiencing intermittent tooth pain and have an appointment scheduled, here are some strategies to manage discomfort in the meantime:

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