Mysterious Toothaches: Possible 'Common' Causes and Treatments | Nourish Dental Care

Mysterious Toothaches: Possible ‘Common’ Causes and Treatments

Mysterious Toothaches with No Answers To

Do you have a mysterious ache in your teeth that no doctor or dentist has answers to? Clinical examination of surrounding tooth structures appear normal, yet the pain is persistent. Mysterious toothaches are frustrating as they are difficult to diagnose. There is a wide assortment of possible causes, and symptoms can overlap.

Some are so rare that not every medical professional has the experience to recognise and diagnose them. Unnecessary root canals, orthodontic treatments and even teeth extractions are done. Yet the mysterious toothaches remain or worsen. Whilst some patients do experience temporary relief, the problem usually returns.

*Disclaimer: The term ‘Orofacial Pain specialist‘ is made within the context of the USA and not Singapore. Please refer to our Disclaimers page and read our FAQs for more information.

What are the Causes of These Mysterious Toothaches?

Mysterious toothaches can develop for many reasons. What’s surprising is that the tooth itself may not even be the main cause. Some other possibilities of mysterious toothaches include:

  • A compressed nerve
  • An autoimmune or CNS (Central Nervous System) dysfunction
  • A fault in muscular or bone structures
  • Post-surgery trauma
  • Psychogenic factors such as stress or depression

Let’s take a look at what some of the more common causes behind them are.

Trigeminal Neuralgia: One of the More ‘Common’ Causes

Trigeminal Neuralgia (TN) is one of the more ‘common’ causes of pain in the face and teeth (Lambru et al., 2021). It is a chronic pain condition that affects the trigeminal nerve, which is one of the most widely distributed nerves in your head that’s attached to the brain. The pain is thus classified as neuropathic.

Trigeminal Neuralgia can manifest in two forms: Type 1 and Type 2. There is also a rarer type, Idiopathic Trigeminal Neuralgia (ITN), which we have diagnosed and treated at our clinic. We have also been seeing a rise in ITN cases after dental work. The occurrence of Trigeminal Neuralgia increases in patients with Multiple Sclerosis. It is also more common in women, especially those who over 50.

The intensity of the pain can be incapacitating, and the unpredictability is disruptive. The patient’s quality of life diminishes. The classic Type 1 form of TN can cause extreme, electric shock-like pain that comes in sudden bursts. These last between a few seconds to minutes.

The atypical Type 2 form of the disorder tends to manifest in a more constant, stabbing type of pain. It may be somewhat lower in intensity than that in Type 1.

It is important to note that treatments for these various forms of Trigeminal Neuralgia differ. Patients have found relief from medications, injections or surgery. Your own physiological needs, health condition, specific problems and treatment preferences all play a role.

Burning Mouth Syndrome: Another Leading Cause

Another more ‘common’ source of mysterious toothaches can be from Burning Mouth Syndrome. Whilst a third of patients claim that the pain started after a bout of illness, medications or dental work, most can’t link it to any specific event. Once again women, especially those who are in post-menopause, are the primary group affected by this disorder.

Other possibilities for Burning Mouth Syndrome include:

  • Dentures with a poor fit
  • Allergies to materials used in dentures
  • Allergies to ingredients used in toothpaste, mouthwashes, or anything you may use within your mouth
  • Stress
  • Autoimmune disorders, such as Sjögren’s Syndrome

You may feel a burning or scalding sensation that varies in intensity throughout the day with Burning Mouth Syndrome. It can affect your tongue, lips, gums, and/or parts of your mouth. You may also experience an increase in thirst and dry mouth. Eating or drinking may help to relieve these symptoms for a while.

There are two forms of Burning Mouth Syndrome – Primary and Secondary. In Primary Burning Mouth Syndrome, no clinical abnormalities are found. Whereas in its Secondary form, an underlying medical condition is usually the cause. This could be due to nutritional deficiencies, fungal infections, allergies, or side effects from medications or other health issues.

Whilst there is no targeted treatment for Burning Mouth Syndrome, there are some measures you can take to prevent and control the pain. You can read a case study about Burning Mouth Syndrome in one of our patients here.

Temporomandibular Joint Disorder (TMD) & Myofascial Toothache

Temporomandibular Joint Disorder (TMD) and myofascial toothache are some other causes of mysterious toothaches. These are fairly common mouth problems, but many are unaware that they even have them.
The patient may experience pain not only in their teeth, but also the surrounding areas such as the jaw, head, face and even ears. The intensity of the pain may increase with chewing or jaw stretching activities, and can vary throughout the day. There are often trigger points in myofascial pain as well, where the patient is able to pinpoint where it hurts exactly. Read more about TMD / TMJ Disorders and how we can help here.

Treatment and Management of Chronic Pain Conditions

These are a few possibilities behind mysterious toothaches. A chronic pain condition is one that never goes away fully. Treatment and pain management as such, differs from that of acute pain.

It is important to find a good dentist whom you can trust and work with. Someone who knows and understands your medical history and how it changes over time. This is important to pick out unusual patterns so as to curb potential problems, and to manage existing ones.

How Nourish Dental Sleep & TMJ Care, Singapore, Can Help

We use the necessary technology to diagnose, treat and manage each patient’s condition at our clinic. Dr. Eric Chionh runs the practice and has over 20 years of hands-on experience. He focuses on TMD / TMJ Disorders and other orofacial pain disorders, myofascial painsleep apnoea, pain & sleep dentistry, and other mouth and jaw conditions.

He is formally trained in Oral Medicine and Orofacial Pain, and holds a Singapore Dental Council approved qualification in these areas. You can learn more about Dr. Eric Chionh’s qualifications and our dental practice here. Visit Our Services page to view all dental and pain management services we provide at Nourish Dental Sleep & TMJ Care in Singapore.


  • Lambru, G., Zakrzewska, J., & Matharu, M. (2021). Trigeminal neuralgia: a practical guide. Practical neurology, 21(5), 392-402.

One Comment

A Chronic Voice
November 22, 2020 4:57 pm

I live with multiple chronic illnesses and burning mouth is one extremely painful symptom I experience from Sjögren’s Syndrome, due to a lack of moisture in the mouth. It really can be very surprising as to how mysterious mouth or teeth pain can be, and the root problems to them!

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