You wake up with a throbbing tooth. Then your ear starts to ache too. It’s on the same side, and now you’re wondering what is going on.

Having a toothache and earache at the same time is more common than most people think. It’s also confusing. Is the problem in your tooth? Is it your ear? Or is it something else, like your jaw or sinuses?

Here’s the short answer. Tooth pain and ear pain often show up together because the nerves in your face share pathways. Pain from one spot can feel like it’s coming from another. In most cases, the cause is a dental problem, such as a tooth infection, a wisdom tooth, or a cracked tooth. Sometimes it’s a jaw joint (TMJ) problem, a sinus infection, or a real ear infection.

The good news is that you can work out a lot from your symptoms. In this guide, you’ll learn why a toothache can cause ear pain, the most common causes, which warning signs are urgent, and what to do tonight. You’ll also learn when it’s time to call an emergency dentist.

Why Do a Toothache and Earache Happen Together?

The main reason is something called referred pain.

A large nerve called the trigeminal nerve carries feeling from your teeth, gums, jaw, and face up to your brain. One branch of it also supplies the area near your ear. When a tooth is inflamed, the brain gets a flood of pain signals. It can't always tell exactly where they started. So you feel pain in your ear, even though the problem is in your mouth.

Your teeth, jaw joint, and ears also sit very close together. That makes it easy for trouble in one spot to spread to the next.

Common Causes of Tooth Pain and Ear Pain

Tooth Infection or Abscess

A deep cavity can let bacteria reach the nerve inside your tooth. This can lead to a tooth abscess, which is a pocket of infection near the root.

Signs include throbbing pain, a bad taste, a swollen gum, and sometimes a fever. The pain often spreads to the ear on the same side. An abscess does not heal on its own, so it needs a dentist.

Wisdom Tooth Problems

Wisdom teeth are the last to come in. Many don't have enough room. When they get stuck or only break through partway, the gum around them can become infected and sore.

Wisdom teeth at the back of the mouth sit close to the jaw joint. That's why wisdom tooth ear pain is so common. You may also notice a sore jaw, bad breath, or trouble opening your mouth wide.

TMJ Disorders

Your jaw joint, called the TMJ, sits right in front of your ear. When it's strained, the pain can feel like both an earache and a toothache.

Clues include clicking or popping when you chew, a jaw that feels stuck, and pain that is worse in the morning. Grinding or clenching your teeth at night is a common trigger.

Cracked Tooth or Deep Decay

A small crack in a tooth can cause sharp pain that radiates toward the ear. If it hurts most when you chew, read our guide on tooth pain when biting down. It explains what that pain can mean.

Sinus Infection

The roots of your upper back teeth sit just below your sinuses. When the sinuses are swollen, those teeth can ache. Pressure can also build in the ear.

With a sinus problem, the pain often affects several upper teeth. You may also have a stuffy nose, facial pressure, or a cold.

Ear Infection

It works the other way too. An ear infection can make your jaw and back teeth hurt. Muffled hearing, fluid drainage, or a fever point toward the ear.

Is It Your Tooth or Your Ear?

You can't diagnose this at home, but some clues help.

Pain is more likely dental if:

• It flares with hot, cold, or sweet foods.
• It hurts when you bite or tap the tooth.
• Your gum looks red or swollen.

Pain is more likely from the ear or sinuses if:

• You feel muffled hearing or ringing.
• You have a cold, congestion, or drainage from the ear.
• Pulling gently on your earlobe hurts.

If you can't tell, that's okay. Many people can't. A dentist can sort it out quickly.

When Is It an Emergency?

Some symptoms mean you should not wait. Get urgent care right away if you have:

• Swelling in your face, cheek, or neck
• Swelling near your eye
• A fever along with tooth or ear pain
• Trouble swallowing or breathing

These can be signs that an infection is spreading. Our article on signs a tooth infection is spreading to your face or jaw explains what to watch for. If you're unsure where to go, see whether you can go to the ER for a toothache.

One more important point. Jaw pain can sometimes come from the heart. If your jaw or ear hurts along with chest pressure, shortness of breath, sweating, or nausea, call 911.

What Can You Do at Home Tonight?

Home care can ease the pain. It will not fix the cause. These steps may help until you can be seen:

• Rinse gently with warm salt water.
• Hold a cold pack against your cheek for 15 minutes at a time.
• Take an over-the-counter pain reliever, following the label and your doctor's advice.
• Eat soft foods and chew on the other side.
• Keep your head raised when you lie down.

Don't put aspirin directly on your gum. It can burn the tissue. Also avoid heat on a swollen area.

For more ideas, see our guide on how to stop a toothache fast at home.

Should You See a Dentist or a Doctor First?

If you have signs of a dental problem, start with a dentist. That means pain with hot or cold, pain when biting, or a swollen gum. If you mainly have cold symptoms, ear drainage, or muffled hearing, start with your doctor.

Not sure? A dentist is a good first stop. Dental causes are very common, and a dentist can take an X-ray, check your bite, and look at your jaw joint.

Don't wait for the pain to pass. Pain that comes and goes can still mean trouble is growing. Here's what happens if you ignore a toothache.

Toothache and Earache FAQs

Q: Why do I have a toothache and earache on the same side?
A: Your teeth, jaw, and ear share nerve pathways. Pain from an inflamed tooth can feel like it’s coming from your ear.

Q: Can a tooth infection cause ear pain?
A: Yes. A tooth infection or abscess can spread pain to the ear, jaw, and neck. It won’t heal on its own, so see a dentist.

Q: Can wisdom teeth cause ear pain?
A: Yes. Wisdom teeth that are stuck or partly through the gum can get infected. They sit near the jaw joint, so the pain often reaches the ear.

Q: Can TMJ cause a toothache and earache at the same time?
A: Yes. Your jaw joint sits right in front of your ear. TMJ problems can cause ear pain, jaw pain, and tooth pain together.

Q: Is a toothache with ear pain a dental emergency?
A: It can be. Get care right away if you have facial swelling, a fever, or trouble swallowing or breathing.

Need an Emergency Dentist Near You?

Tooth and ear pain at the same time is hard to ignore. It's even harder at night or on a weekend.

247 Local Dentist connects you with dentists in your area. Our live operators are available 24 hours a day, 7 days a week. Call (833) 220-2448 or find a dentist in your state.