What does this mean?
Throbbing means the pain comes and goes in time with your heartbeat. In migraine-type pain this throbbing settles on one side of the head, lasts for hours and increases when you walk or climb stairs; it comes with nausea and with discomfort from light, sound and smells. When the attack ends the pain lifts completely and nothing is left in between.
Pain that comes from a tooth behaves differently. It is set off by a trigger such as cold, heat or biting, it increases when that tooth is touched, and its location is narrow enough to point to with a fingertip. Discomfort in light, nausea and being unable to move about during the pain are not expected with a dental cause. This distinction matters, because healthy teeth can feel painful during an attack, and unnecessary root canal treatment or an extraction may end up on the table.
The two do not rule each other out. A feeling of pain in the upper teeth can accompany a headache attack; conversely, tension in the chewing muscles and night-time clenching may affect how often attacks come. That is why the assessment is not one-sided: the teeth and the jaw muscles are examined, and the headache's own pattern is asked about as well.
Several different pictures can lie behind a one-sided throbbing headache; the length of the attack, what comes with it and the age at which the pain first started decide the distinction. Below you will find the headings this description most often points to.
Likely causes
What helps at home?
- Note the day of each attack, how long it lasted, which side it was on and what had changed beforehand, such as sleep, meals or your period; this record is what speeds up the assessment most.
- Resting in a dark, quiet room during an attack may reduce how severe it feels; stay away from screens and noise until the pain passes.
- Keep your use of painkillers to a few days a week; frequent use may contribute to the pain keeping itself going.
- Do not make any lasting decision about your teeth while an attack is going on; work out where the pain sits again once the attack has passed.
- The pain is the worst headache you have ever had and reached its peak within seconds
- The pain comes with a fever, a stiff neck or confusion
- There is slurred speech, weakness on one side, drooping of the face or loss of vision
- It is a headache that has started for the first time after the age of fifty
- The pain increases markedly when you cough, strain or bend over
Frequently asked questions
- How can I tell whether this is migraine or toothache?
- The most useful distinction is about triggers. Pain that comes from a tooth is set off by cold, heat or biting, and increases when that tooth is touched. Migraine-type pain starts without any such trigger, lasts for hours, worsens with light and sound, and makes you feel sick. To settle it, a dentist looks with X-rays and with tests that measure whether the tooth is still alive; if there is no finding in the tooth, nothing is done to it.
- My teeth ache during a headache attack too. Is that normal?
- The nerve pathways carrying sensation from the face and the teeth share stops in the brain with those carrying headache. Because of this, pain or sensitivity may be felt in the upper teeth during an attack, and the feeling settles again once the attack is over. If there is no sign of decay, a crack or infection in the tooth, this feeling on its own is not counted as a reason for root canal treatment or extraction.
- Will dental treatment make this pain go away?
- Diagnosing migraine-type headache and treating it with medication belong to neurology; it is not expected to go away with dental treatment. A dentist contributes somewhere else: working out whether the pain comes from a tooth, addressing the factors that add to the picture such as clenching and chewing muscle pain, and preventing unnecessary work on a healthy tooth.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.