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Q. What could cause constant pulsatile tooth pain?

Answered by
Dr. Prerna Jain
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 16, 2016 and last reviewed on: Aug 21, 2020

Hi doctor,

I have constant pain in my front tooth (11). I have not had any trauma to it as of I aware and I take good care of my teeth. I do not have gum disease. There may be a tiny bit of gum recession due to over brushing. The ache is constant. I do not get any pain from cold or hot food or drinks. When I eat the pain seems to disappear, but it is present when I am not doing anything. I can feel it as pulsatile pain. Please help.

Dr. Prerna Jain

Dentistry Orthodontist


Welcome to

  • The tooth pain you are experiencing is indicative of pulpitis that is there is inflammation of the living part of your tooth. It may or may not be irreversible.
  • It would be clearer if you could answer a few more questions. When did the pain start? How long has it been? How long does the pain last? Does it last all day?
  • Do you have any pain on biting hard food or biting even normal food? Is there any sensitivity to sweet foods?
  • The way to go forward in such a case where there is no obvious tooth decay or gum disease or history of trauma is to take a small x-ray (IOPA - intraoral periapical radiograph) and eliminate any of the problems listed above along with any root problems.
  • Occasionally, there is no evident reason such as injury or trauma, but over a period of time accumulated insult to the tooth can cause such pain.
  • Next step is to check the tooth vitality and the response to pulp vitality test. This can be done by a dentist to check the response time.
  • Another probable reason could be sinusitis. However, that pain is more generalized.
  • There are more complex reasons as well, but we start from the simplest and eliminate them one by one.

The Probable causes:

1. Long term micro trauma or hypersensitivity.
2. Deep traumatic bite with lower teeth.
3. Tooth decay not visible to naked eye.
4. Sinusitis referred pain.

Investigations to be done:

IOPA and pulp vitality test.

Probable diagnosis:

Pulpal inflammation.

Treatment plan:

After investigations, depending on results treatment plan can be formed. You might require root canal treatment and capping.

Regarding follow up:

Revert back with the x-ray to a dentist online.--->

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