Toothache is defined as pain originating from a tooth and its supporting structures, often described as the most frequent type of orofacial pain. Therefore, this systematic review aimed to assess the prevalence of toothache in adults.
Methods:
The study selection process adhered to the PECOS inclusion criteria: Population (P): Adults; Exposure (E): Toothache; (C): None; Outcome (O): Prevalence; Studies (S): Observational studies.
Results:
The initial search yielded 1,781 studies, and after eligibility criteria were applied, 48 studies were included in the analysis. The overall prevalence of toothache was found to be 24% (95% confidence interval [21, 27.2]; n = 447,373).
Conclusions:
When categorized, the prevalence among adults was as follows: 34.6% currently experiencing tooth pain, 14.5% in the past month, 19.5% in the past 6 mo, and 29.0% in the past 12 mo. Geographically, toothache prevalence varied as follows: 43.2% in Africa, 30.6% in Asia, 24.6% in Europe, 17.0% in South America, 15.0% in Oceania, and 13.44% in North America.
Clinical Significance:
Based on the available evidence, this systematic review suggests that the overall prevalence of toothache in adults is 24%, with higher rates in Africa (43.2%) and Asia (30.6%) and lower rates in Oceania (15.0%) and North America (13.4%).
Knowledge Transfer Statement:
The worldwide prevalence of toothache was found to be 24%. Toothache prevalence varied by continent as follows: 43.2% in Africa, 30.6% in Asia, 24.6% in Europe, 17.0% in South America, 15.0% in Oceania, and 13.44% in North America.
AdulyanonSVourapukjaruJSheihamA.1996. Oral impacts affecting daily performance in a low dental disease Thai population. Community Dent Oral Epidemiol. Dec; 24(6):385-9. doi: 10.1111/j.1600-0528.1996.Tb00884.x. PMID: 9007354.
2.
Al-KhazaliHMAl-KhazaliSIljaziAChristensenRHAshinaSLiptonRBAminFMAshinaH.2023. Prevalence and clinical features of hemicrania continua in clinic-based studies: a systematic review and meta-analysis. Cephalalgia. 43(1):3331024221131343. https://doi.org/10.1177/03331024221131343.
3.
AranhaR.L.B., et al. 2020. Factors associated with toothache among Brazilian adults: a multilevel analysis. Braz Oral Res. 34: p. e036.
4.
ArantesR.FrazaoP.2018. Subjective oral symptoms associated with self-rated oral health among Indigenous groups in Central-West Brazil. Community Dent Oral Epidemiol.46(4): p. 352–359.
5.
ArdilaC.M.Agudelo-SuarezA.A.2016. Association between dental pain and caries: a multilevel analysis to evaluate the influence of contextual and individual factors in 34 843 adults. J Investig Clin Dent. 7(4): p. 410–416.
6.
Ayo-YusufIJNaidooS.2016. Social gradient in the cost of oral pain and related dental service utilisation among South African adults. BMC Oral Health. 16(1):117. https://doi.org/10.1186/s12903-016-0313-x.
7.
BastosJ.L.GiganteD.P.PeresK.G. 2008. Social gradient in the cost of oral pain and related dental, Toothache prevalence and associated factors: a population based study in southern Brazil. Oral Dis. 14(4): p. 320–6.
8.
BatistaMJLawrenceHPde Sousa MdaL.2014. Impact of tooth loss related to number and position on oral health quality of life among adults. Health Qual Life Outcomes. 12:165. https://doi.org/10.1186/s12955-014-0165-5.
9.
BushFMHarkinsSWHarringtonWGPriceDD. 1993. Analysis of gender effects on pain perception and symptom presentation in temporomandibular pain. Pain. 53(1):73–80.
10.
CavalheiroC.H., et al. 2016. Dental pain, use of dental services and oral health-related quality of life in southern Brazil. Braz Oral Res. 30(1).
11.
CohenL.A., et al. 2009. Toothache pain: behavioral impact and self-care strategies. Spec Care Dentist. 29(2): p. 85–95.
12.
ConstanteH.M.2020. Racial inequalities in public dental service utilization: Exploring individual and contextual determinants among middle-aged Brazilian adults. Community Dent Oral Epidemiol. 48(4): p. 302–308.
13.
ConstanteHMBastosJLPeresKGPeresMA. 2012. Socio-demographic and behavioural inequalities in the impact of dental pain among adults: a population-based study. Community Dent Oral Epidemiol. 40(6):498–506.
14.
ConstanteHMPeresMASchroederFCBastosJL. 2016. Mediators between education and dental pain: a cross-sectional study to assess the role of dental services utilization. Eur J Oral Sci. 124(1):62–67.
15.
ConstanteHM.2020. Racial inequalities in public dental service utilization: exploring individual and contextual determinants among middle-aged brazilian adults. Community Dent Oral Epidemiol. 48(4):302–308.
16.
de Barreto AranhaRLPintoRSde AbreuMHNGde Castro MartinsR.2020. Factors associated with toothache among Brazilian adults: a multilevel analysis. Braz Oral Res. 34:e036. https://doi.org/10.1590/1807-3107bor-2020.vol34.0036.
17.
da CunhaARBastosLFIserBPMMaltaDCde GoesPSAHugoFN. 2022. Toothache and tooth extraction as reasons for dental visits: an analysis of the 2019 National Health Survey. Braz Oral Res. 36:e070. https://doi.org/10.1590/1807-3107bor-2022.vol36.0070.
18.
de PinhoA.M., et al. 2012. Toothaches in the daily lives of Brazilian adults. Int J Environ Res Public Health. 9(8): p. 2587–600.
19.
de SiqueiraS.R.VilelaT.T.FlorindoA.A.2015. Prevalence of headache and orofacial pain in adults and elders in a Brazilian community: an epidemiological study. Gerodontology. 32(2): p. 123–31.
20.
De StefanoRBrunoAMuscatelloMRACedroCCicciuARulloRGaetaMFiorilloL.2020. Oral health and fibromyalgia syndrome: a systemic review. J Funct Morphol Kinesiol. 5(1):7. https://doi.org/10.3390/jfmk5010007.
21.
De ToledoIPConti RéusJFernandesMPorporattiALPeresMATakaschimaALinharesMNGuerraEDe Luca CantoG.2016. Prevalence of trigeminal neuralgia: a systematic review. J Am Dent Assoc. 147(7):570–576.
22.
Delgado-AnguloE.K.MangalM.BernabeE.2019. Socioeconomic inequalities in adult oral health across different ethnic groups in England. Health Qual Life Outcomes. 17(1): p. 85.
23.
DuncanRPGilbertGHPeekCWHeftMW.2003. The dynamics of toothache pain and dental services utilization: 24-month incidence. J Public Health Dent. Fall;63(4):227-34. doi: 10.1111/j.1752-7325.2003.Tb03504.x. PMID: 14682646.
24.
Favaro ZeolaLSoaresPVCunha-CruzJ.2019. Prevalence of dentin hypersensitivity: systematic review and meta-analysis. J Dent. 81:1–6.
25.
FDI World Dental Federation. 2017. FDI policy statement on minimal intervention dentistry (MID) for managing dental caries: adopted by the General Assembly: September 2016, Poznan, Poland. Int Dent J. 67(1):6–7.
26.
FillingimRBOhrbachRGreenspanJDKnottCDiatchenkoLDubnerRBairEBaraianCMackNSladeGD, et al. 2013. Psychological factors associated with development of TMD: the OPPERA prospective cohort study. J Pain. 14(12 suppl):T75–T90.
GouveaG.R., et al. 2018. Variables associated with the oral impact on daily performance of adults in the state of Sao Paulo: A population-based study. PLoS One. 13(9): p. e0203777.
29.
HafnerMBZanattaJRasera ZotelliVLBatistaMJSousa MdaL.2013. Perception of toothache in adults from state capitals and interior cities within the Brazilian geographic regions. BMC Oral Health. Jul31;13:35. doi: 10.1186/1472-6831-13-35. PMID: 23902872; PMCID: PMC3733821.
30.
Headache Classification Committee of the International Headache Society. 2013. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 33(9):629–808.
31.
HorstOVCunha-CruzJZhouLManningWManclLDeRouenTA. 2015. Prevalence of pain in the orofacial regions in patients visiting general dentists in the Northwest Practice-Based Research Collaborative in Evidence-Based DENTistry research network. J Am Dent Assoc. 146(10):721–728.
International classification of orofacial pain. 1st ed. 2020. Cephalalgia. 40(2):129–221.
34.
JamiesonL., et al. 2021. Oral health changes among Indigenous and non-Indigenous Australians: findings from two national oral health surveys. Aust Dent J.66Suppl 1: p. S48–S55.
35.
JeddyNNithyaSRadhikaT.2018. Dental anxiety and influencing factors: a cross-sectional questionnaire-based survey. Indian J Dent Res. 29(1):10–15.
36.
JouryE., et al. 2018. Burden of orofacial pain in a socially deprived and culturally diverse area of the United Kingdom. Pain. 159(7): p. 1235–1243.
37.
KakoeiSParirokhMNakhaeeNJamshidshiraziFRadMKakooeiS.2013. Prevalence of toothache and associated factors: a population-based study in southeast iran. Iran Endod J. Summer;8(3):123-8. Epub 2013 Aug 1. PMID: 23922574; PMCID: PMC3734515.
38.
KiselyS.NajmanJ.M.2022. A study of the association between psychiatric symptoms and oral health outcomes in a population-based birth cohort at 30-year-old follow-up. J Psychosom Res. 157: p. 110784.
39.
KuhnenM., et al. 2009. Toothache and associated factors in Brazilian adults: a cross-sectional population-based study. BMC Oral Health. 9: p. 7.
40.
LavigneGJSessleBJ. 2016. The neurobiology of orofacial pain and sleep and their interactions. J Dent Res. 95(10):1109–1116.
41.
LebelALescailleGAlajbegIAlajbegIBoucherY.2025. The role of stress in burning mouth syndrome triggered by dental treatments: a two-step hypothesis. J Oral Rehabil. 52(7):1001–1014.
42.
LeeJSSomermanMJ. 2018. The importance of oral health in comprehensive health care. JAMA. 320(4):339–340.
43.
LeeS.R., et al. 2022. Oral health status and behavior in elderly Koreans with periodontal disease. J Public Health Dent. 82(4): p. 378–384.
44.
LeungWSMcMillanASWongMC.2008. Chronic orofacial pain in southern Chinese people: experience, associated disability, and help-seeking response. J Orofac Pain. Fall;22(4):323–30. PMID: 19090405.
45.
LiptonJ.A.ShipJ.A.Larach-RobinsonD.1993. Estimated prevalence and distribution of reported orofacial pain in the United States. J Am Dent Assoc, 124(10): p. 115–21.
46.
LockerDGrushkaM.1987. The impact of dental and facial pain. J Dent Res. 66(9):1414–1417.
47.
LockerDGrushkaM.1987. Prevalence of oral and facial pain and discomfort: preliminary results of a mail survey. Community Dent Oral Epidemiol. Jun;15(3):169-72. doi: 10.1111/j.1600-0528.1987.Tb00508.x. PMID: 3474103.
48.
MacfarlaneTVGlennyAMWorthingtonHV. 2001. Systematic review of population-based epidemiological studies of oro-facial pain. J Dent. 29(7):451–467.
49.
ManskiRJMoellerJFChenHSchimmelJSt ClairPAPepperJV. 2014. Dental usage under changing economic conditions. J Public Health Dent. 74(1):1–12.
50.
MaulinaT.RachmiC.N.2020. The Association between Reported Dental Pain Symptoms and Increased BMI in Indonesia: Evidence From The Indonesian Family Life Survey. The Open Dentistry Journal. 14(1): p. 103–110.
51.
MomeniZ., et al. 2016. Dental pain and its determinants in an adult population in Tehran, Iran, Urban HEART-2. Community Dent Health. 33(3): p. 232–236.
52.
MonteroJBravoMVicenteMPGalindoMPLopez-ValverdeACasalsECortes-MartinicorenaFJLlodraJC.2011. Oral pain and eating problems in Spanish adults and elderly in the Spanish National Survey performed in 2005. J Orofac Pain. Spring;25(2):141–52. PMID: 21528121.
53.
MsyambozaK.P., et al. 2016. Magnitude of dental caries, missing and filled teeth in Malawi: National Oral Health Survey. BMC Oral Health. 16: p. 29.
54.
NaiduGMReddyVBKandregulaCRSattiNRAllareddySBabuRP. 2014. Self-reported and clinically diagnosed dental needs among institutionalized adults in Vijayawada: a cross-sectional study. J Int Soc Prev Community Dent. 4(1):35–39.
55.
NattoZSPetersenFFNiccolaQ.2014. The oral health status and the treatment needs in Chad: a pilot study. Niger Postgrad Med J. 21(3):245–249.
56.
NeedlemanIG.2002. A guide to systematic reviews. J Clin Periodontol. 29(suppl 3):6–9.
57.
OcwiaJ., et al. 2021. Oral health seeking behaviors of adults in Nebbi District, Uganda: a community-based survey. BMC Oral Health, 21(1): p. 453.
58.
OkunseriCHodgesJSBornD.2005. Self-reported toothache experience in an adult population in Benin City, Edo State, Nigeria. Oral Health Prev Dent. 3(2):119-25. PMID: 16173389.
59.
PauA.CroucherR.E.MarcenesW.2007. Demographic and socio-economic correlates of dental pain among adults in the United Kingdom, 1998. Br Dent J. 202(9): p. E21; discussion 548–9.
60.
PeiY., et al. 2022. Orofacial pain among Chinese older adults in the last year of life. Gerodontology. 39(4): p. 384-390.
61.
PengpidS.PeltzerK.2023. Poor Self-Rated Oral Health Status and Associated Factors Amongst Adults in Algeria. Int Dent J. 73(5): p. 701–708.
62.
PeresK.G., et al. 2019. Socioeconomic gradients in toothache experience among Australian adults: A time trend analysis from 1994 to 2013. Community Dent Oral Epidemiol. 47(4): p. 324–332.
63.
PeresMAIserBPMPeresKGMaltaDCAntunesJLF. 2012. Desigualdades contextuais e individuais da prevalência de dor dentária em adultos e idosos no Brasil. Cad Saúde Pública [Internet]. 28:s114–23. Available from: https://doi.org/10.1590/S0102-311X2012001300012
64.
PeresMAMacphersonLMDWeyantRJDalyBVenturelliRMathurMRListlSCelesteRKGuarnizo-HerrenoCCKearnsC, et al. 2019. Oral diseases: a global public health challenge. Lancet. 394(10194):249–260.
65.
RaittioE.HelakorpiS.SuominenA.L.2020. Age-period-cohort analysis of trends in toothache prevalence among 15- to 64-yr-old Finns over a 25-yr period. Eur J Oral Sci. 128(1): p. 66–73.
66.
RaittioEHelakorpiSSuominenAL. 2020. Age-period-cohort analysis of trends in toothache prevalence among 15- to 64-yr-old Finns over a 25-yr period. Eur J Oral Sci. 128(1):66–73.
67.
RavaghiVQuiñonezCAllisonPJ.2013. Oral pain and its covariates: findings of a Canadian population-based study. J Can Dent Assoc. 79:d3. PMID: 23522141.
68.
RileyJL3rdGilbertGHHeftMW.1998. Orofacial pain symptom prevalence: selective sex differences in the elderly?Pain. May;76(1-2):97-104. doi: 10.1016/s0304-3959(98)00030-x. PMID: 9696462.
69.
SalunkeSShahVOstbyeTGandhiAPhalguneDOgundareMOSableV.2019. Prevalence of dental caries, oral health awareness and treatment-seeking behavior of elderly population in rural Maharashtra. Indian J Dent Res. 30(3):332–336.
70.
SamaranayakeLPorntaveetusTTsoiJTuygunovN.2025. Facts and fallacies of the fluoride controversy: a contemporary perspective. Int Dent J. 75(4):100833. https://doi.org/10.1016/j.identj.2025.04.013.
71.
SangalliLSouzaLCLetraAShaddoxLIoannidouE.2023. Sex as a biological variable in oral diseases: evidence and future prospects. J Dent Res. 102(13):1395–1416.
72.
SantiagoBMValençaAMVettoreMV.2013. Social capital and dental pain in Brazi and dental pain in Brazilian northeast: a multilevel lian northeast: a multilevel cross-sectional study. BMC Oral Health. Jan4;13:2. doi: 10.1186/1472-6831-13-2. PMID: 23289932; PMCID: PMC3543847.
73.
SantosPSBarasuolJCMocceliniBSMagnoMBBolanMMartins-JuniorPAMaiaLCCardosoM.2022. Prevalence of toothache and associated factors in children and adolescents: a systematic review and meta-analysis. Clin Oral Investig. 26(2):1105–1119.
74.
ShaeferJRKhawajaSNBaviaPF. 2018. Sex, gender, and orofacial pain. Dent Clin North Am. 62(4):665–682.
75.
SipiläKTolvanenMMitrirattanakulSSitthisomwongPJärvelinMRTaanilaAAnttonenVLahtiS.2015. Orofacial pain and symptoms of temporomandibular disorders in Finnish and Thai populations. Acta Odontol Scand. Jul;73(5):330-5. doi: 10.3109/00016357.2014.949842. Epub 2015 Jan 23. PMID: 25613141.
76.
SoaresG.H., et al. 2021. Factors associated with utilisation of dental services by the elders from Sao Paulo, Brazil. Gerodontology.38(2): p. 216–227.
77.
SteinerTJStovnerLJ. 2023. Global epidemiology of migraine and its implications for public health and health policy. Nat Rev Neurol. 19(2):109–117.
78.
TraceyKJ.2002. The inflammatory reflex. Nature. 420(6917):853–859.
79.
ValesanLFDa-CasCDRéusJCDenardinACSGaranhaniRRBonottoDJanuzziEde SouzaBDM. 2021. Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clin Oral Investig. 25(2):441–453.
80.
VargasCMMacekMDMarcusSE.2000. Sociodemographic correlates of tooth pain among adults: United states, 1989. Pain. Mar;85(1–2):87–92. doi: 10.1016/s0304-3959(99)00250-x. PMID: 10692606.
WanS., et al. 2021. Prevalence of toothache in Chinese adults aged 65 years and above. Community Dent Oral Epidemiol. 49(6): p. 522–532.
83.
WanSYTaoLYLiuMLiuJ.2021. Prevalence of toothache in Chinese adults aged 65 years and above. Community Dent Oral Epidemiol. 49(6):522–532.
84.
WuLZhangSQZhaoLRenZHHuCY.2022b. Global, regional, and national burden of periodontitis from 1990 to 2019: results from the Global Burden Of Disease Study 2019. J Periodontol. 93(10):1445-1454.
85.
WuSZhangWYanJNomaNYoungAYanZ.2022. Worldwide prevalence estimates of burning mouth syndrome: a systematic review and meta-analysis. Oral Dis. 28(6):1431–1440.
86.
YangSEParkYGHanKKimSY. 2016. Association between dental pain and tooth loss with health-related quality of life: the Korea national health and nutrition examination survey: a population-based cohort study. Medicine (Baltimore). 95(35):e4707. https://doi.org/10.1097/md.0000000000004707.
87.
YangSEParkYGHanKMinJAKimSY. 2016. Dental pain related to quality of life and mental health in South Korean adults. Psychol Health Med. 21(8):981–992.
88.
ZieglerKAEngelhardtSCarnevaleDMcAlpineCSGuzikTJDimmelerSSwirskiFK. 2025. Neural mechanisms in cardiovascular health and disease. Circ Res. 136(11):1233–1261.
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