Toothache in Tokyo – Pain Relief & Dental Referral

Is This You?

It’s 1 AM in your Asakusa hotel room. The pain started as a dull ache after dinner and is now a hot, throbbing pulse on one side of your jaw that worsens every time you lie flat. Cold water, hot water, pressing on your cheek — nothing helps. Tomorrow was supposed to be Senso-ji at sunrise. Instead you are awake, wondering whether any dentist here will see a foreigner, and how you get through the next six hours.

This page is written for exactly that moment: what you can safely do tonight, how to tell a tooth problem that can wait for a dental appointment from a spreading infection that cannot, and how Japan International Clinic ASAKUSA fits in — honestly, including what we cannot do.

Important: We Are a Medical Clinic, Not a Dental Clinic

Before anything else, because your time and money matter: in Japan, dentistry (歯科 / shika) is a separate licence and a separate type of clinic from general medicine. We are an internal medicine and travel medicine clinic. That means:

• We cannot drill or fill a cavity, place a crown, perform a root canal, extract a tooth, or take dental X-rays. We have chest X-ray equipment for general medicine, but not the dental X-ray equipment a dentist uses to see inside a tooth.
• We can assess your pain, examine your mouth and face for signs of infection, check your temperature and general condition, rule non-dental causes in or out, provide prescription pain relief, and — where the doctor judges a bacterial infection is present — prescribe antibiotics.
• We can write a referral letter (紹介状 / shōkaijō) to a dental clinic and call ahead on your behalf, so you arrive somewhere expecting you rather than cold-calling clinics in Japanese. The referral letter costs ¥11,000 on top of the consultation fee.

If a dental clinic is open and can take you, going straight there is the fastest route to fixing the tooth. Coming to us makes sense outside dental hours, when you cannot find anywhere that will see you in English, when pain needs controlling before you can function, or when there are signs the problem has spread beyond the tooth. For how Japanese dental care works — costs, insurance, finding an English-speaking dentist — see our guide: Visiting a Dentist in Japan as a Foreigner.

What Is Actually Causing the Pain?

Toothache is a symptom, not a diagnosis. Only a dentist with imaging can confirm the cause, but knowing the possibilities helps you describe the pain clearly.

Inflamed pulp (pulpitis)

The classic “can’t sleep” toothache. Deep decay or a crack lets bacteria reach the nerve inside the tooth. Pain is often spontaneous, throbbing, worse lying down, and may radiate to the ear or temple. Over-the-counter painkillers often take the edge off without resolving the cause, so this is one to have looked at rather than wait out.

Dental abscess

Infection at the root tip or in the gum: a swollen, tender gum, a bad taste, pain on biting, or a feeling that the tooth sits “taller” than the others. Facial swelling means it is spreading — see the severity guide below.

Cracks, worn enamel, and failed dental work

Sharp pain from cold or sweetness that stops within seconds points to exposed dentin. Pain on releasing a bite suggests a crack — and Japan is full of genuinely hard food: senbei, konbini ice, unexpectedly bony karaage. A filling or crown that falls out leaves a surface extremely sensitive to air and cold.

Wisdom tooth inflammation (pericoronitis)

The gum flap over a partially erupted back molar becomes swollen and infected: pain at the very back of the jaw, difficulty opening the mouth, sometimes cheek swelling. Travel exhaustion often precedes a flare-up.

Clenching and grinding (bruxism)

Long-haul flights, unfamiliar pillows, and jet lag are a reliable recipe for night-time clenching: a dull ache across several teeth and a sore jaw rather than one sharply painful tooth.

When a “Toothache” Is Not a Tooth

This is one of the genuinely useful things a general physician can do for you. Several non-dental conditions produce pain that feels exactly like a bad tooth, and dental treatment will not fix them.

• Sinusitis. The roots of the upper back teeth sit close to the maxillary sinus, so sinus inflammation — often after a cold or flu — can make several upper teeth ache at once, typically worse when you bend forward.
• Jaw joint (TMJ) problems. Pain in front of the ear, clicking, pain on chewing — closer to the muscle and joint pain pattern than to a tooth.
• Ear infections, and less often nerve pain such as trigeminal neuralgia.
• Barodontalgia — “airplane tooth pain.” Cabin pressure changes can make an existing cavity or recent dental work suddenly painful during descent. If your pain began on the flight, mention that.
• Referred cardiac pain. Rarely, jaw or lower-tooth pain is the presenting symptom of a heart problem, particularly alongside chest pressure, breathlessness, cold sweating, or nausea. That combination is a 119 call, not a dental appointment.

Getting Through Tonight: What You Can Safely Do

None of this treats the underlying problem, but it can make the hours until a dental appointment bearable.

Pain relief from a Japanese pharmacy

Over-the-counter anti-inflammatory painkillers are the mainstay. Ibuprofen products such as イブ (EVE) and acetaminophen products such as タイレノールA (Tylenol A) are sold at drugstores (ドラッグストア) without a prescription. ロキソニンS (Loxonin S) is stronger, but falls into a pharmacist-only category and can only be sold while a licensed pharmacist is on duty — late at night, many stores can sell the weaker categories only.

Practical points that catch travellers out:

• Do not count on a convenience store at 2 AM. Some konbini carry a limited range of medicines, but many do not, and the stronger categories are not sold there.
• Do not exceed the dose on the box, and do not double up on two products containing the same ingredient — Japanese combination cold and headache remedies often already contain ibuprofen or acetaminophen.
• Do not place aspirin or any tablet directly against the gum. It does not reach the nerve and can cause a chemical burn of the soft tissue. Alcohol is not a substitute either — it worsens swelling and interacts with several medications.
• If you take regular medication or are pregnant, check compatibility before adding anything new. See our medication guidance if you also need a refill in Japan.

Non-drug measures

• Sleep propped up. Many people find throbbing eases when the head is raised rather than flat.
• Cold on the outside of the cheek — a cooling sheet (冷却シート) or wrapped ice pack, 15–20 minutes at a time. Avoid heat on the face if there is swelling.
• Warm salt-water rinses — half a teaspoon of salt in a cup of warm water, swished gently.
• Keep the area clean. Brush gently and floss carefully — trapped food is a common cause of sudden severe pain that stops the moment it is removed.
• Avoid triggers: very hot, very cold, hard, and sugary foods; chew on the other side.
• Do not poke at the tooth with a pin, wire, or toothpick, and do not try to extract anything yourself.

How Urgent Is It? A Severity Guide

What Happens If You Come to Us

Everything is conducted in English directly by the doctor — no interpreter in the middle.

1. History. When it started, what makes it better or worse, recent dental work, what you have already taken, allergies, and regular medications.
2. Examination. We look in your mouth, check the gum and face for swelling and tenderness, assess lymph nodes and jaw movement, and take your temperature. We also check the sinuses, ears, and jaw joint — the common non-dental causes.
3. Assessment. The doctor explains what appears to be going on, how urgent it is, and what the realistic options are. We do not pretend to give a dental diagnosis — that needs a dentist and imaging.
4. Treatment of symptoms. Prescription pain relief, and antibiotics if the doctor judges a bacterial infection warrants them. Medication is provided at the clinic, so there is no separate pharmacy trip.
5. Referral. A referral letter (¥11,000) describing the findings and what has been given, plus a call to the receiving clinic to confirm they can take you.
6. Documentation. English receipts and, if you need one, a medical certificate for your insurance claim.

Cost, Insurance, and Paperwork

Our fee is ¥33,000 — consultation, examination, and an English medical certificate if required. A prescription is an additional ¥11,000. A referral letter is an additional ¥11,000. No hidden charges. You do not need Japanese national health insurance; patients are treated on a self-pay basis, and we can issue English-language receipts and an English medical certificate to support an insurance claim.

This covers our medical consultation; any dental treatment you go on to receive is billed separately by the dental clinic. Travel insurance policies often treat emergency dental pain differently from routine dental care, with its own sub-limit — check your policy wording and keep every receipt. Our insurance claim guide covers the documents you will need; the dentist guide covers typical Japanese dental prices.

Useful Japanese for a Toothache

Show these on your phone at a pharmacy counter or a dental reception desk:

• 歯が痛くて眠れません — Ha ga itakute nemuremasen — “My tooth hurts so much I can’t sleep.”
• 痛み止めをください — Itamidome o kudasai — “Painkillers, please.”
• 頬が腫れています — Hoho ga harete imasu — “My cheek is swollen.”
• 今日診てもらえますか？ — Kyō mite moraemasu ka? — “Can I be seen today?”

Our printable pharmacy phrase card is also worth having on your phone.

Avoiding This on Your Next Trip

• Have a dental check before a long trip. A cavity that is silent at sea level can announce itself on the descent into Haneda.
• Pack floss, your usual painkiller, and your night guard if you grind — and go carefully with senbei, hard candy, ice, mochi, and bones in izakaya dishes.

Frequently Asked Questions

Can you pull my tooth or fill the cavity?

No. We are a medical clinic, not a dental clinic, and in Japan those are separate licences and separate facilities. We do not perform extractions, fillings, or root canals, and we have no dental X-ray equipment on site. What we can do is assess you, control the pain, treat infection where the doctor judges it necessary, and write a referral letter to a dental clinic (¥11,000), contacting them on your behalf so you are expected when you arrive.

My tooth hurts and it is the middle of the night. What should I do right now?

Take an OTC painkiller at the labelled dose if you have one and it is safe for you, sleep propped up on extra pillows, apply something cold to the outside of the cheek, rinse gently with warm salt water, and avoid hot, cold, hard, and sugary foods. Do not put a tablet against the gum. If swelling is spreading across your face or neck, you cannot swallow properly, or you have a fever with facial swelling, call 119 rather than waiting for morning. Otherwise, we open at 9:00 and take walk-ins every day.

Will antibiotics fix my toothache?

Antibiotics can control a spreading bacterial infection, but they do not repair the tooth and are not appropriate for every toothache — pain from an inflamed nerve, a crack, or exposed dentin will not respond to them. Whether they are indicated is a judgement the doctor makes from your examination findings. Even when prescribed, they buy time and reduce risk; the tooth itself still needs a dentist.

Do I need an appointment, and is the consultation really in English?

No appointment is required — walk in any day between 9:00 and 19:00, including weekends and public holidays, or book in advance if you prefer. Consultations are conducted in English directly by the doctor, not through an interpreter, and our staff also assist in Chinese, Korean, and Japanese. Our first visit guide explains what to bring.

Is it worth coming to you at all, instead of just finding a dentist?

If you can get a dental appointment promptly and communication is not a barrier, going straight to the dentist is the more direct route, and we will tell you so. Our value lies around that: pain that needs controlling now, signs an infection has moved beyond the tooth, uncertainty about whether the pain is even dental, English documentation for an insurance claim, or simply needing someone to make the arrangements in Japanese. That is what our referral network is for.

Don’t Spend Another Night Like This

A toothache does not have to end your trip — but it will not fix itself either. Come in, get the pain under control, and leave with a plan and an appointment.

Japan International Clinic ASAKUSA
1-minute walk from Asakusa Station | Open 9:00–19:00, every day of the year
English · Chinese · Korean · Japanese | Walk-ins welcome
Basic Medical Consultation ¥33,000 | Prescription +¥11,000 | Referral letter +¥11,000

Related Pages

• Visiting a Dentist in Japan as a Foreigner — Costs, Insurance & Finding an English-Speaking Clinic
• All Symptoms We Treat
• Headache & Dizziness
• Our Referral Network
• Insurance Claim Guide
• First Visit Guide
• Clinic Access & Directions
• Contact Us