Immediate observations (zoomed image review)

-A metallic structure is visible on the lower posterior tooth area (looks like a crown/abutment or large restoration).

-The occlusal surfaces of adjacent molars show brown staining and pits consistent with caries (decay).

-The local gum tissue is mildly red and slightly swollen near the affected tooth — a sign of inflammation.

-No large facial swelling is obvious in the image, but the tissue around the tooth looks tender when manipulated (you reported pain).

Most likely causes of the pain (ranked)

1. Deep caries reaching the pulp → acute pulpitis (tooth nerve inflammation) — very common cause of severe tooth pain.

2. Failed/ leaking restoration or crown (the metal visible) allowing bacteria to enter under it → reinfection of the tooth or root.

3. Periapical abscess (infection at the root tip) beginning to form — often causes continuous pain and tenderness.

4. Cracked tooth / vertical fracture — can cause sharp pain on biting and persistent discomfort.

5. Localized gingival infection / food impaction exacerbating the pain.

Tests the dentist will do (next visit)

• Periapical X-ray (or CBCT if available) to see root and bone involvement.

• Pulp vitality tests (cold/electric) to check nerve status.

• Percussion and bite tests to localize the painful tooth.

• Clinical inspection for cracks and a probe for periodontal pockets.

Best immediate actions you can take (home care)

• Avoid chewing on that side.

• Rinse gently with warm salt water (1 tsp salt / cup warm water) 3× daily.

• Over-the-counter analgesics: ibuprofen (if tolerated) or paracetamol/acetaminophen for pain control — follow dosing on the pack or your doctor’s advice.

• Do not try to remove or pry at the restoration yourself.

• If you have a dentist’s phone number, call for an urgent appointment.

Definitive clinical solutions (likely)

• If pulp is infected but tooth restorable → Root canal treatment (RCT) followed by a new crown.

• If the restoration/crown is failing → remove/replace the crown and assess underlying tooth; RCT if pulp involvement.

• If tooth is non-restorable or fractured → extraction followed by socket management and options for replacement (bridge/implant) later.

• If abscess present → drainage + antibiotics (antibiotics only if systemic signs or spreading infection; dentist will decide type/dose).

• Occlusal adjustment if bite is stressing the tooth.

Typical healing / timeframes

• Pain relief with analgesics: hours (temporary).

• Symptom improvement after drainage/antibiotic (if needed): 24–72 hours.

• Root canal completion & initial recovery: 1–2 weeks to feel much better; full comfort may take several weeks.

• Extraction soft-tissue healing: 1–2 weeks (bone remodels over months).

• If a crown/definitive restoration is placed: allow 1–2 weeks after final cementation for full comfort.

If NOT treated within 14 days — likely progression

• Pain will often increase and become constant.

• Local infection can progress to a dental abscess with pus, swelling, and bad taste/odor.

• Infection can spread to adjacent teeth and bone (osteomyelitis) or cause a significant facial swelling.

• Increased risk of tooth loss, more complex surgery, and longer healing times.

• Rare but serious: spread of infection beyond oral tissues (seek emergency care for facial swelling, fever, breathing or swallowing difficulties).

Urgent warning signs — get immediate care if you have:

• Increasing facial swelling or rapidly spreading redness

• Fever, difficulty breathing or swallowing

• Severe uncontrolled pain or inability to open mouth

Practical next steps (recommended)

1. Call and book an urgent dental appointment today.

2. Ask the clinic to take an X-ray and prioritize a possible endodontic (root canal) exam.

3. Follow home-care measures until you are seen.

Find a nearby clinic here:
https://cebudentalimplants.com/map-dental-clinic

Comment

This looks like a tooth that needs professional attention soon — most likely deep decay or a failing restoration with pulp involvement. Acting within the next few days to a week greatly increases the chance of saving the tooth with a root canal and new crown, and avoids an abscess or extraction. If you want, I can draft a short message you can send to a clinic to book an “urgent exam + X-ray” — ready to paste in the clinic’s contact form.