Durerea de dinți apare împreună cu umflătura.

Because -a at the end is the definite article attached to the noun.

• durere = pain
• durerea = the pain

Romanian usually puts the definite article at the end of the noun, unlike English, which uses a separate word like the.

So durerea de dinți literally means the tooth pain or more naturally the toothache.

In Romanian, toothache is commonly expressed as durere de dinți, literally pain of teeth or pain related to teeth.

Here, de links the type of pain to what it concerns:

• durere de cap = headache
• durere de spate = back pain
• durere de dinți = toothache

So de here is part of a very common pattern for naming kinds of pain.

Because Romanian normally uses the plural in this fixed expression: durere de dinți.

Even if only one tooth hurts, Romanian still usually says durere de dinți, not durere de dinte. This is just the standard idiomatic form, much like how languages often package these expressions in their own way.

Useful pair:

• dinte = tooth
• dinți = teeth

Apare is the 3rd person singular present tense of the verb a apărea, which means to appear, to show up, or in medical contexts to occur.

So here:

• a apărea = to appear / to occur
• apare = appears / occurs

It is singular because the subject, durerea, is singular.

Împreună cu means together with or along with.

• cu = with
• împreună cu = together with / along with

In this sentence, împreună cu makes the relationship clearer: the toothache appears at the same time as the swelling.

If you said only cu, the sentence might sound less precise or less natural in this context. Împreună cu emphasizes that the two symptoms come together.

Again, this is the definite article attached to the noun.

• umflătură = swelling
• umflătura = the swelling

So the sentence refers to a specific swelling, not just swelling in general.

They are related, but not always identical.

• umflătură usually means a swelling, often a visible swollen area
• umflare can mean swelling more generally, including the process or condition

In a medical-type sentence like this, umflătura sounds like the swelling as a symptom you can notice.

The given word order is natural and standard:

Durerea de dinți apare împreună cu umflătura.

Romanian word order is somewhat flexible, but not all versions sound equally natural.

This sentence starts with the subject durerea de dinți, then the verb apare, then the accompanying phrase împreună cu umflătura. That is a very normal structure.

A different order may be possible for emphasis, but the original is the safest version for learners.

A rough pronunciation guide is:

doo-REH-rah deh DEENTS ah-PAH-reh eem-pray-OO-nuh koo oom-floo-TOO-rah

A few important sounds:

• ă in durerea, împreună, umflătura is a short central vowel, somewhat like the a in sofa
• î in dinți and împreună is a close central sound that English does not really have
• ț in dinți sounds like ts
• ce/ci are not in this sentence, but ți here still ends with that ts sound

Because Romanian usually expresses definiteness with an article attached to the end of the noun.

In this sentence:

• durerea = the pain
• umflătura = the swelling

This is one of the big differences between Romanian and English. Instead of saying a separate word like the pain, Romanian says pain-the, so to speak.

Yes, depending on the context, English might say:

• appears
• occurs
• comes
• shows up

In symptom descriptions, Romanian apare is very common and often corresponds to English appears or occurs. If the meaning shown to the learner is something like The toothache comes along with the swelling, that is still a natural interpretation.