Why is toothache worse at night? What to do when tooth pain starts at night
There are several reasons toothache gets worse at night: lying down increases blood flow to the head and raises the pressure inside an inflamed tooth, there are fewer distractions so the pain feels stronger, and painkillers taken during the day wear off. In some people, clenching during sleep adds to the pain. Raising your head on an extra pillow, taking painkillers as directed and using a cold compress on your cheek can help you through the night. Throbbing pain that gets worse at night usually means the tooth's nerve is inflamed, so you should be seen the next day.
Why does toothache get worse at night?
- Lying down: When you lie flat, more blood flows to your head. Because the inside of a tooth is enclosed by hard tissue, pressure in an inflamed nerve rises easily and the throbbing gets worse.
- No distractions: During the day, work, conversation and moving about keep pain in the background; in the quiet of the night it feels more intense.
- Painkillers wearing off: Medicine taken during the day may lose its effect around midnight.
- Clenching: Clenching during sleep puts extra load on a tooth that is already sensitive. See teeth clenching and grinding.
- Blocked sinuses: Lying down can increase sinus pressure, which may feel like pain in the upper back teeth. See can sinusitis cause toothache.
What helps at night
- Sleep with your head raised on an extra pillow or two.
- Before bed, take a painkiller at the dose on the leaflet. See which painkiller is best for toothache.
- Apply a cold compress to the outside of your cheek for 15–20 minutes at a time.
- Rinse gently with warm salt water; if food is stuck between your teeth, floss carefully. See food getting stuck between teeth.
- Avoid very hot, very cold and sugary food and drinks before bed.
- Don't chew on the painful side.
We cover other things you can do at home, and what to avoid, in how to relieve toothache.
What night-time pain can tell you
| What the pain is like | Likely cause | When to be seen |
|---|---|---|
| A twinge with cold that passes in seconds | Sensitivity, early decay | Within a few days |
| Throbbing that starts on its own and wakes you | Inflamed nerve | The next day |
| Worse when biting, tooth feels “raised” | Inflammation at the root tip | The next day |
| With jaw and temple pain in the morning | Clenching | Within a few days |
| Pain with a fever or facial swelling | Abscess | The same day; see can toothache cause a fever |
What to avoid with night-time toothache
- Don't put aspirin on the gum or the tooth; it burns the tissue.
- Don't take more than the recommended dose of painkillers or mix different ones at random.
- Don't start an old course of antibiotics you have at home. See do antibiotics cure toothache.
- If there is swelling, don't put heat on your cheek.
- Don't rub alcohol or cologne on the tooth.
What if the pain has gone by morning?
It's common for pain that was severe at night to ease by morning, but that doesn't mean the problem has gone. Inflammation in the nerve can progress and come back a few days later with stronger pain or swelling. Seen early, a tooth can often be saved with simpler treatment. We explain when root canal treatment is needed in root canal treatment.
Next-day appointments in Beylikdüzü
Dent32 is open seven days a week; if toothache starts at night, you can call in the morning and ask for a same-day appointment. For nights and public holidays, see emergency dentists in Beylikdüzü, and for weekends, weekend dental clinic.
Dent32 is at Barış Mah., Ginza Lavinya, E-5 Yanyolu No:30 D:179, 34520 Beylikdüzü, Istanbul and is open seven days a week. To book, call or WhatsApp +90 555 011 33 68, or use our contact page. At the examination we share the findings, the options and the approximate cost in writing; you are under no obligation to start treatment afterwards.
Frequently asked questions
Why is toothache worse at night?
Lying down increases blood flow to the head and raises the pressure inside an inflamed tooth; there are also fewer distractions, so pain feels stronger, and daytime painkillers wear off.
How can I sleep with toothache?
Raise your head on an extra pillow, take a painkiller at the dose on the leaflet before bed and use a cold compress on your cheek. Avoid very hot, cold and sugary things before bed.
Do I need to go to A&E for toothache that starts at night?
If there's no fever, no swelling spreading to the face or neck and no trouble swallowing or breathing, seeing a dentist the next day is usually enough. If you have any of these, go to A&E without waiting.
My toothache had gone by morning. Should I still go?
Yes. Pain that gets worse at night is often a sign of an inflamed nerve and can come back more strongly a few days later; it's easier to save the tooth if it's seen early.
Is heat or cold better for toothache at night?
A cold compress on the outside of the cheek usually helps more. Don't use heat if there is swelling.
