Why Is Toothache Worse at Night?

Key takeaways

• Lying flat raises pressure in an irritated tooth, and a quiet room makes pain easier to notice.
• Grinding or clenching in your sleep can cause or worsen tooth and jaw soreness.
• Home steps like a salt water rinse, a cold compress and an extra pillow may help you get through the night.
• Swelling, fever or pain that will not settle can mean infection and should be seen promptly.
• Same-day emergency care is available, and walk-ins are welcome.

Why is toothache worse at night?

Toothache feels worse at night mainly because lying flat changes blood flow to your head, and because nothing else is competing for your attention. Both make an already irritated tooth feel louder.

Inside every tooth is soft tissue called the pulp, which holds nerves and blood vessels. When a cavity, crack or infection irritates that tissue, it swells. The tooth is hard on every side, so the swelling has nowhere to go and pressure builds.

When you stand or sit, gravity helps draw blood away from your head. When you lie down, more blood reaches the head and face, and the pressure inside a sore tooth can rise. That throbbing you feel against the pillow is often this pressure.

A few other things can make the night harder:

• Fewer distractions. Work, screens and conversation pull your attention away during the day. In a quiet, dark room, pain is easier to notice.
• Clenching or grinding. Many people squeeze or grind their teeth in their sleep, which can aggravate a tooth that is already sore.
• Stress and tiredness. Worry and poor sleep can make pain feel more intense.

Can grinding your teeth at night cause or worsen a toothache?

Yes. Clenching and grinding put steady pressure on your teeth and jaw muscles, which can leave teeth sore, sensitive or achy in the morning. It can also make an existing problem, like a cracked tooth, feel worse.

Because grinding happens while you sleep, many people do not know they do it. Clues include a sore jaw when you wake up, a dull headache around the temples, teeth that look flat or worn, or a partner who hears grinding. A dentist can look for wear patterns during an exam.

Grinding pain tends to feel like a general ache across several teeth or the jaw. Pain from a single tooth that throbs, reacts to hot or cold, or hurts when you bite more often points to a problem inside that tooth, such as decay or infection. Only an exam can tell the two apart.

How do you get rid of a toothache at night?

You can often take the edge off a toothache at home for a night, but home care only eases symptoms. It does not fix the cause, so plan to see a dentist soon.

1. Rinse gently with warm salt water. Stir about half a teaspoon of salt into a glass of warm water, swish and spit. This can calm irritated gums and clear out food debris.
2. Floss carefully. A bit of food wedged between teeth can cause real pain, and gentle flossing sometimes removes it.
3. Use a cold compress. Hold a cold pack wrapped in a cloth against your cheek for short periods. It can ease throbbing and swelling.
4. Prop your head up. An extra pillow or two keeps your head higher than your chest, which may reduce the pressure that builds when lying flat.
5. Take an over-the-counter pain reliever. Follow the label, and check with a pharmacist or your doctor if you have health conditions or take other medicines.

Avoid placing aspirin directly on the gum, which can burn the tissue. Skip very hot, cold or sugary foods and drinks before bed. These steps are meant to get you to morning, not to replace care.

How do you stop grinding your teeth at night?

The most reliable way to protect your teeth from grinding is a custom-fitted night guard made by a dentist. Home habits can help with the stress and routines that often go along with grinding, but they do not physically protect your teeth.

If you want to try things at home, or you are waiting on a night guard, these may help:

• Cut back on caffeine and alcohol in the evening, since both can disturb sleep.
• Build a wind-down routine, such as a warm shower, stretching or quiet reading.
• Rest a warm, damp cloth on your jaw muscles before bed to help them relax.
• During the day, notice whether your teeth are touching. A relaxed jaw has lips closed and teeth slightly apart.
• Avoid chewing gum and pen caps, which keep the jaw muscles working.

Without protection, grinding can keep wearing down enamel over time. If you wake with jaw soreness or tooth pain, mention it at your next visit so a dentist can check for wear.

How do you stop a child from grinding their teeth at night?

Many children grind their teeth in their sleep, and it is worth mentioning to a dentist. Home steps focus on helping your child relax and looking for possible causes.

A calm, predictable bedtime routine helps: dim lights, a bath, a story and no screens close to sleep. Limit sugary or caffeinated drinks in the evening. Gently ask whether anything is worrying them, since stress at school or changes at home can play a part.

Ask a dentist to look at your child's teeth if you notice worn tips, complaints of jaw or tooth soreness, or grinding that is loud and frequent. A dentist can tell you whether it simply needs watching or whether a protective option makes sense. If a child has a toothache at night, treat it as you would for an adult and arrange a dental visit.

When is a nighttime toothache a dental emergency?

A toothache is urgent when it comes with facial swelling, fever, a pimple-like bump on the gum, a bad taste, or pain that keeps you awake despite basic care. These can be signs of an abscess, an infection that needs a dentist's attention. Trouble swallowing or breathing is more serious and calls for the emergency room right away.

Not sure where your situation falls? Our overview of what is considered a dental emergency covers common cases, such as a cracked tooth, a knocked-out tooth and severe pain.

Antibiotics may be part of treatment when there is infection, but the source of the problem usually still needs dental care. Waiting for the pain to go away on its own can let an infected tooth get worse, even if the ache fades for a while.

You do not need to wait for a perfect moment to call. Our team offers same-day emergency care, and walk-ins are welcome. You can learn more about our emergency dentist services, or call the Peoria, North Phoenix or Metro office to ask about the next opening, since hours vary by location.

What will a dentist do about a toothache that is worse at night?

A dentist will find the cause first, then recommend the simplest treatment that solves it. You will get a clear explanation of what is going on before anything begins.

The visit usually starts with questions about when the pain happens, what triggers it and how long it lasts. Next comes an exam, often with X-rays, and simple tests such as tapping on the tooth or checking how it responds to cold. Common findings and treatments include:

• A cavity: usually a tooth-colored filling.
• A cracked or heavily damaged tooth: often a crown, or sometimes removal.
• Infected or inflamed pulp: a root canal, which removes the damaged tissue. Anesthesia is used so you stay comfortable.
• An abscess: treating the source of the infection, which may include drainage or an extraction.
• Grinding: a night guard to protect your teeth.

Worries about cost should not keep you at home in pain. We accept most major dental PPO plans, and for people without insurance we offer CareCredit, in-house payment plans and the Ultra Discounts plan. Our team can walk you through your options before treatment starts.

This article is general education, not a diagnosis. A dentist can advise on your own situation whenever you are ready to come in.

Part of our Dental emergencies articles.

Sources

1. Dental emergencies, American Dental Association (MouthHealthy)
2. Abscess, American Dental Association (MouthHealthy)
3. Tooth Disorders, MedlinePlus (National Library of Medicine, NIH)