It is almost always the same story. Your tooth was a bit sore during the day, manageable enough to ignore. Then you lie down to sleep and the pain seems to turn itself up. If you have ever dealt with a toothache at night, you will know exactly how frustrating and exhausting it can be.
At Hocking Dental Care we hear this a lot, especially from parents and shift workers across Hocking, Wanneroo and the surrounding northern suburbs. The good news is there are reasons why pain behaves this way at night, and there are things you can do to get more comfortable until you can be seen. This guide walks through the common causes, what helps in the meantime, and the signs that mean you should not wait.
Why does a toothache at night feel worse?
A toothache rarely gets worse just because it is dark outside. What changes is your body position and how distracted you are.
When you lie flat, more blood flows towards your head. If a tooth is already irritated, inflamed or infected, that extra blood flow adds pressure inside and around the tooth. This can make a dull ache turn into a throbbing toothache at night that is hard to ignore.
On top of that, night time is quiet. There is no work, no conversation, no television to take your mind off things. Your brain has far less to focus on, so it pays much more attention to the signal coming from your tooth. The pain has not necessarily changed, but your awareness of it has.
Some people also clench or grind their teeth while asleep, which can add strain to a tooth that is already under pressure. Sinus congestion can play a part too, since the roots of your upper back teeth sit close to the sinuses, and lying down can increase that pressure as well.
Common toothache at night causes
There are a few dental problems that tend to show up or get worse once you are lying down. These include:
- Tooth decay that has reached the softer, nerve-filled part of the tooth
- A cracked or chipped tooth that is letting in air, food or temperature changes
- A dental abscess, which is a build-up of infection near the root of a tooth
- Gum inflammation or a piece of food trapped under the gum
- Teeth grinding or clenching overnight, which can leave teeth and jaw muscles sore
- A loose or failing filling that is exposing part of the tooth underneath
If you are only ever noticing pain at night, or a throbbing toothache at night that settles somewhat by morning, that pattern is still worth mentioning to us. It does not mean the problem is any less real just because it eases off once you are upright again.
Toothache at night: what to do until you can be seen
While you wait for an appointment, there are some simple things that may make the night more bearable. None of these fix the actual problem, but they can take the edge off.
Try an extra pillow
Propping your head up a little higher than usual can reduce the amount of blood pressure building up around the tooth. Many people find this takes some of the throb out of the pain, even if it does not remove it completely.
Use a cold compress
Holding a cold pack wrapped in a cloth against your cheek, rather than directly on your skin, can help settle swelling and take some sensation away from the area. Fifteen to twenty minutes at a time is usually enough.
Rinse with warm salt water
A gentle rinse with warm salty water can help clear away any trapped food and soothe irritated gum tissue around the sore tooth. It will not cure an infection, but it can make things feel a little cleaner and calmer.
Take care with pain relief
Over-the-counter pain relief can help in the short term. Always follow the directions on the pack, and if you are unsure what is suitable for you, ask your pharmacist. We are not able to give antibiotic advice over the phone, as the right treatment depends on what is actually causing the pain, which needs an examination.
Avoid obvious triggers
Steer clear of very hot, very cold or very sugary food and drink while the tooth is sore, and try not to chew on that side. These can all set off sharper pain in a tooth that is already inflamed.
When toothache at night is an emergency
Most toothaches, even miserable ones, can wait safely until you can get an appointment. But some signs mean you should not sit it out until morning. Seek urgent care at a hospital emergency department if you have:
- Swelling that is spreading into your face, neck or under your eye
- A fever along with your tooth pain
- Trouble breathing or swallowing
- Heavy bleeding from your mouth that will not stop
These are signs of a more serious infection that needs attention straight away, not something to manage at home.
For everything else, including a throbbing toothache at night that is keeping you up, a cracked tooth, or pain that keeps coming back, our emergency dentistry service is there to help. We will have a look, explain what we think is going on, and talk you through the options before anything is done.
What happens when you come in
At Hocking Dental Care, we take a toothache seriously, but we also try to keep the whole experience calm. We will ask about your pain, have a look with a digital x-ray if needed, and show you what we see using a camera on the screen beside the chair. You will get a written estimate with item numbers before any treatment goes ahead, so you know what to expect and can check it against your health fund if you have one.
If you are a preferred provider member with HBF, Medibank, HCF, nib or Bupa, we can process your claim on the spot through HICAPS, which usually means a smaller gap to pay. Other funds can still claim, just not on the spot in the same way. If your child is eligible for the Child Dental Benefits Schedule, or you are a DVA patient, it is worth checking the current rules on the Services Australia or DVA website, as we bill DVA patients directly.
If your pain happens when you bite down rather than mostly at night, it is worth reading our separate guide on toothache when biting down, which covers that pattern in more detail.
Frequently asked questions
Why does my tooth only hurt at night?
This usually comes down to lying flat, which increases blood flow and pressure around an already irritated tooth, combined with having fewer distractions to take your mind off it. It does not mean the problem only exists at night, just that it is easier to notice once things are quiet.
If you are a preferred provider member with HBF, Medibank, HCF, nib or Bupa, we can process your claim on the spot through HICAPS, which usually means a smaller gap to pay. Other funds can still claim, just not on the spot in the same way.
Can a toothache go away on its own?
Sometimes pain settles for a while, especially if swelling goes down or a piece of trapped food comes loose. This does not mean the underlying cause has gone. It is still worth having it checked, since problems like decay or infection do not fix themselves.
Is it okay to wait until morning with a toothache?
For milder pain without swelling, fever or breathing trouble, waiting until you can get an appointment is usually fine. If you notice spreading swelling, a fever, or trouble breathing or swallowing, you should seek urgent care at a hospital emergency department rather than waiting.
What painkillers can I take for a toothache at night?
Over-the-counter pain relief can help in the meantime. Always follow the directions on the pack, and ask your pharmacist if you are unsure what is suitable for you or whether it is safe alongside anything else you take.
Should I see a dentist even if the pain has eased?
Yes. Toothache that comes and goes often points to a problem that is still there, even when it is not hurting. Having it looked at early can mean simpler treatment than waiting until it flares up again.
If a toothache at night has been keeping you up, our team at Hocking Dental Care is here to help you work out what is going on and what to do next. You can find out more about becoming a new patient, check details on our contact page, choose a time that suits you by booking online, or call us on (08) 9306 2755. You can also book an appointment online whenever it suits you.
