Night-time toothache is undoubtedly one of the worst and most unbearable types of pain. At night, people want to rest, their pain threshold is lower, and they tolerate pain much less well.

However, this is only one of the reasons why toothache at night feels much more unpleasant, and even more intense, than during the day.

It can be listed among common dental complaints and may manifest in various forms. Some describe it as a mild, throbbing pain, while for others it is intense and splitting, but there are also those who only experience it at night and not at all during the day.

Why is toothache so common at night? What can we do about it at home? When is it actually necessary to dentist Can we help? We've answered all your questions in this article!

Why is toothache worse at night?

Contrary to popular belief, one of the most common reasons for the onset and unbearable nature of toothache at night is not exhaustion, nor is it that people are more sensitive to pain at this time.

Naturally, this also contributes, but in reality, we find toothaches much more unpleasant and agonising at night because we are lying down. In this body position, blood flow changes, meaning more blood goes to the head than during the day, when we are usually sitting or standing.

The larger volume of blood increases pressure and tends to exacerbate dental problems associated with some form of inflammation. This is why toothache at night is often accompanied by throbbing, which can be linked to the impulses generated by the heart.

The sleeping position can also aggravate toothache at night.

Regarding the topic, we consider it important to highlight that toothache experienced at night can also be influenced by body position.

For example, those who sleep without a pillow may often experience it more intensely than those who rest with their heads raised.

During horizontal positioning, enormous pressure is placed on the teeth and jaw, which can cause much greater pain in case of inflammation or infection.

If you frequently wake up at night with toothache, but don't experience it during the day, it's worth adjusting your sleeping position and elevating your head. This minimises blood flow to the affected area and can alleviate symptoms until you can visit the dentist.

Causes of toothache at night

So, it will have become apparent from the above that lying down and body position can significantly affect toothache at night. However, we haven't yet discussed what the actual causes of the pain might be.

It is important to note that only a dentist can provide an accurate diagnosis in all cases, but based on our experience, the following factors are usually behind toothache that is also painful at night:

• Tooth decay During tooth decay, the outer enamel layer of the teeth thins, gets damaged, and disappears in several places, leaving the sensitive inner part underneath vulnerable. This often causes only mild sensitivity during the day, but can trigger severe pain at night.
• Infected gums Infected gums often hurt more during the night because when you lie down, more blood rushes to the affected area, and increased blood flow also intensifies the pain.
• Abscess: An abscess is a very serious dental infection, which can also frequently worsen during the night. It is easily recognisable as it often causes significant swelling and fever.
• Broken tooth In a similar way to tooth decay, the inner, sensitive layer of a broken or cracked tooth becomes completely vulnerable, which can be exacerbated, especially when lying down and thus during the night.
• Non-dental problems It should be mentioned that toothache – particularly during the night – can also be caused by non-dental problems such as sinusitis or otitis media, as well as neurological conditions.

Relieving toothache at night

Alleviating toothache at night is often a very difficult task, because as it turns out from the above:

• In the background, a more serious change could also be hidden,
• and posture can both affect its appearance and intensity.

If you are suffering from toothache at night, you can do the following to alleviate the discomfort:

Painkiller use

This is obviously something the average person would think of, yet we consider it important to highlight some information here.

The first thing is to exclusively use over-the-counter preparations, so in most cases, medications containing ibuprofen can quickly and effectively relieve toothache, even at night.

However, before use, it is always recommended to read the patient information leaflet and follow the dosage recommendations. Deviating from this or using stronger painkillers should only be done on medical advice!

Cold compress

If the painkillers aren't working, it's worth applying a cold compress to ease the toothache, and even an ice pack can be advisable if you can bear it.

To do this, all you need is a frozen ice pack – or any frozen food – wrapped in a towel, and then held against the painful area from the outside.

The method's effectiveness comes from the fact that the cold constricts the blood vessels in the affected area, thereby reducing pain, thus helping the patient to fall asleep.

Cold compresses are also beneficial for prevention. If you apply cold compresses to the affected area for 15-20 minutes one to two hours before going to bed, it can prevent the onset of pain, thus ensuring a restful night's sleep.

Change sleeping position

As we've already pointed out above: sleeping position can also negatively affect toothache during the night, as blood flow to the head increases, which can intensify inflammation and pain.

It is therefore worth lifting your head at night, using an extra pillow, or going to sleep in a semi-sitting position, which can alleviate the pain so much that it even aids sleep.

Saltwater gargle

Another pocket-friendly trick for a toothache at night is to rinse with salt water, which is one of the most effective methods among our grandparents' home remedies.

It is effective because salt water is a natural antibacterial agent, which reduces inflammation and protects teeth from developing or worsening infections.

Moreover, rinsing with salt water helps to remove any leftover food particles from between your teeth, which can help to reduce pain by improving oral hygiene.

Pain-relieving gum gel

The science of pain relief today covers an extremely wide range, so there are, for example, special gum gels that can locally alleviate toothache.

These gels are available over the counter, have a short duration of action, and most often cause numbness, but they are still worth using as an additional treatment for sleep, or until the oral painkiller takes effect.

Rinsing with hydrogen peroxide mouthwash

We left this to the very end, as hydrogen peroxide mouthwash is not typically found in households, but if it were, and the toothache was caused by gum infection or periodontal disease, then it might be worth using.

However, it is important not to use these types of preparations at your own discretion, but to always follow the instructions in the patient leaflet or from your doctor precisely, as maintaining the correct mixing ratio is crucial.

When should we see a dentist with toothache at night?

If someone experiences mild toothache at night that responds well to painkillers and does not return the next day, it generally does not require a dental examination.

In all cases, however, it is advisable to see a dentist immediately if

• the pain is unbearably severe, throbbing, and does not respond to any home remedies, or it keeps coming back regularly;
• The night-time toothache is accompanied by swelling, fever and associated general malaise.;
• chewing, swallowing, speaking, and even breathing are causing difficulty;
• The pain is no longer limited to nighttime, but is also present during the day.

Frequently asked questions

Can night-time toothache occur for no reason?

In most cases, no. It may not be a dental emergency yet, but pain most often indicates that some problem has developed in the oral cavity.

What does it mean if a toothache is accompanied by throbbing at night?

Usually, that the dental problem causing the pain is associated with some kind of infection or inflammation.

What does a dull ache at night mean?

If you experience a dull ache in your mouth at night around a tooth, it most often suggests a chronic condition, such as inflammation, but it's also possible that the patient grinds their teeth during sleep.

Can gingivitis also cause tooth pain at night?

Although in most cases it does not cause significant pain, in advanced stages it can also cause such discomfort.

Is a warm compress effective for toothache?

Nor is it recommended, as heat can exacerbate any inflammation, thus worsening the condition.

When is toothache considered an emergency?

Then, if the pain does not respond to over-the-counter medicines, or causes fever or swelling.

Can night-time toothache go away on its own?

Generally not, but this can only be stated with certainty following a thorough dental examination, once any underlying dental issues causing the pain have been investigated or ruled out.

Can toothache also occur in children at night?

Naturally. For very young children, teething can often be painful, and for older children, tooth decay, for example, can cause the same problems as in adults.

Can a toothache at night cause any complications?

If someone does not see a dentist when experiencing severe pain, fever, and swelling, infections can develop that may spread to surrounding tissues.