Why Does My Tooth Hurt at Night? Causes, Relief and Helpful Tips!

If you have a severe toothache, it can be a real struggle to fall asleep. Many people find that any mild discomfort from their teeth during the day becomes severe and throbbing at night. So why is your tooth hurting at night?

Understanding why your tooth is hurting at night can help you gain control over your oral health. This guide will explain why your teeth hurt more at night and how to relieve the pain at home. We have also included information about when to see a dentist.

Why Does Tooth Pain Get Worse at Night?

How Does Increased Blood Pressure in the Head Cause Tooth Pain?

When lying down your body is in a horizontal position. This means your blood cannot flow down your body due to gravity. Blood then moves around your torso and upper part of your body. This significantly increases blood flow in your head, neck and jaw.

• Increased Blood Flow – The increased blood flow to your head causes your small blood vessels within your teeth to widen. This means your inflamed nerves are under extreme pressure.

• Pulpit-is – If you have an infected or inflamed tooth nerve (pulpit-is) then this pressure will push the swollen pulp against the inner walls of your teeth causing intense pain.

Lying flat on your back will increase this pressure. Raising your head with several soft pillows will help reduce the blood flow to your face.

Why Does Tooth Pain Feel Worse When There Are Fewer Distractions During the Day?

Throughout the day your brain is constantly receiving thousands of sensory signals. This could include work, talking, background noises, movement and visual stimuli.

• Less Distractions – When lying in a dark and quiet room at night your brain will receive fewer signals.

• Focus On Pain – With no distractions your central nervous system will be focused on the pain coming from your mouth.

• Anxiety – Often when lying awake with pain this can cause anxiety. This will raise your stress levels by releasing hormones such as cortisol. This will increase your pain threshold.

How Does Less Saliva at Night Cause Tooth Pain?

Saliva is a natural defense system in your mouth. It helps wash away small pieces of food, neutralize acidic bacteria and deliver important minerals such as calcium.

• Less Saliva At Night – Less saliva is produced by your salivary glands when you are sleeping.

• More Acid – With less saliva in your mouth, bacteria can grow rapidly. This will cause them to feed off remaining sugars and create acidic bacteria causing irritation to any open cavities, exposed dentine and sensitive gums.

• Dry Mouth – If you are mouth breathing whilst you sleep (due to congestion, snoring or apnoea) your mouth will become even dryer. This will cause bacteria to grow faster and cause your nerves to become more sensitive.

Can Teeth Grinding (Bruxism) Cause Tooth Pain at Night?

Many adults will unconsciously grind their teeth during deep sleep. This condition is known as bruxism.

• Extreme Pressure – This causes extreme pressure on your teeth, TMJ joints and facial muscles.

• Tooth Enamel Damage – Over time heavy clenching will cause your enamel to wear away. This exposes your sensitive dentine and creates micro cracks reaching your nerve.

• Sore Gums – The repeated pressure causes your gums to become inflamed. This causes a dull ache in your teeth which will be worse when you wake up.

Can Late Night Sweet Snacking Make Your Tooth Hurt?

Eating sweet foods, citrus fruits, fizzy drinks or acidic foods can aggravate the bacteria in your mouth.

• Fast Acid Production – Bacteria such as Streptococcus mutans will start breaking down the simple sugars in your mouth within minutes. This causes harsh acids to be released which will start dissolving your enamel.

• Nerve Irritation – If you have an open cavity, eating sweet or acidic foods before bed will cause food to settle in your cavity irritating your sensitive nerve.

• Poor Oral Hygiene – Eating snacks after brushing your teeth will remove your mouth’s defense barrier. This will leave sugar sitting on your teeth all night.

Can Tooth Decay Cause Severe Tooth Pain at Night?

One of the main causes of severe sudden tooth pain at night is severe tooth decay.

• Tooth Decay – Tooth decay starts on the surface of your enamel. Once it has worn through to the dentine layer it will cause pain when your teeth come into contact with temperature changes or sugar.

• Pulpit-is – If the decay reaches your center of your tooth, bacteria will enter the nerve causing irreversible pulpit-is. This will cause intense throbbing pain.

• Abscess – Bacteria will travel down your root canal and cause an infection in your jawbone. This will cause a painful abscess.

Can Gum Disease Cause Tooth Pain at Night?

Gum disease starts with mild gingivitis. If left untreated this can develop into severe periodontitis. This can cause severe pain in your gums which will get worse at night.

• Deep Gum Pockets – Bacteria will start growing underneath your gums. This will cause deep pockets to form. These pockets will be full of plaque, tartar and infection which will swell overnight.

• Exposed Roots – As your gums become infected they will start to recede. This will expose your sensitive roots. As they do not have a protective layer of enamel they will be very sensitive to temperature changes.

• Bone Loss – Chronic inflammation from periodontitis will cause your tissues to swell. This will cause constant dull pain around your jawbone which will get worse with increased blood pressure at night.

Can Sinus Infections Cause Tooth Pain at Night?

Not all tooth pain comes from the mouth. The maxillary sinuses are located above the roots of your back upper teeth and premolars.

• Increased Pressure – If you have a cold, allergy or virus your maxillary sinuses will become inflamed. This will cause fluid to build up.

• Nerve Irritation – The nerves to your back upper teeth run along the same pathway as your sinuses. Increased pressure in your sinuses will put pressure on your nerves causing intense toothache.

• Flat Position – When lying flat your sinuses cannot drain naturally. This will increase the pressure of the fluid over your upper tooth roots.

How Can a Dentist Help With Nighttime Tooth Pain?

The only way to permanently get rid of your persistent tooth pain at night is to see a dentist. They will carry out the following procedures:

• Digital X-Rays – Your dentist will take high quality 3D CBCT scans or x-rays to look deeper into your mouth. This will show any cavities between your teeth, tooth fracture or abscess in your bone.

• Pulp Tests – Your dentist will carry out special tests to check if your tooth nerve is healthy, inflamed or dying. This will involve gently heating/cooling your teeth and tapping them (percussion).

• Treatment – Depending on what they find your dentist may fill your tooth with a protective filling, carry out a pain free root canal to remove the infected pulp or extract your tooth.

What Home Remedies Can Help With Nighttime Tooth Pain?

Whilst home remedies will not cure any infections in your mouth they can help give you some temporary relief until you can see an emergency dentist.

• Raise Your Head – Try raising your head with 2 or 3 firm pillows. This will keep your head above your heart to reduce the blood pooling and pressure.

• Salt Water Rinse – Mix ½ tsp of salt into a glass of warm water. Swish this around your mouth for 30 seconds. This will help wash away any loose food, soothe sore gums and fight bacteria.

• Cold Compress – Apply an ice pack wrapped in a soft cloth to the outside of your cheek for 15 minutes. This will cause your blood vessels to constrict reducing the swelling and numbing the pain.

• Painkillers – Take an anti-inflammatory painkiller such as ibuprofen to help reduce the swelling. You can also take paracetamol to block the pain signals to your brain. Follow the instructions on the packet.

• Avoid Eating – Avoid eating extremely hot, cold, hard or sweet foods late at night.

When Should You See a Dentist for Nighttime Tooth Pain?

Some toothaches can be a sign of spreading infections.

• Swelling – If your cheek, jawline or neck is swelling quickly this is a sign of aggressive bacterial infection.

• High Temperature – If you have a high temperature with your toothache this means your immune system is fighting an infection.

• Breathing Difficulties – If the infection is spreading into your neck this can cause difficulty breathing. This is a medical emergency and you should go straight to A&E.

• Bad Taste – If you can see a spot on your gums that is leaking a bad tasting liquid this means you have an active infection in your bone. This needs to be drained and you will need antibiotics.

How Can You Prevent Nighttime Tooth Pain?

To prevent your teeth from aching at night you should establish good oral hygiene routines.

• Brush Twice Daily – Brush your teeth thoroughly each morning and before bed using a soft bristled brush and fluoride toothpaste. This will remove any acid producing plaque.

• Floss – Floss between your teeth every night to remove any trapped food and plaque.

• Night guard – If you suffer from bruxism whilst you sleep ask your dentist for a custom fitted acrylic night guard. This will protect your teeth.

• Avoid Eating – Avoid eating sugary foods, fruit juice or acidic drinks after brushing your teeth.

• Visit Regularly – Visit your dentist every 6 months for a check up. This will help spot any small cavities and treat them before they reach your nerve.

What Are the Top Tips for Relieving Tooth Pain at Night?

• Raise your head with multiple pillows.

• Rinse with warm salt water.

• Apply an ice pack wrapped in a cloth to the outside of your cheek.

• Take painkillers as instructed.

• Avoid eating hot, cold, hard or sweet foods late at night.

• Do NOT apply crushed aspirin tablets directly onto your gums. This will cause severe chemical burns.

• Check your gums and cheeks for any swelling, pus or spots.

• Book an appointment with an emergency dentist to get diagnosed.

• If you have a toothache with a temperature, swollen face or difficulty breathing go straight to A&E.

What Are the Frequently Asked Questions About Tooth Pain at Night?

Why Does My Tooth Hurt When I Lay Down?

When you lie down flat there is no gravity pulling your blood down your body. This causes your blood to circulate more around your head, neck and jaw. This puts pressure on your swollen inflamed nerves in your infected teeth causing intense thumping pain. This will stop when you sit up.

Can My Toothache Get Better on Its Own?

No. If you have a deep cavity, nerve pulpit-is or abscess in your tooth it will not get better on its own. Although your nerve may die temporarily and the pain may disappear, the infection will still be active in your jawbone and will continue to spread until you see a dentist.

Is It Okay to Take Ibuprofen Every Night?

Taking ibuprofen will help with mild swelling but will only be a temporary solution. It will also hide any infection you have. Taking painkillers regularly can irritate your stomach, affect your liver and let your dental infection get worse.

How Do I Know If My Toothache Is Caused by a Sinus Infection?

If your toothache is caused by a sinus infection you will usually feel pain in multiple upper back teeth. The pain will usually get worse when you bend over. You will also usually have a blocked nose, pressure in your eyes, postnasal drip or a lingering cold.

Severe tooth pain at night is a clear sign that your mouth needs help. Whilst raising your head, rinsing with warm salt water and taking painkillers can help with the pain they will not get rid of any cavities, nerve infections or gum disease. Working with a qualified dentist will help identify and treat the cause of your pain. This will help get you back to feeling well and keep your smile looking great. Book an emergency appointment today!