The short answer
Tooth pain is worse at night mainly because lying down sends more blood to your head, which raises the pressure on an inflamed nerve inside the tooth. With no daytime distractions you also notice it more, and night-time teeth grinding, sinus pressure and lower levels of the body’s natural anti-inflammatory hormone add to it.
Why does tooth pain get worse at night?
- Blood flow when you lie flat. More blood reaches your head, so a swollen nerve in a tooth with hard walls feels the pressure more. That’s the throbbing.
- Nothing else to focus on. In a quiet, dark room the brain pays full attention to pain.
- Grinding or clenching. Many people grind in their sleep without knowing, which aggravates a cracked tooth or a loose filling. Waking with a sore jaw or a headache is a clue.
- Sinus pressure. Congestion settles when you lie down and presses on the roots of the upper back teeth, a common complaint in Hudson Valley allergy season.
- Lower cortisol. The body’s own anti-inflammatory hormone dips at night, so inflammation feels stronger.
Why does my tooth hurt when I lie down?
If the pain starts or throbs harder as soon as you lie down, the nerve inside the tooth is usually inflamed, and sometimes infected. Pressure that changes with your position is a sign the problem is inside the tooth rather than in the gum. It’s worth getting checked even if the pain fades by morning. An inflamed or infected nerve is usually treated with a root canal, which saves the tooth.
How can I sleep with a toothache tonight?
- Prop your head up on two or three pillows.
- Take an anti-inflammatory such as ibuprofen before bed, as the label directs.
- Hold a cold compress on your cheek for 15 minutes.
- Rinse with warm salt water and floss gently, so no food is left around the tooth.
- Skip sweet snacks and very cold drinks before bed.
Read more on what to do for a toothache at home, including what never to put on a sore tooth.
What does tooth pain only at night mean?
Pain that comes mostly at night can be an early sign of an inflamed nerve, before it hurts all day. It can also come from grinding, which overloads the teeth while you sleep, or from your sinuses if several upper back teeth ache together. A dentist can tell these apart with an exam and X-rays.
When is night-time tooth pain an emergency?
Call a dentist the next morning if the pain wakes you up, if painkillers don’t touch it, or if you notice a pimple on the gum, a bad taste or swelling. Our emergency dentistry page explains what to do while you wait. Go to the emergency room if the swelling spreads to your eye or neck, or you have trouble breathing or swallowing.
Night-time toothache questions
Is it normal for a tooth to hurt only at night?
It’s common, but not normal. It often means the nerve is starting to become inflamed, so get it checked before it gets worse.
Why does cold water ease my toothache at night?
Cold can calm a badly inflamed nerve for a while. That is often a sign of advanced inflammation, so see a dentist soon.
Can grinding my teeth cause tooth pain at night?
Yes. Grinding strains the teeth and jaw and can crack teeth. A custom night guard protects them.
Losing sleep to a toothache? Call 845-336-5855 in the morning or book an appointment.
