Why Toothaches Get Worse at Night and How to Find Relief


Few things can disrupt your day, and especially your night, quite like a throbbing toothache. These dental problems are a surprisingly common experience, affecting millions of people each year. A toothache not only disrupt your daily routine, but it can also make getting a good night’s sleep seem like an impossible feat. If you’ve ever tossed and turned with a pulsing toothache keeping you company, you’re not alone. Dr Beeram will discuss the reasons why toothaches seem to become amplified at night, and more importantly, offer solutions to help you find relief and finally get some sleep.

Understanding Toothaches

Toothaches arise from a complex interplay between the intricate structures within your teeth and the body’s response to internal disturbances. To effectively manage and treat tooth pain, it’s crucial to understand the underlying mechanisms at play.

The Dental Pulp: The Source of the Ache

Each tooth functions as a self-contained unit. At its core lies the dental pulp, a soft tissue chamber housing the tooth’s blood vessels and nerves. This vital chamber nourishes the tooth and provides sensory perception, allowing you to feel temperature changes and pain.

Inflammation and Infection

When bacteria infiltrate the tooth due to factors like tooth decay or gum disease, the body’s immune system kicks in to combat the invaders. This response triggers inflammation within the dental pulp. The inflamed pulp tissue becomes congested, putting pressure on the nerves and causing the characteristic throbbing pain associated with a toothache.

Furthermore, if the bacterial invasion progresses, it can lead to an abscess, a localized collection of pus within the tooth or surrounding bone. The presence of an abscess further intensifies the inflammatory response and significantly amplifies the pain.

Pain Perception

The pain we experience from a toothache isn’t solely a local phenomenon. The nerves within the inflamed pulp transmit electrical signals to the brain, which interprets them as pain. These signals can sometimes travel along radiating pathways, leading to referred pain – discomfort felt in a seemingly unrelated area, such as the jaw, ear, or temple.

Understanding the intricate dance between dental structures, inflammation, and the nervous system is the first step towards effectively managing and alleviating toothaches.

Factors that Worsen Toothaches at Night

So, why does that dull ache in your tooth morph into a jackhammer at night? Several factors contribute to the nocturnal intensification of toothaches.

Body Position: When you lie down to sleep, gravity does its thing, causing increased blood flow to your head. This influx of blood can put additional pressure on the inflamed area in your tooth, amplifying the pain.

Hormonal Changes: Our bodies are complex ecosystems, and nighttime brings hormonal fluctuations. Cortisol, a natural pain-suppressing hormone, tends to decrease at night. This decrease in cortisol can make you more sensitive to pain, including the throbbing in your tooth.

Distractions and Stress: During the day, we’re bombarded with distractions that take our minds off minor aches and pains. At night, however, the quiet darkness allows us to focus solely on the discomfort, making it seem worse. Additionally, the stress of experiencing a toothache can heighten your overall pain perception, creating a vicious cycle.

Teeth Grinding: Teeth grinding (bruxism) can worsen at night, especially during periods of stress. The constant friction puts strain on teeth, further aggravating an existing toothache.

Dehydration: Dehydration is more common at night, especially if you don’t have water readily available. Saliva plays a crucial role in keeping your mouth healthy and reducing inflammation. Reduced saliva flow due to dehydration can exacerbate toothache pain.

Managing Toothache Pain at Night

Just because a toothache likes to play nighttime games doesn’t mean you have to surrender your sleep entirely. Here are some strategies to help you manage the pain and get some much-needed rest.

Over-The-Counter Pain Relievers

Pain relievers like ibuprofen or acetaminophen can offer temporary relief. Consult the dosage instructions carefully and adhere to the recommended amount.

What’s more, applying a topical numbing agent, such as a lidocaine-based gel or ointment, directly to the affected tooth can provide temporary relief from the pain. These products can help to numb the nerve endings, providing a sense of immediate relief.

Home Remedies

A cold compress applied to the outside of your cheek can help reduce inflammation and provide some pain relief. Saltwater rinses (made with warm water and a teaspoon of salt) can also help soothe irritated gums.

a woman with a toothache or needing an emergency dental appointment holding cloth or cold compress to cheek

Elevate Your Head

Physics can be your friend when battling a nighttime toothache. Gravity plays a role in intensifying pain by increasing blood flow to the head when you lie flat. To counteract this, prop yourself up with extra pillows at night. Elevating your head above your body helps reduce blood flow to the area, potentially offering some welcome pain relief and easing you into sleep.

Dietary Adjustments for Nighttime Relief

While reaching for a sugary snack might seem tempting at night, it’s best to resist the urge if you’re experiencing a toothache. Sugary, acidic, or cold foods and drinks can irritate sensitive teeth and exacerbate existing cavities. Opt for plain water instead to stay hydrated without further stimulating the discomfort.

Maximizing Your Oral Hygiene Routine

Don’t relegate your oral hygiene routine solely to daytime. Brushing and flossing your teeth before bed is crucial, but consider incorporating a nighttime mouthwash rinse as well. Look for a mouthwash containing alcohol or salt, as these ingredients boast both antibacterial properties and mild numbing effects. This can help reduce inflammation and provide temporary pain relief from plaque buildup or minor cavities.

Routine Dental Check-ups

Schedule regular dental checkups and cleanings at a dentist near you like Beach Grove Dental in Tsawwassen to identify and address potential problems early on before they escalate into painful toothaches.

Dr Beeram and assistant at Beach Grove Dental maintaining the oral health of a patient

When to Seek Professional Help

Sometimes, home remedies just aren’t enough. Here are some signs that indicate it’s time to seek professional help from a dentist:

  • Severe pain that is unresponsive to over-the-counter medication
  • Visible swelling in your face or gums
  • Fever or chills
  • Difficulty breathing
  • A broken or loose tooth

These symptoms may point to a more serious underlying condition that requires immediate dental attention.

Emergency Dental Care at Beach Grove Dental

Toothaches can be a real pain (literally!), but understanding the reasons behind their nighttime dominance and having the tools to manage them can make a world of difference. By practising good oral hygiene, scheduling regular dental checkups, and knowing when to seek professional help, you can reclaim your nights and minimize the possibility of experiencing a night-time toothache.

At Beach Grove Dental in Tsawwassen, we understand that dental emergencies don’t happen on a convenient schedule. That’s why we offer emergency dental services to provide prompt and professional care when you need it most. Our team of experienced dentists will diagnose the source of your toothache and create a treatment plan to alleviate the pain and restore your oral health. 

Contact Us 

We often have walk-in or same-day appointments for emergency dental services. Contact us at 604-330-1163 and tell us about your situation and we will do our best to accommodate you and provide dental treatment. We work from Monday to Thursday from 9 am until 6 pm and offer appointments on alternating Saturdays from 9 am until 2 pm. For more information about our dental services, you can also contact us online. Please note that if you experience severe pain outside our business hours, it may require an immediate visit to the emergency room. If the pain is accompanied by swelling, fever, or difficulty swallowing, it’s crucial to seek medical attention right away.

Our dental clinic is conveniently located off Highway 17 and 56 Street, steps from Tsawwassen Town Centre Mall. We proudly serve patients from Tsawwassen including Ladner, Boundary Bay, Point Roberts, and other South Delta communities.