Have you ever experienced that excruciating tooth pain that seems to worsen at night, leaving you tossing and turning in bed? Toothaches can be unbearable and are ranked among the worst pains people can experience. Nighttime toothaches, a frequently experienced phenomenon, aggravates the discomfort, making a bad toothache even worse. This article will explore the reasons why toothaches hurt more at night and provide helpful insights on how to ease the pain and promote better oral health.

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The Nighttime Toothache Phenomenon

Having a toothache at night

Nighttime toothache, a common phenomenon, often results from factors such as elevated blood pressure and unconscious habits like teeth grinding and clenching. Sinus infection can also contribute to the nighttime toothache phenomenon. Common culprits of nighttime toothaches include untreated dental issues, increased blood flow to the head, unconscious habits (like grinding your teeth), and late-night snacking.

Treating a nagging toothache at night may be more challenging, as there are not many at-home treatments that can completely alleviate the pain. However, there are some helpful remedies that can help relieve the discomfort before bedtime, such as:

  • Flossing around the painful tooth
  • Rinsing your mouth with warm saltwater
  • Applying a cold compress to the affected area (for 10-20 minutes, followed by a break)
  • Taking over-the-counter pain medication (like Tylenol or ibuprofen, making sure to follow the recommended dosage)
  • Using a numbing gel or ointment specifically designed for toothaches (like Orajel)

Addressing the main causes of nighttime toothaches will enable you to find the most effective solution to ease the pain and enjoy a peaceful night’s sleep.

 

Unconscious Habits: Teeth Grinding and Clenching

Bruxism, or teeth grinding, is a long-term condition that involves teeth clenching and grinding, often leading to dental discomfort, particularly during the night. It affects as much as 8% of the adult population. This unconscious habit can increase toothache pain at night due to the pressure on the teeth and jaw, resulting in a sore jaw, soreness, and headaches. When your teeth hurt, it could be a sign of this condition.

To reduce the impact of bruxism on nighttime toothaches, using a night guard while sleeping may help. A night guard is a dental appliance that serves as a protective barrier between the upper and lower teeth, reducing the damage caused by teeth grinding and clenching, and helping when your tooth hurts at night. Over-the-counter mouthguards can be used as a temporary solution, but a custom-fitting mouthguard made by your dentist is the best long-term solution. Massaging your jaw and the area around your ear can help reduce the pain from clenching or grinding.

Dental Issues Causing Nighttime Pain

A variety of dental problems can instigate or intensify nighttime tooth pain, including:

  • Cavities

  • Gum recession

  • TMJ disorders

  • Damaged teeth or dental appliances

A potential cause of pain that intensifies when lying down or pain that awakens you during the night could be an abscessed tooth, a serious condition wherein the tooth has become infected. A dentist can determine whether or not a tooth is infected.

Gum recession, the exposure of the roots of teeth due to receding gumlines, can cause a painful toothache, especially at night. Sensitivity toothpaste or a gum graft may be beneficial for treating gum recession, while over-the-counter medication can help alleviate toothache pain. A dentist can help determine if any of these options would be helpful in your situation. It is crucial to address these underlying dental issues to prevent nighttime toothaches and avoid further complications.

Late-Night Eating and Its Effects on Tooth Pain

Person has a toothache by a lamp at night

Consuming foods, particularly those high in sugar or acidity, late at night can aggravate existing dental problems and escalate tooth discomfort during the night. Foods such as:

  • soda

  • citrus fruits

  • chewy candy

  • crunchy foods like pretzels

can contribute to tooth decay, tooth sensitivity, and other dental issues. To ensure good dental health, it is recommended to abstain from consuming these types of foods before bed.

The timing of meals can also impact dental health and tooth pain. Allowing sufficient time between meals enables saliva to wash away food particles that bacteria would otherwise consume, reducing the risk of tooth decay. Moreover, a poor diet, particularly one high in sugary foods, can heighten the risk of gum disease and tooth decay. Prioritizing proper oral hygiene and healthy eating habits can help prevent nighttime toothaches.

The Role of Blood Flow and Pressure When Lying Down

Blood flow and pressure play a significant role in nighttime toothaches. The act of lying down can stimulate increased blood flow to the head, potentially escalating sensitivity and discomfort in teeth, gums, and the jaw. This increased blood flow and pressure, combined with fewer distractions at night, can make toothache feel worse.

Lying down may also cause alterations in steady-state cerebral hemodynamics, making it difficult to fall asleep when experiencing a toothache at night. To mitigate the pain and enhance your sleep quality, consider keeping your head elevated with an additional pillow or two. This will help reduce the increased blood flow and pressure to the head, providing some relief from the pain.

Remedies for Temporary Relief

Illustration of temporary toothache relief

Nighttime toothaches can be temporarily relieved through the following methods:

Utilizing a cold compress or an ice pack on the affected area may assist in diminishing swelling and inhibit fluids from accumulating in the mouth.

Saltwater rinses can help kill bacteria, reduce inflammation, and alleviate toothache pain. Pain from a toothache can be relieved by taking medications containing over-the-counter pain relief drugs like naproxen, acetaminophen, and ibuprofen. These can help alleviate the discomfort associated with the condition. While these remedies can provide temporary relief, it is essential to address the root cause of the toothache for lasting relief and improved oral health.

When to Seek Professional Help

Professional dental assistance should be sought for unyielding or intense tooth pain, given that neglected dental issues can evolve into more serious problems impacting overall oral health. Patients experiencing a toothache at night should see a dentist immediately to address the dental emergency. Upon identifying the cause of the toothache, the dentist can initiate treatment and provide guidance on managing any discomfort experienced during the night.

Not only is it crucial for your oral health to address toothaches, but it may also be a sign of other underlying health issues that need attention. Don’t ignore persistent toothaches; seeking professional help early can prevent further complications and ensure better oral health.

Preventative Measures to Avoid Nighttime Toothaches

Illustration of preventative measures for oral health

Adopting preventative measures like good oral hygiene maintenance, use of a night guard for teeth grinding, and resolution of underlying dental problems can help deter nighttime toothaches and bolster overall oral health. Good oral hygiene includes daily brushing and flossing, regular dental visits, and employing antimicrobial mouthwash. Additionally, avoiding certain types of food and beverages that can damage teeth and gums is essential for maintaining good oral health.

A night guard can provide the following benefits:

  • Safeguard the surfaces of your teeth from grinding against each other during sleep

  • Inhibit tooth damage

  • Decrease jaw tension and pain

  • Deter headaches

  • Foster healthy sleep patterns

Addressing dental issues such as repetitive motions (grinding teeth or chewing gum), damaged fillings, tooth fractures, abscessed teeth, and tooth decay can also help prevent nighttime toothaches.

Summary

In conclusion, nighttime toothaches are a common issue that many people face. Various factors such as blood flow and pressure, unconscious habits, underlying dental issues, and late-night eating contribute to this painful phenomenon. By understanding the root causes of nighttime toothaches and implementing preventative measures, you can alleviate the pain and improve your oral health.

Don’t let nighttime toothaches disrupt your sleep and overall well-being. Take action to address the underlying issues, seek professional help when necessary, and maintain good oral hygiene practices for a healthier and pain-free future.

FAQ

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Why does toothache hurt more at night?

At night, increased blood flow and pressure to the head, lack of distractions, and unconscious habits like teeth grinding and clenching can make toothache more painful.

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How can I alleviate toothache pain at night?

To alleviate toothache pain at night, try using a cold compress for 10-20 minutes, keep your head elevated when lying down, rinse with warm salt water, and use over-the-counter pain medications for temporary relief.

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What are some preventative measures to avoid nighttime toothaches?

Good oral hygiene, a night guard for teeth grinding, and addressing any underlying dental issues are effective measures to prevent nighttime toothaches.

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When should I seek professional help for a toothache?

If you have persistent or severe toothache, it is important to seek professional help as soon as possible, as untreated dental issues can lead to further complications.

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What are some common dental issues that cause tooth pain at night?

Common dental issues such as cavities, gum recession, TMJ disorders, and broken teeth or defective dental appliances can lead to tooth pain at night.

References

1.  Cohen, L. A., Bonito, A. J., Akin, D. R., Manski, R. J., Macek, M. D., Edwards, R. R., … [Additional authors]. (2009). Toothache pain: Behavioral impact and self-care strategies. Journal of Public Health Dentistry, 69(2), 111-117. https://doi.org/10.1111/j.1754-4505.2008.00068.x

2.  Reddy, S. V., Kumar, M. P., Sravanthi, D., Mohsin, A. H. B., & Anuhya, V. (2014). Bruxism: A Literature Review. Journal of International Oral Health, 6(6), 105-109. PMCID: PMC4295445, PMID: 25628497.

3.  Lee, Y.-H. (2022). Supportive Home Remedies for Orofacial Pain during the Coronavirus Disease 2019 Pandemic: Their Value and Limitations. International Journal Of Dentistry, 2022, Article ID 2005935. https://doi.org/10.1155/2022/2005935

4.  Greenstein, G. (2007). Therapeutic Efficacy of Cold Therapy After Intraoral Surgical Procedures: A Literature Review. Journal of Periodontology, 78(5). https://doi.org/10.1902/jop.2007.060319

5.  Lavigne, G. J., & Montplaisir, J. Y. (1994). Restless Legs Syndrome and Sleep Bruxism: Prevalence and Association Among Canadians. Sleep, 17(8), 739-743. https://doi.org/10.1093/sleep/17.8.739

6.  Pozzi, A., & Gallelli, L. (2011). Pain Management for Dentists: The Role of Ibuprofen. Annals of Stomatology (Roma), 2(3-4 Suppl), 3–24. Published online 2012 Apr 15. PMCID: PMC3414241, PMID: 22888399.

Author:  Ryan Smith DDS

Medically Reviewed by:  Erik Smith DDS