Why do I have Toothache and why it gets worse at nights?

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Why do I have Toothache and why it gets worse at nights

Toothache is no ordinary pain. It can be one of the most unpleasant types of pain you can experience. Many people wonder why toothache is so sore. Along with the pain, you may also be dealing with sensitive teeth and difficulty with eating and drinking. Toothache pain is real, it’s in your head and it can make it hard to go about your day and even think straight.

A lot of tooth pain is caused by inflammation in the pulp or inside part of the tooth. The pulp of each tooth contains lots of nerve endings that are highly sensitive to pain. This can cause the often constant throbbing pain that makes toothache especially unbearable.

What are the causes of toothaches?

Toothaches can be caused by something happening to your teeth or gums. They also can be caused by pain in other parts of your body. Common causes of toothaches include:

  • Mouth or jaw injury. These can occur from blunt force trauma to the facial area.
  • Sinus infection. Drainage from sinus infections may cause tooth pain.
  • Tooth decay. When bacteria causes tooth decay, the nerves in your teeth may be exposed, causing pain.
  • Losing a filling. If you lose a filling, the nerve inside the tooth may be exposed.
  • Abscessed or infected tooth. Sometimes called a dental abscess, this condition is described as a pocket of pus in the tooth.
  • Food or other debris wedged in your teeth. Organic and inorganic matter wedged in your teeth can cause pressure between the teeth.
  • Teething or wisdom teeth crowning. If you have wisdom teethHow to deal with Wisdom teeth? coming in, as well as breaking through the gums, they may be pressing against other teeth.
  • Temporomandibular joint disorders. TMJ is classified as pain in your jaw joint, but can also affect your teeth.
  • Gum disease. Gum diseases such as gingivitis or periodontal disease can cause toothaches or pain.
  • Grinding. You may grind or clench your teeth at night which can cause additional pain.

Why is toothache worse at night?

Toothache stimulates your dental nerves to an intense degree and this contributes to why it can be more severe at night. This nerve stimulation activates your brain and can keep you awake. And sometimes the anxiety from staying awake can disrupt your sleep even more. In some cases what you eat for dinner might aggravate a painful tooth. Food that is very hot, cold, sugary, acidic or starchy can quickly make an underlying toothache issue worse. It’s often true that at night, without the distraction of daily activities, pain can seem more obvious and feel worse. Sometimes toothache gets worse when you lie down because blood rushes to your head, which then puts extra pressure on the already sensitive areas in your mouth.

Getting rid of a toothache at night

Getting rid of a toothache at night


Treating a toothache at home usually involves pain management. Here are a few ways to dull your pain so you can get a good night’s sleep.

  • Use over-the-counter pain medication. Using medications such as ibuprofen (Advil, Motrin), acetaminophen (Tylenol), and aspirin can relieve minor pain from a toothache. Using numbing pastes or gels — often with benzocaine — can help to dull the pain long enough for you to fall asleep. Don’t use any products with benzocaine to treat infants or children under age 2.
  • Keep your head elevated. Propping your head higher than your body can keep the blood from rushing to your head. If blood pools in your head, it might intensify the toothache pain and possibly keep you awake.
  • Avoid eating acidic, cold, or hard foods right before bed. These foods can aggravate your teeth and any cavities that may have already formed. Try to avoid foods that trigger pain.
  • Rinse your teeth with mouthwash. Use a mouthwash that contains alcohol to both disinfect and numb your teeth.
  • Use an ice pack before bed. Wrap an ice pack in cloth and rest the painful side of your face on it. This can help to dull the pain so you can rest.

The Best Home Remedies for Toothache Relief

The Best Home Remedies for Toothache Relief


If you can’t take ibuprofen (Advil), or try to avoid medications when possible, there are several natural methods you can use to reduce the pain of a toothache.

Salt Water Rinse

Salt water rinses are one of the first ways your doctor may recommend you treat a toothache at home. To make it, pour a glass of warm to hot water (boiling isn’t necessary) and slowly stir in salt until you see salt crystals at the bottom that are no longer dissolving.

Rinse with this solution 4-5 times daily to reduce inflammation and contract the tissues. This rinse is especially effective with gum pain and foreign body response to something like a poppy seed stuck in between the gums.

Clove Oil

Clove is an essential oil that may provide pain relief as strong as benzocaine (Orajel). It’s important to note, however, that the active ingredient in clove oil is eugenol. Although eugenol occurs in nature, synthetic versions carry some safety concerns.

Clove oil also has antibacterial properties, which means it can kill beneficial bacteria in the mouth and cause an imbalance in the oral microbiome. For this reason, it is not recommended using this remedy for more than a couple of days.

To use clove oil to treat a toothache, apply a very small amount to a cotton swab or piece of tissue and apply gently to the affected area. This works well if there is an exposed nerve due to a deep cavity. Specific placement of the clove oil is crucial for success—it will only work if you place the oil near the pulpal tissue (the inner substance of the tooth).

Grab a Pillow

Keeping your head elevated at all times can reduce the excess blood flow to the inflamed tooth that can make swelling increase and pain feel worse. It sounds overly simplistic, but this small change can make a huge difference in tooth pain. For sleeping, stay elevated with a wedge-shaped pillow or by stacking several standard pillows.

Keep the Area Cold

Frozen peas or a plastic Ziploc bag with half water and half ice works great to keep the toothache area cold and reduce swelling. Other patients I’ve seen like to freeze corn syrup in a Ziploc, since it doesn’t ever get hard like ice.

You can also try a wrap that lets you apply ice consistently to the area without having to hold it up to your face, like this one:

Garlic Paste

Garlic has medicinal and anti-bacterial properties that can kill dental bacteria that cause plaque, while also serving as an effective pain reliever. To try, use a garlic press to crush raw garlic before rubbing onto on the affected tooth.

Peppermint Tea

Some studies have shown that peppermint tea has antioxidant and antibacterial properties and can help in numbing painful areas. 

To give it a shot, brew a cup of peppermint tea, let it cool, and then swish around in the mouth. Add a bit of ice to cool it down faster. Alternately, press the cooled (slightly warm is OK) tea bag against your painful tooth.

Knotted Floss

If your pain is caused by food stuck between the teeth, there’s a very simple solution that may entirely eliminate your need for a dentist. The best way to tell if this is the problem is to identify the basic source of your pain. Is it tender gums somewhere near the space between teeth?

If so, knot a piece of floss and floss through your teeth. You’ll find out pretty quickly if your pain is caused by a bit of food—flossing it out will result in almost immediate relief.

When to see a dentist? 

When to see a dentist


If in doubt, check it out. Book an appointment to see a dentist as soon as possible if:

  • The pain lasts longer than a day or two
  • The pain is severe or starts to become unbearable
  • You have a fever, earache or pain when you open your mouth wide

What treatments are available?

Treatment is based on the cause of your toothache.

  • If a cavity is causing the toothache, your dentist will fill the cavity or take the tooth out, if necessary.
  • A root canal (a procedure to remove and replace infected pulp with sealing material) may be needed if the cause of the toothache is an infection of the tooth’s nerve. Bacteria that have worked their way into the inner space of the root of the tooth cause such an infection.
  • An antibiotic may be prescribed if there is fever or swelling of the jaw. A small piece of food (like a popcorn hull) can get stuck under the gums causing an infection. In this instance, a deep cleaning may be performed or recommended followed by further periodontal therapy if necessary.

How can toothaches be prevented?

How can toothaches be prevented


Since most toothaches are the result of tooth decay, these good oral hygiene practices can prevent toothaches:

  • Brushing regularly with a fluoride toothpaste
  • Flossing at least once a day
  • Seeing your dentist twice a year for professional cleaning

In addition to these practices, eat foods low in sugar and ask your dentist about sealants and fluoride applications.

Toothache FAQs

What’s the best over-the-counter toothache medicine? 

The go-to anti-inflammatory medication for toothaches is ibuprofen (Advil). You can take 600-800 milligrams at a time for inflammation over a three-day period, but don’t take it for more than a few days at a time.

Why does my toothache come and go?

Sometimes, pain is responding to a temporary stimulus, like hot, cold, or sugar, as in the case of root sensitivities or cavities. Other times, it might be an abscess flaring up and then healing enough that the pain subsides, even if the infection itself isn’t completely gone.

Cracked teeth also often have acute pain that fades and recurs as the pulp inside the tooth gets irritated or infected, heals, and then gets irritated again.

Can a toothache cause a headache?

Can a toothache cause a headache


Yes. The trigeminal nerve is responsible for carrying messages for almost all toothaches as well as headaches, which often means that toothaches can be directly responsible for headaches.

Additionally, we often tense up other areas of the body like the jaw when our teeth hurt, which can lead to headaches. Other problems, like sinus infections, can sometimes radiate as both toothaches and headaches.

When do you need to take an antibiotic for tooth pain?

When your dentist or doctor prescribes it! Typically, you’ll get a prescription antibiotic if your dentist suspects or finds infection.

This is also a common prescription for the period of time before a root canal, in order to get the large infection under control before opening the tooth.

Should I use a hydrogen peroxide mouthwash to get rid of bacteria that’s causing my toothache?

No! Hydrogen peroxide should never be used in the mouth. Peroxide is highly antibacterial, which is actually not a good thing for your oral microbiome in the first place. (That’s the reason It’s not recommended using essential oils in the mouth very often.)

However, the more serious reason you should avoid using hydrogen peroxide in the mouth is the increased risk of oral cancer.

Can toothache go away on its own?

The short answer is yes. In some situations toothache or tooth sensitivity can come and go. If this happens it’s probably a reversible inflammatory response by your tooth. Your relief may be short lived though. Only after a dentist has made a proper diagnosis about the cause of your pain can you potentially avoid further damage and find a permanent pain solution. To get the right treatment you really do need a professional assessment and diagnosis by a dentist.

How much does it cost to treat toothache?

The price of treating toothache varies depending on what is causing the pain. Toothache can be a symptom of something serious, so it is recommended that you see a dentist to check it out. Your dentist will be able to diagnose the cause and advise you about the cost of treatment. When you book online for toothache, simply select an appointment for toothache or emergency.