Patient guide
Toothache at night: what to do until you can see a dentist
Toothache often feels worse at night. Lying down sends more blood to the head, and with no distractions the pain is all you notice. You can usually make the night more bearable with simple steps, but the cause still needs a dentist, ideally within a day or two.
Reviewed by Dr. Sharifa B, BDS ·
Why tooth pain gets worse when you lie down
When you lie flat, blood flow to the head increases. If the nerve inside a tooth is inflamed, that extra pressure can turn a dull ache into a throbbing pain. Pain that wakes you from sleep, or that throbs on its own without any trigger, usually means the nerve is involved and should not be ignored.
Safe things you can do tonight
- Rinse gently with warm salt water (half a teaspoon of salt in a glass of warm water)
- Brush and floss gently around the tooth to remove trapped food
- Sleep with your head raised on an extra pillow
- Hold a cold pack wrapped in a cloth against the cheek, 10 minutes at a time, if there is swelling
- Avoid very hot, very cold and sweet food and drinks on that side
Things to avoid
- Do not place a tablet, clove or any powder directly on the gum: it can burn the gum
- Do not apply heat to the face if it is swollen
- Do not take antibiotics left over from earlier or borrowed from someone else
- Do not take any medicine you have not taken safely before without a doctor's or pharmacist's advice, especially if you are pregnant, have stomach, kidney or liver problems, or take other medicines
What the pain may be telling you
These are only patterns. A dentist needs to examine the tooth, and usually take an X-ray, to know the cause.
- Sharp pain with cold that stops in seconds: often sensitivity or an early cavity
- Pain that lingers after hot or cold, or throbs on its own: the nerve may be inflamed
- Pain when biting: a crack, a high filling, or infection at the root tip
- Pain with swelling of the gum or face: likely an infection (abscess) that needs prompt care
Go to a hospital now if you notice
Do not wait for the morning if you have:
- Swelling spreading to the eye, neck or under the jaw
- Difficulty swallowing, breathing or opening your mouth
- High fever or feeling very unwell with the toothache
- Bleeding that will not stop, or a facial injury
In the morning
If the pain has eased, it is still worth getting the tooth checked: pain can settle when a nerve dies, while the infection continues. If you cannot get to a dentist quickly, an online consultation can tell you how urgent it looks, what to do in the meantime, and what kind of in-person treatment to look for.
Frequently asked questions
Can I talk to a dentist online at night?
Consultations on AskMyDentist run from 10 AM to 10 PM. If you have any of the warning signs above, go to the nearest hospital instead of waiting.
Will the toothache go away on its own?
Pain may come and go, but a cavity or infection does not heal by itself. Getting it treated early usually means a simpler treatment.
Which painkiller should I take for toothache?
We do not recommend medicines on this page because the safe choice depends on your health and other medicines. Ask a doctor or pharmacist, or book a consultation.
