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It’s common for people to complain of toothaches that hurt more at night. When you lie down in bed, blood no longer works against gravity to flow to your head. This increases pressure on aching teeth and can cause them to throb.
Another reason may be that you’re less distracted at night. Activities that occupy you during the day can make it easier to ignore tooth pain.
Whatever the underlying causes, a toothache at night can interfere with your sleep. This article will discuss effective pain relief, what causes extreme tooth pain, and treatment options.
Here are some steps you can take to relieve tooth pain and help you sleep better:
Over-the-counter (OTC) pain medications can help relieve toothache pain. These include:
Make sure to follow the directions on the packaging, and don’t exceed the recommended dosage. If these medications aren’t providing adequate pain relief, see your dentist as soon as possible. They will address the underlying cause and may prescribe stronger medications.
Numbing gels and ointments are also available OTC. These often contain lidocaine or benzocaine, which act as local anesthetics. Similar to OTC pain medications, use these products according to the instructions.
Rinsing with mouthwash can disinfect the area. A mouthwash containing alcohol or certain other compounds, like those in Listerine, may work best for this.
Swishing with hydrogen peroxide diluted with water may also disinfect the area. Follow the instructions on the label, and don’t swallow mouthwash or hydrogen peroxide.
A 2-minute salt water rinse is an old home remedy that can disinfect and promote healing.1 Be careful with mouth rinse if your tooth has an exposed nerve. You could end up making the pain worse.
An ice pack or cold compress can help relieve pain by:
Wrap a bag of ice or frozen vegetables in a towel to create a quick, effective compress. Apply it to the area closest to the toothache for a few minutes every half hour as you wind down before bed.
Keeping your head higher than your chest can help slow blood flow to an aching tooth. Place an extra pillow under your head, or try propping yourself up to sit in bed.
Find a comfortable position that allows you to go to sleep easily. This will help you avoid waking up with a stiff neck or sore muscles.
Stay away from foods that will likely irritate your tooth and make the pain worse. These include:
By sticking to foods that cause little to no irritation to your sensitive tooth, you can avoid worsening the toothache. This will help maximize the benefits of other pain relief methods.
Oil of clove is a well-known toothache remedy. It contains eugenol, which has analgesic (pain relieving) and anti-inflammatory properties.2 Applying a small amount directly to your tooth with a cotton swab can numb and reduce the pain.
Peppermint oil contains menthol. Like eugenol, it has a cooling, minty taste, and a numbing effect. It also has antibacterial benefits.3
Instead of essential oils, you can also try a clove or peppermint tea to relieve tooth pain. You can also grind cloves into a paste and apply them to the affected tooth. Do not use these products if you have an allergy to clove or peppermint.
Garlic contains allicin, an antiviral and antibacterial agent.4 Slowly chewing a small amount of raw garlic and allowing it to rest in the area of your toothache may alleviate the pain.
The strong garlic taste may make this a less desirable remedy for some people. If you do use it, do not apply garlic to your skin. This could cause a chemical burn.5 As with clove and peppermint, don’t consume garlic if you’re allergic.
Other natural remedies for toothache include:
If you have any known allergies or health conditions, or if you’re concerned about potential side effects, talk to your doctor or dentist before trying these remedies.6, 7, 8, 9, 10
Not brushing your teeth or late-night snacking can play a role in the development of a toothache. However, there are various possible causes for severe tooth pain.
These include:
Oral bacteria produce acid that eats away at teeth over time. This eventually creates cavities, which are holes in teeth.
Not all cavities are noticeable, but in some cases, they cause significant pain. The longer tooth decay continues, the deeper into the tooth it will spread, and the more likely it will cause pain.
If you don’t address tooth decay, it can spread through the tooth’s enamel, dentin, and pulp. This can result in an abscess, which is extremely painful.
An abscess is a pocket of pus caused by an infection deep within the tooth. An untreated abscess can be life-threatening.
You may be left with an exposed nerve if you’ve lost a dental restoration, such as a crown or filling. This can cause severe pain, especially when eating or drinking.
A mouth or jaw injury can sometimes cause a toothache. One or more teeth may break or displace, or the surrounding area may become inflamed.
Tooth decay or injury can cause a tooth to lose blood supply and die. Dead teeth can be painless or cause severe pain.
A tooth that hasn’t been able to erupt properly may cause persistent pain. Wisdom teeth are commonly impacted and can sometimes ache.
If you have an unconscious habit of teeth grinding or a TMJ (jaw joint) disorder, you may have chronic tooth pain. Treatment for bruxism or TMJ disorders may help the pain subside.
Any persistent tooth pain is a reason to see a dentist. Some causes of tooth pain, such as dental abscesses, are considered emergencies.
If you're experiencing any of the following symptoms alongside a toothache, seek emergency treatment:
Other causes may not be emergencies but can develop into more severe issues if left unaddressed. Depending on the underlying cause of your toothache, your dentist may offer one or more of the following treatments:
If your toothache results from tooth decay, your dentist will carefully clean the area, remove the decay, and fill in the cavitation with a dental filling. The filling may be made from composite resin, metal, or another material.
Teeth that have died or have an abscess must have root canal treatment, also known as endodontic therapy. This procedure removes the root canal and pulp of the tooth, including nerve tissue that may be causing pain. The tooth is then filled in and protected with a crown.
Root canal treatment is intended to preserve a dead or abscessed tooth. With the inner part of the tooth removed, the hard exterior of the tooth can still function normally.
If a tooth is too damaged to be saved, it must be extracted. General dentists can extract your tooth, but a more complicated procedure may require an oral surgeon.
Once extracted, a tooth will often need to be replaced. A dental bridge or implant may be used for this purpose.
Maintaining good oral hygiene is the best way to avoid future tooth pain. Take the following steps to keep your teeth and mouth healthy:
If you play a contact sport, you can also reduce your risk of injury by wearing a mouthguard.
There are some remedies for toothache you should avoid. These include:
Severe tooth pain can disrupt sleep. You may feel a toothache more at night because lying down increases blood flow to your head or because you’re less distracted.
Fortunately, there are remedies you can apply at home to get the relief you need to fall asleep. Many of these are easy to obtain, and many are also free of artificial chemicals.
These remedies are never a replacement for professional treatment. If you’re experiencing a persistent toothache, see your dentist as soon as possible to address the underlying cause.
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