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Updated on November 7, 2023
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How to Relieve Tooth Pain at Night

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Why Does a Toothache Hurt More at Night? 

It’s common for people to complain of toothaches that hurt more at night.

When you lie down in bed, you experience a change in blood flow. 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.

The following can also play a role:

  • Late-night snacking, which often results in getting food particles stuck in your teeth
  • Not brushing your teeth before bed
  • Bruxism (unconscious teeth grinding)

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.

What Causes Extreme Tooth Pain?

There are various possible causes for severe tooth pain:

Tooth Decay

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.

Dental Abscess

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.

Lost Crown or Filling

If you’ve lost a dental restoration, such as a crown or filling, you may be left with an exposed nerve. This can cause severe pain, especially when eating or drinking.

Injury

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.

Dead Tooth

Tooth decay or injury can cause a tooth to lose blood supply and die. Dead teeth can be painless or cause severe pain.

Impacted Tooth

A tooth that hasn’t been able to erupt properly may cause persistent pain. Wisdom teeth are commonly impacted and can sometimes ache.

Bruxism or Jaw Problems

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.

When to See a Dentist for a Toothache

Any persistent tooth pain is a reason to see a dentist. Some causes of tooth pain, such as dental abscesses, are considered emergencies. 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:

Dental Filling

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.

Root Canal Treatment

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.

Tooth Extraction

If a tooth is too damaged to be saved, it must be extracted. More complicated tooth extractions may be performed by oral surgeons rather than general dentists.

Once extracted, a tooth will often need to be replaced. A dental bridge or implant may be used for this purpose.

9 Tips to Relieve a Toothache While You Sleep

Here are some steps you can take to relieve tooth pain and help you sleep better:

1. Try Over-the-Counter (OTC) Medication

Over-the-counter (OTC) pain medications like aspirin, acetaminophen (Tylenol), or ibuprofen (Advil or Motrin) can relieve a toothache.

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.

2. Use a Numbing Gel

Numbing gels and ointments are also available OTC. These often contain lidocaine or benzocaine, which act as local anesthetics.

As with OTC pain medications, use these products according to the instructions.

3. Rinse with Mouthwash or Salt Water

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. 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.

4. Use an Ice Pack

An ice pack or cold compress can help relieve pain by:

  • Providing a numbing effect
  • Slowing blood flow to the area
  • Reducing swelling and inflammation

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.

5. Keep Your Head Elevated

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.

6. Avoid Certain Foods

Stay away from foods that will likely irritate your tooth and make the pain worse. These include:

  • Cold or frozen foods
  • Hard or crunchy foods
  • Tough foods that require a lot of chewing, such as certain meats
  • Spicy or acidic foods
  • Sugary foods and drinks that feed harmful oral bacteria

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.

7. Apply Clove or Peppermint Oil

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.

8. Chew Garlic

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.

9. Try Other Natural Remedies

Other natural remedies for toothache include:

  • Toothache plant or electric daisy, which acts as a local anesthetic
  • Guava leaves, which offer antimicrobial and anti-inflammatory benefits
  • Vanilla extract, which contains alcohol and has antioxidant potential
  • Wheatgrass and thyme, which may provide anti-inflammatory effects

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

Ineffective Home Remedies for Toothaches

There are some remedies for toothache you should avoid. These include:

  • Avoiding the dentist
  • Relying on alcohol consumption to reduce the pain
  • Using prescription pain medication that wasn’t prescribed to you
  • Using a mouth rinse if the toothache is caused by an exposed nerve (this can make the pain worse)
  • Attempting to remove your own tooth

How Can You Prevent Future Toothaches?

Maintaining good oral hygiene is the best way to avoid future tooth pain. Take the following steps to keep your teeth and mouth healthy:

  • Brush your teeth regularly and properly to disrupt oral bacteria
  • Floss your teeth at least once a day and after eating foods that get stuck in between your teeth 
  • Maintain a diet low in refined sugar and high in vitamins and minerals
  • Visit your dentist for check-ups and routine cleanings
  • Don’t put off necessary dental treatment

If you play a contact sport, you can also reduce your risk of injury by wearing a mouthguard.

Summary

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.

Last updated on November 7, 2023
10 Sources Cited
Last updated on November 7, 2023
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
  1. Huynh, Nam Cong-Nhat, et al. "Rinsing with Saline Promotes Human Gingival Fibroblast Wound Healing In Vitro." PLOS One, 2016.
  2. Chung, Gehoon, and Seog Bae Oh. "Eugenol as Local Anesthetic." Natural Products, 2013.
  3. Zhao, Hui, et al. "Peppermint essential oil: its phytochemistry, biological activity, pharmacological effect and application." Biomedicine and Pharmacotherapy, 2022.
  4. Bayan, Leyla, et al. “Garlic: a review of potential therapeutic effects.” Avicenna journal of phytomedicine, 2014.
  5. Sisson, D., and C. Balmer. "A Chemical Burn from a Garlic Poultice Applied to the Face to Treat Toothache: A Case Report." Primary Dental Journal, 2014.
  6. Prachayasittikul, Veda, et al. “High therapeutic potential of Spilanthes acmella: A review.” EXCLI journal, 2013.
  7. Denny, Carina, et al. “Guava pomace: a new source of anti-inflammatory and analgesic bioactives.” BMC complementary and alternative medicine, 2013.
  8. Shyamala, B.N., et al. “Studies on the antioxidant activities of natural vanilla extract and its constituent compounds through in vitro models.” Journal of agricultural and food chemistry, 2007.
  9. Bar-Sela, Gil, et al. “The Medical Use of Wheatgrass: Review of the Gap Between Basic and Clinical Applications.” Mini reviews in medicinal chemistry, 2015.
  10. Jaradat, Nidal, et al. “Chemical composition, anthelmintic, antibacterial and antioxidant effects of Thymus bovei essential oil.” BMC complementary and alternative medicine, 2016.
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