7 Reasons Why Your Toothache Hurts More at Night & How to Fix It

Do your teeth hurt at night? Are you completely fine during the daytime, but then suddenly feel tooth pain lying down when you go to bed? You don’t necessarily need to learn how to sleep with a toothache. The important thing is to figure out what’s causing it so that you know how to stop tooth pain fast. Since tooth pain can come from many different sources, toothache home remedies can buy you time until you’re able to get into the dentist’s office. Knowing what to look for—and what to try—can get you back to enjoying a comfortable night’s rest again.

What Is A Toothache?

Toothaches come in all shapes and sizes. Some are dull and achy, others are sharp. Yours might come on suddenly (like when your teeth hurt at night) or could throb on all day long, radiating through your face.

Toothaches usually ebb and flow, depending on whatever it is that’s causing them. If you have tooth pain lying down, there’s a good chance that pressure elsewhere in or around your mouth is contributing to the problem.

Not all infected, decaying, or dying teeth cause pain. If your teeth hurt bad enough that you need toothache home remedies, make sure you plan on seeing your dentist too.

Why Is Tooth Pain Only At Night?

Does it seem like your teeth hurt worse when you’re trying to sleep? To get any kind of rest, you’ll want to know how to stop tooth pain fast.  Extreme tooth pain and not being able to sleep is not fun. Otherwise, you’ll be tossing and turning, feeling completely miserable, and waking up feeling even worse the next morning.

Whenever we lay down to sleep, it can actually raise our blood pressure. Odd, right? You might think it would do the opposite. But that increased blood pressure can then push against the nerves and blood supply to your teeth, causing it to flare up whenever you go to bed. That’s why a lot of dentists and oral surgeons will tell you to sleep with your head elevated after a surgery or tooth extraction.

Have you ever noticed your sinuses hurting more at night, too? It’s similar to tooth pain and they’re right next to each other. If you lay down at night and feel stronger sinus pressure and congestion, there’s also a good chance your teeth will hurt too.

Tooth pain doesn’t only happen at night. If you have an abscess or cavity, your teeth can hurt at any point throughout the day. But if you’re constantly distracted during the daytime hours, the mild pain might not cross your mind until you’re trying to figure out how to sleep with a toothache.

7 Reasons Why Your Tooth Pain Is Worse At Night

There’s something about toothaches in that they always seem to happen whenever the dentist’s office is closed, or you’re out of town traveling somewhere. Just like Murphy’s law, it seems like most toothaches are at night while you’re sleeping, or over the weekend! There’s even a good chance that it will be completely fine by the next morning, making you second-guess calling your dentist’s office.

Here are 7 reasons why it’s probably happening right when you go to bed:

1. Lying Down

When you lay down in bed, your head is immediately dropped down onto the same level as your heart, lungs, and limbs. This creates an even playing field for your blood flow and pressure, which can result in a rush of blood up toward your face, mouth, sinuses, and brain. The extra blood pressure may be pressing on your mouth and triggering slightly sensitive areas to hurt more than normal.

On a related note, most of us also feel more sinus pressure when we lay down at night. If the teeth that hurt are in the top of your mouth, you’ll want to rule out any sinus infections, congestion, or allergies being to blame.

2. Unconscious Teeth Grinding

3. Cavities

One thing about cavities is that they always seem to hurt when they feel like it, rather than consistently. The pain can come and go or there might not be a toothache at all. If you can feel a radiating throbbing or sharp pain coming from a specific part of your mouth, be sure to let your dentist know. Larger cavities that have already developed into an abscessed nerve create additional pressure, which can cause them to hurt at night when you go to bed. Usually, there is also visible swelling in the form of a fistula (pimple) on your gums.  

4. Gum Recession

The roots of our teeth are naturally more sensitive and prone to pain than the “crown” part that extends above the gumlines. When the roots of your teeth are exposed because of receding gumlines, it causes your teeth to hurt more. Anything from cold water to the physical stimuli of brushing your teeth right before bedtime can make your mouth hurt. Are you taking medication before bed? Going through your brushing and flossing routine? Take a look in the mirror to check your mouth for gum recession. If you do, sensitivity toothpaste or a gum graft will help.  

5. TMJ Disorders

Jaw pain, popping, clicking, headaches, earaches, and tooth pain are all symptoms of TMJ disorder. When you wake up, you might notice a sore jaw or limited range of motion, making it difficult to bite into or chew your breakfast. Even though your TMJ is still quite a bit behind your back teeth, the tension that it causes might be exerting extra force onto the roots of your teeth. In turn, those teeth can get sore and start to ache or throb. Especially the molars (back teeth) since they take on the brunt of the pressure.  

6. Broken Tooth Or Dental Appliance

Sometimes cracked teeth don’t hurt until pressure is applied to them. Broken or chipped enamel and dental work might go unnoticed throughout the day. But once you lay down and clench your teeth or run your tongue over them, you remember that it’s there.  If you happen to grind your teeth at night or wear a removable retainer to sleep in, those broken areas might get a little irritated from the extra stimuli. Make sure you see your dentist as soon as you can before those broken teeth or appliances crack in half altogether.

7. Late-Night Meals

Did you happen to indulge in a snack or nightcap right before bed? Those foods or drinks might be settling into areas throughout your mouth—especially if you haven’t brushed or flossed—irritating existing cavities, receding gumlines, or leaky fillings. Whatever you’re snacking on at nighttime, especially if it’s sweets, can start to catch up with you after a while. Stop and re-assess your nighttime routine to see if it involves anything related to eating or drinking. Sweets in particular can cause tooth pain at night if you have a cavity.

How To Relieve A Toothache At Night

Some of the best toothache home remedies will help you get to sleep again ASAP. Here are some important things to try to get you through the night, before you can see your dentist the next day:

• Take over-the-counter pain medication as prescribed. For best results, use an anti-inflammatory NSAID, like ibuprofen (Motrin.)
• Prop your head up with a couple of extra pillows, or sleep in a recliner to keep your head elevated.
• Make a cold compress to place against the side of your mouth that hurts.
• If you have sinus pressure or a sinus infection, take a decongestant.
• Use one of several dentist-approved toothache remedies such as saltwater rinses, clove oil, or placing a teabag against the side of your gums. Depending on what you have on hand, you can try two or three different options to see which one helps best.

If for any reason you’re experiencing, extreme tooth pain and can't sleep, facial swelling, bleeding that won’t stop, or inflammation is blocking your airway, call 911 and/or head straight to the emergency room.

Related: Best Electric Toothbrushes for Sensitive Teeth and Gums

Talk To A Dentist 

Tooth pain doesn’t happen for no reason. Either there is an infection, some type of trauma, or an underlying condition that’s triggering your toothache to flare up at night. Since dental infections—including gum disease and cavities—can’t get better on their own, you need to see a dentist.

Don’t avoid your dental exam and hope your tooth pain will go away. In a typical scenario, dental infections will continue to spread deeper into teeth or adjacent structures, complicating things. It’s best to treat them immediately, while they’re as small (and affordable) as possible to correct. If you haven’t seen your dentist recently, be sure to go ahead and schedule a checkup. Don’t cross your fingers and hope for things to get better. The only way they will is to have them treated by your dentist.