Why is there a toothache at night?

Toothache is considered to be the nastiest feeling, with the situation even worse when a tooth hurts at night, since it makes impossible for the body to get a desirable break. What are the causes of the state and how to manage annoying dental nightmare?

What causes night toothache?

As such, the pain always results from sensitive nerve that runs through a soft part of the tooth (endodontium). A toothache at night stands typically for a symptom of those that accompany pulp inflammation, aka pulpitis.

Though, recent researches in dental diseases and neuroscience have revealed other facts making this information outdated. In fact, nearly any dens and gum condition can provoke painful feeling when it is bedtime. At times, tooth hurts at night after filling as well.

This happens due to the peculiarities of the human excitatory system. When in daytime, it ‘chooses’ priority signals, coming from the vitals, vestibular apparatus, senses (sight, hearing, smell, etc.), and other units that are to work properly to provide healthy performance of the body. Teeth are recognized as being not that relevant, with discomfort feeling blocked by more significant impulses.

But when the priorities of CNS are changed, with a person being not distracted by everyday tasks, it all starts. It does not mean that you don’t have it during the day, but that you only begin to feel it when your brain decides it is the right time to let you know about the issue. That is why it may seem that your tooth hurts at night only.

toothache at night photoTherefore, dental pain at night is an equal indicator for such conditions as:

  • Pulpitis
  • Periodontitis
  • Periostitis
  • Alveolitis
  • Other disorders

That said, note pulpitis is the most likely disease, for the inflammation develops directly in the dental nerve.


Dental diseases, accompanied with pain, rarely show specific signs that can tell this very condition from the others.

Here are odontalgia criteria to lead the medical assessment:

  1. Pulpitis is characterized by constant nagging ache. But when you are eating or drinking something 5-7°C warmer or cooler your body, a pang happens. It calms down after a while, but at night (or during the nap) it is back, disturbing you with nasty painful throbbing in a tooth.
  2. Pulpitis, periodontitis and tooth root cysts feature pangs when a sore dens is affected (with pressure, temperature, chemicals, etc.). Nagging and obtuse feeling that does not become worse belongs more often to alveolysis, gingivitis, median caries.
  3. Single time pain is regarded as being only of a traumatic origin, whereas the other cases are signaled beforehand with a continuously progressing agony that develops for days or even months.

More criteria are needed to provide a comprehensive answer as to the reason of wisdom tooth pain at night. Only a registered expert is to determine a diagnosis particularly on the basis of performed examination.

Treatment options

Treatment options and medications are selected for every particular case.

  • wisdom tooth pain at night photoTo kill a nerve with a chemical or remove it from a previously prepared tooth is preferred for advanced pulpitis. Unfortunately, in most if any cases, it makes no sense to preserve endodontium in order to prevent infection spread and further inflammation of healthy tissues. A reason solid enough to see your dentist as soon as you found the issue, for the mild degree of pulpitis can be cured giving chance to the nerve and blood vessels.
  • Conservative treatment options and surgery can be resorted to, to treat diseases of parodontium, alveolar bone, and jaw bony tissue. Prescription includes drugs of local and systemic action that combat inflammation and infection, while boosting body own regenerative and protective abilities.
  • A surgery is recommended when your doctor comes to the conclusion that regular treatment is of low efficiency. It may involve both a causative tooth and tissues/neoplasms, adjacent to the root, being removed.

Home remedies for pain relief

When you develop toothache at night, you cannot ask for emergency dental care for it may not be available round the clock. Not every person is able to bear this nagging fiery feeling. Besides, you don’t need to: there are several easy steps for you to follow in order to fall asleep and wait for the reception time.

  1. tooth hurts at night only photoBrush your teeth thoroughly though gently as plaque and food debris can ‘seal’ carious cavity and thus lead to an intense discomfort.
  2. Rinse your mouth with a soda solution (1 tea spoon for ½ cup of water, heated to body temperature).
  3. Take anesthetic that you normally rely on when you have a headache, joint pain, menstrual cramps, or other (Ketanov, Ibuprofen, Nurofen, Naproxen, Nise, etc.)
  4. When in bed, have your causative tooth side over the top. For example, if it is a left side agony, make sure to lie on your right side. Blood will outflow from the soft tissues reducing edema and pressure that nerve fibers are exposed to.

When chronically ailing or elderly person suffers toothache, it is crucial to apply immediately to the nearest hospital or Primary Health Care Centre. Experts having provided pain relief, patient will feel better, with no more adverse effects, triggered by prolonged severe agony, for their nervous and cardiovascular system.

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