Toothache at night
why it gets worse and how to get through it
Written with input from the clinical team at Nottingham Dental Care, led by principal dentist Dr Zeinab Attarwala (GDC 177583).
It’s late, the house is quiet, and the tooth that was niggling at you all afternoon is now throbbing so badly you can’t settle. You’re not imagining it. Toothache at night really does feel worse, and there are good reasons for that.
We see patients every single morning who’ve had a sleepless night with tooth pain. So we’ve put together the advice we’d give you if you rang us right now: what to do tonight, what’s likely causing it, and how we’ll sort it out properly.
If you're reading this in pain right now
Start here. These steps won’t fix the cause, but they should help you get some rest.
- Take a painkiller. Ibuprofen tends to work best for dental pain because it reduces inflammation. Paracetamol is a good alternative. Follow the dose on the packet, and check with a pharmacist if you’re unsure what’s safe for you.
- Prop your head up. Use an extra pillow or two so your head is higher than your heart.
- Rinse with warm salt water. Half a teaspoon of salt in a glass of warm water. Swish gently and spit.
- Hold a cold compress against your cheek. A bag of frozen peas wrapped in a tea towel, 15 minutes on, 15 minutes off.
- Keep cold and hot drinks away from the tooth. Sip water at room temperature.
- Check for red flags (see the list further down). If you have any, don’t wait until morning.
- Plan to see a dentist tomorrow. Our practice is open 7 days a week, so you won’t have to wait until Monday.
Why toothache gets worse at night
There are three main reasons the pain ramps up once you go to bed.
Lying down sends more blood to your head. When you’re upright, gravity helps keep blood pressure in your head lower. When you lie flat, more blood flows there, which increases pressure on the inflamed nerve inside the tooth. That pressure is a big part of the throbbing feeling.
There’s nothing to distract you. During the day, work, conversations and noise compete for your attention. At night, your brain has nothing else to focus on, so the pain takes centre stage.
You might be clenching or grinding. Many people clench their teeth in their sleep without realising. If a tooth is already sore, cracked or infected, that extra pressure can make it much worse.
What's causing your toothache? A quick symptom guide
The type of pain you have says a lot about what’s going on. This table is a rough guide only. A proper examination, often with an X-ray, is the only way to know for sure.
What you’re feeling | Likely cause | How soon to be seen |
|---|---|---|
A quick, sharp twinge with cold or sweet things that fades in seconds | Sensitivity, early decay or a worn filling | Within a week or two |
Pain that lingers for minutes after hot or cold, or starts on its own | An inflamed nerve (pulpitis), often from deep decay | Within a day or two |
Constant throbbing, pain when biting, swollen gum or face | A dental abscess (infection) | As soon as possible, ideally the same day |
Sharp pain when you bite down, then let go | A cracked tooth or a filling that’s too high | Within a few days |
Sore, swollen gum right at the back of your mouth | An infected wisdom tooth | Within a day or two |
A dull ache in several top back teeth, worse when you bend over | Sinus pressure, often after a cold | See a GP or pharmacist; see us if it lasts |
Aching jaw and teeth when you wake up | Grinding or clenching at night | At your next appointment |
The second and third rows are the ones that most often cause toothache at night. Both involve a nerve that is inflamed or infected, and both need treatment from a dentist rather than waiting it out.
How to stop toothache at night: what actually helps
If you’re searching for how to stop toothache quickly, these are the options we’d stand behind.
Painkillers, used properly
Ibuprofen is usually the most effective over-the-counter option for dental pain. For some adults, a pharmacist may suggest taking ibuprofen and paracetamol together, as they work in different ways. Ibuprofen isn’t suitable for everyone, including some people with asthma, stomach problems or who are pregnant, so always check first.
Keeping your head raised
It sounds simple, but sleeping more upright makes a real difference to throbbing pain. A couple of extra pillows or a reclining chair can help.
Cold, not heat
A cold compress on the outside of your cheek can numb the area and reduce swelling. Heat feels comforting, but it can draw infection towards the surface and make swelling worse.
Clove oil, with care
Clove oil has a mild numbing effect. Dab a tiny amount on a cotton bud and hold it against the tooth, not the gum. Don’t swallow it, and don’t use it for children.
What doesn't work (and can make things worse)
We hear about some of these remedies more often than you’d think.
- Putting an aspirin on the gum. It doesn’t relieve tooth pain this way, and it can cause a painful chemical burn.
- Swishing whisky or vodka. Alcohol irritates sore tissue and does nothing for the nerve.
- A hot water bottle on your face. As above, heat can make an infection spread.
- Taking extra painkillers. Going over the maximum dose is dangerous, especially with paracetamol, and it still won’t fix the problem.
- Waiting to see if it goes away. Pain can ease for a while if a nerve dies, but the infection is still there and usually comes back worse.
When you shouldn't wait until morning
Most toothache can safely wait for a dental appointment the next day. But some symptoms suggest an infection may be spreading. Call 999 or go to A&E if you have:
- Difficulty breathing or swallowing
- Swelling around your eye, or swelling spreading down your neck
- Swelling so bad you can’t open your mouth properly
Call NHS 111 tonight if you have a high temperature, feel very unwell, or the pain is severe and not helped by painkillers.
What happens when you come in with toothache
A lot of people put off seeing a dentist because they’re not sure what to expect, or they’re worried about cost. Here’s exactly how an emergency visit works with us.
Booking. Most patients book their emergency consultation online, often first thing in the morning after a bad night. You can also call us on 0115 962 3432. We keep emergency slots free every day, including weekends.
The cost. Emergency appointments start from £30. If you need treatment, we’ll explain the options and give you a clear price before we do anything. All of our prices are listed on our fees page.
The examination. Your dentist will ask about your symptoms, look at the tooth and usually take an X-ray. This shows us what’s happening below the surface, such as decay near the nerve or an infection at the root.
Getting you out of pain. Depending on the cause, this might be a temporary filling, removing the infected nerve to relieve pressure, adjusting a high filling, or treating a gum infection. If antibiotics are needed because an infection is spreading, we’ll prescribe them alongside treatment.
A plan for the long term. Once you’re comfortable, we’ll talk you through the options for fixing the tooth properly, whether that’s a filling, root canal treatment, a crown or, if the tooth can’t be saved, an extraction. Nothing happens without your agreement.
If you’re nervous about dental treatment, tell us when you book. We see a lot of anxious patients and we’re happy to go at your pace. You can find out more about being seen as an emergency dentist in Nottingham on our emergency page.
Stopping it from happening again
The honest truth is that most night-time toothache starts as a small problem that went unnoticed for months. Decay doesn’t hurt in the early stages, which is why it’s so easy to miss.
Regular dental check-ups let us spot early decay, cracks and worn fillings while they’re still quick and inexpensive to fix. Visits to our dental hygienist keep gum disease under control, which protects the bone and gum around your teeth.
At home, the basics go a long way:
- Brush twice a day for two minutes with a fluoride toothpaste
- Spit, don’t rinse, after brushing so the fluoride keeps working
- Clean between your teeth once a day
- Keep sugary snacks and drinks to mealtimes
- Ask us about a night guard if you wake up with an aching jaw
Why patients choose Nottingham Dental Care
Nottingham Dental Care is a private practice on Mansfield Road in Carrington. Our team is led by Dr Zeinab Attarwala, and every clinician is registered with the General Dental Council. We welcome patients of all ages, and new patients are always welcome.
What matters most when you’re in pain is being seen quickly by someone who’ll be straight with you. That’s why we open 7 days a week, keep emergency appointments available every day and price them from £30. As an emergency dentist in Nottingham, our aim is simple: find the cause, get you comfortable, and help you keep your natural teeth wherever possible.
You’ll find us at 473 Mansfield Rd, Carrington, Nottingham NG5 2DR.
Why patients come to us
At Nottingham Dental Care, we want you to be seen quickly when you are in pain, and to understand what is going on. Our principal dentist, Dr Zeinab Attarwala, explains each option plainly and does not push treatment you do not need. We are at 473 Mansfield Road, Carrington, and you can reach us on 0115 962 3432.
Disclaimer
The information in this article is intended for general educational guidance only and does not constitute personalised dental advice. For concerns about tartar, tooth sensitivity or gum health, please book an appointment with a qualified dental professional.
Nottingham Dental Care is a private dental practice at 473 Mansfield Rd, Carrington, Nottingham NG5 2DR, open seven days a week. We offer dental check-ups, dental hygienist appointments, emergency dental appointments from £30, Invisalign, composite bonding, porcelain veneers, teeth whitening, dental crowns and smile makeovers. Call 0115 962 3432 or book an emergency consultation directly online.
Frequently asked questions
Why does my toothache only hurt at night?
When you lie down, more blood flows to your head, which increases pressure on an inflamed nerve. You also have fewer distractions, so you notice the pain more. If toothache at night keeps coming back, it’s usually a sign the nerve is inflamed and needs to be checked.
What's the fastest way to stop toothache?
For most adults, ibuprofen is the quickest over-the-counter relief, alongside keeping your head raised and using a cold compress on your cheek. These ease the symptoms only. The only way to stop toothache for good is to treat the cause, which means seeing a dentist.
Can toothache go away on its own?
Mild sensitivity sometimes settles. But throbbing pain, pain that wakes you up or pain with swelling rarely goes away for good. If the pain suddenly stops, the nerve may have died, and the infection can return later as an abscess.
Should I go to A&E for toothache?
Only if you have difficulty breathing or swallowing, or swelling spreading to your eye or neck. A&E can’t usually treat the tooth itself. For everything else, call NHS 111 out of hours or book an emergency dental appointment.
How much does an emergency dentist in Nottingham cost?
At Nottingham Dental Care, emergency appointments start from £30. That covers your assessment and a clear explanation of your options. Any further treatment is priced before we begin, and you can see all our prices on our fees page.