Toothache at night: Causes, remedies and when to call a dentist

16 / 10 / 2026

Toothache at night: Causes, remedies and when to call a dentist

Toothache always seems to get worse at night, just when you are trying to sleep and your dentist is closed. If you are lying awake with a throbbing tooth, here is why it happens, what you can do to ease it, and when you need to get help.

Why does toothache feel worse at night?

When you lie down, more blood flows to your head, increasing pressure around an inflamed tooth. There are also fewer distractions at night, so you notice the pain more. And if you clench or grind your teeth in your sleep, that can make things worse.

Common causes

• Tooth decay: once decay reaches the inner part of the tooth, it can cause throbbing pain;
• A dental abscess: an infection that can cause severe pain and swelling;
• A cracked tooth: often painful when biting or with hot and cold;
• A lost filling: leaving the tooth exposed and sensitive;
• Wisdom teeth: the gum around a partly erupted wisdom tooth can become inflamed;
• Gum problems: such as a gum infection; and/or
• Sinus pressure: can cause aching in the upper back teeth.

Getting through the night

• Take over-the-counter pain relief such as paracetamol or ibuprofen, following the dose on the packet (check it is suitable for you).
• Sleep with your head propped up on an extra pillow.
• Hold a cold compress wrapped in a cloth against your cheek.
• Avoid very hot, cold or sugary food and drinks.
• Rinse gently with warm salt water.
• Never put aspirin directly on the gum, as it can burn.

When to get urgent help

Call NHS 111 or go to a&e straight away if you have:

• Swelling that is spreading to your eye, neck or making it hard to swallow or breathe.
• A high temperature with facial swelling.
• Heavy bleeding that will not stop.

Call us in the morning

For most toothache, call us as early as possible the next day. We keep time aside for emergency appointments and will do our best to see you the same day.

Urgent NHS treatment costs £27.90 (from April 2026). A private emergency appointment at Castle Street costs £50.

Do not ignore it

Toothache that goes away on its own is not always good news. It can mean the nerve has died, and infection may still be developing. Always get it checked. Call us on 01494 527 971.