Toothache at Night: What to Do Until You Can See a Dentist

Clinically reviewed by Dr Shaheen Alghofari, GDC-registered dentist (GDC no. 318372) at Twilight Dental, Leeds. In pain right now? See our emergency toothache page or call 0113 819 7865 — reception answers 24 hours a day.

Why does toothache get worse at night?

Most people notice their toothache ramps up after they go to bed. There are three main reasons. When you lie down, more blood flows to your head, which raises pressure inside an already inflamed tooth. During the day you are busy and distracted; at night the pain has your full attention. And many people clench or grind their teeth in their sleep, which loads a sore tooth even more.

A tooth that throbs when you lie down, wakes you up, or lingers for minutes after a hot drink is usually telling you the nerve inside is inflamed or infected. That is a problem that needs a dentist, not just a better night’s sleep.

What can I do right now to ease the pain?

• Take over-the-counter pain relief correctly. Paracetamol or ibuprofen, at the dose on the packet, are the usual choices. Many adults can take both together, but check the leaflet or ask a pharmacist first, especially if you have asthma, stomach problems, are pregnant or take other medicines.
• Raise your head. An extra pillow reduces the pressure that makes night-time pain throb.
• Use a cold compress. A bag of frozen peas wrapped in a tea towel, held on the cheek for 15 minutes at a time, can calm swelling and dull the ache.
• Rinse gently. Warm salt water (half a teaspoon in a glass of warm water) can help if food is trapped or the gum is sore.
• Avoid triggers. Very hot, very cold and sugary food and drink will set off a sensitive tooth. Chew on the other side.

What should I avoid?

Do not put aspirin directly on the gum or tooth — it burns the soft tissue and does nothing for the nerve. Do not take more painkillers than the packet allows, even if the pain is severe; overdosing on paracetamol is dangerous. And try not to rely on leftover antibiotics: they do not treat the cause of most toothache, and the wrong course can do more harm than good (we explain why in can I just take antibiotics for a tooth infection?).

When is night-time toothache an emergency?

Most toothache is urgent but not life-threatening. Some signs mean you should not wait until morning:

• Swelling spreading to your eye, under your jaw or down your neck
• Difficulty swallowing, breathing or opening your mouth
• A high temperature with facial swelling, or feeling generally very unwell

If any of these apply, go to A&E or call 999. Spreading infection from a tooth can become serious quickly. For swelling without these red flags, see our guide to dental abscesses and facial swelling.

What will a dentist do?

At the appointment we examine the tooth, take an X-ray if needed and find the cause — deep decay, a cracked tooth, an abscess, a lost filling or a wisdom tooth flaring up. The pain is usually stopped at the same visit, either by removing the inflamed nerve and dressing the tooth (the first stage of root canal treatment), placing a temporary filling, draining an abscess or, where the tooth cannot be saved, an extraction. You are told the cost before anything starts.

Can I see a dentist tonight in Leeds?

Yes. Twilight Dental at 1 Moor View, Woodhouse (LS6) sees patients 24 hours a day, seven days a week. Our scheduled evening clinic runs 6:30pm to 10pm, and the new patient consultation is £24 until 10pm. After 10pm, reception books you in with the on-call dentist and the consultation is £499. If the pain is bearable with painkillers, the cheapest option is often to call us and take an evening slot; if it cannot wait, we can see you overnight. See our out-of-hours dentist page for details.