It usually starts right after you switch off the lamp. The house goes quiet, you finally lie down, and there it is again: the dull throb in a back tooth that you mostly ignored all afternoon. Now you can’t think about anything else.
A toothache at night is miserable, and it’s natural to lie there wondering what’s going on. The pain itself won’t tell you much. It could come from a cavity, a crack, an irritated nerve or an infection, and only a dentist looking at the tooth can say which one it is.
First, a quick word on urgency. If the pain is severe, keeps you awake, or comes with swelling, contact a dentist in Woodbridge soon instead of waiting to see what happens. If swelling is making it hard to breathe or swallow, go for emergency medical care right away.
Why it seems to get worse when you go to bed
During the day, you have work, conversations and the radio in the car competing for your attention. At night nothing competes, so an ache that was there all along suddenly feels a lot louder. Lying down can also make a throbbing tooth more noticeable. Neither of these things explains what’s actually wrong with the tooth, though.
A more useful thing to pay attention to is what sets the pain off. Does a sip of cold water make it flare? Does the ache hang around after the drink is gone? Does it hurt when you bite down, or does it throb even when you leave it alone? If you’re awake anyway, type the answers into your phone. Your dentist will ask about exactly these details.
What might be causing it
Tooth decay. Early on, a cavity may just make a tooth a little sensitive. Once the decay goes deeper, the pain can get stronger or start for no obvious reason.
An inflamed or infected nerve. Deep decay, a crack or an old injury can reach the soft tissue inside the tooth. This kind of pain often throbs, lingers after something hot or cold, and is the type that keeps people up. Your dentist will need to look at whether the tooth can be restored and whether root canal treatment makes sense.
A cracked tooth or a failing filling. You might feel a sharp twinge when you chew or when you let go of a bite. Cracks are hard to see at home, so try not to keep testing the tooth by biting on it.
A dental abscess. An infection can bring constant pain, a sore or puffy gum, a bad taste in your mouth, or swelling in your face or jaw. An abscess should be seen promptly. It won’t reliably go away on its own.
Irritated gums or food stuck between teeth. Sometimes a bit of food wedged in the wrong place is enough to make the area ache. Cleaning gently may settle it, but if the soreness hangs on or keeps coming back, have it checked.
Keep in mind that these are possibilities to talk through with your dentist, not a way to work out the answer yourself. Treatment depends on what they find.
A few things that may help tonight
None of these will fix the underlying problem, but they can take the edge off while you arrange an appointment.
- Rinse with lukewarm water.
- If you suspect something is caught between your teeth, floss gently, and stop if it makes things worse.
- Chew on the other side and skip whatever food or drink seems to set the pain off.
- If you can safely take an over-the-counter pain reliever, follow the directions on the package, or ask a pharmacist which one is right for you.
- If the pain started after a knock or injury, a cold compress held against the outside of your cheek can help.
One thing to avoid: don’t put aspirin or any other painkiller directly on the tooth or gum. It can irritate or even burn the tissue.
When to call the dentist
Call soon if the pain is severe, keeps you from sleeping, keeps returning, or just won’t settle. The same goes for pain when you bite, a broken tooth or filling, swelling around a tooth, or a bad taste that might mean an infection is draining.
And if you wake up and it feels fine? That’s good news for your morning, but it doesn’t mean the problem has gone. Tooth pain can come and go while the cause is still there. When you call the office, mention what happened overnight and whether you had any swelling or fever.
If you’re looking for a dentist in Woodbridge or nearby Vaughan, the team at Milani Dentistry can examine the tooth and walk you through your options once they know what’s going on.
When it’s an emergency
Go for emergency medical care right away if swelling is affecting your breathing or swallowing. Swelling that is spreading or getting worse quickly, especially if you have a fever or feel very unwell, also needs urgent attention. Don’t hold out for a regular dental appointment in these situations. If you have severe tooth pain without these warning signs, contact an emergency dentist in Woodbridge for prompt advice.
What happens at the appointment
Expect some questions first: when the pain started, where exactly you feel it, and what makes it better or worse. Your dentist will then look at the tooth and gums, check how your teeth meet when you bite, see how the tooth reacts to hot and cold, and take an X-ray if it’s needed.
What comes next depends on the diagnosis. It might be a new filling, protecting a damaged tooth, treating the nerve, dealing with an infection, or another option you’ll discuss together. Painkillers can make you more comfortable, but they can’t tell you which treatment the tooth needs.
Questions people often ask
Why does my tooth only hurt when I lie down?
A throbbing ache is often easier to notice when you’re resting. The timing on its own doesn’t reveal the cause, so book an exam if it keeps happening.
Can a cavity really keep me up at night?
Yes. Decay can be painful, especially once it reaches the deeper layers of the tooth. Your dentist can check whether that’s what is going on.
Should I go to the ER for a toothache?
Usually a dentist is the right person to see for tooth pain. Head to emergency care if you’re having trouble breathing or swallowing, or if there are signs of a serious infection that is spreading.
Will antibiotics get rid of the pain?
Not every toothache calls for antibiotics. Your dentist needs to find the cause first and decide whether an infection needs them along with dental treatment.
The pain was gone by morning. Do I still need to go in?
If it was strong, kept you awake or has happened before, yes, make an appointment. Feeling better for a while doesn’t mean the tooth is healthy.
I have some swelling. Can I wait a few days?
It’s better to call a dentist promptly about swelling near a sore tooth. If it’s getting worse quickly or affecting your breathing or swallowing, get emergency medical care immediately.
A bad night with tooth pain is reason enough to find out what’s wrong, particularly if it’s costing you sleep or keeps coming back. If you need a dentist in Woodbridge to take a look, call Milani Dentistry at +1-905-856-9966.