Why Do My Teeth Hurt at Night? Causes and What to Do
Tooth pain at night can be unsettling and disruptive, ranging from a dull ache to a sharp, throbbing sensation. Understanding its potential causes is the first step toward finding relief.
Common Dental Causes
Tooth decay, or cavities, frequently causes nighttime tooth pain. As bacteria erode enamel, they expose sensitive inner layers like dentin. Deep decay reaching the pulp, which contains nerves, can cause significant pain, especially when lying down.
Gum disease, including gingivitis and periodontitis, involves gum tissue inflammation and infection. Gingivitis causes red, swollen, and bleeding gums. Untreated, it can advance to periodontitis, where infection spreads below the gum line, potentially damaging bone and leading to pain and sensitivity.
Cracked or chipped teeth can cause sharp, sudden pain. Fractures expose dentin or pulp to temperature changes and pressure. Pain might be intermittent, occurring when biting or releasing pressure, or persistent if the pulp is inflamed.
A dental abscess is a severe localized infection at a tooth’s root or between the gum and tooth. It causes intense, throbbing pain from pus accumulation and pressure on nerves. Abscess pain can worsen at night, sometimes with facial swelling or fever.
Pulpitis is inflammation of the dental pulp, the soft tissue inside the tooth. Reversible pulpitis, from minor decay or trauma, causes temporary sensitivity. Irreversible inflammation, often due to deep decay or infection, causes the pulp tissue to die, leading to persistent, severe pain that feels more pronounced at night.
Impacted wisdom teeth, molars without enough space to erupt, can cause significant nighttime discomfort. They may pressure adjacent teeth or become partially erupted, creating a gum flap where food and bacteria accumulate. This leads to inflammation, infection, and pain in the jaw and surrounding teeth.
Non-Dental Contributors and Exacerbating Factors
Bruxism, unconscious teeth grinding or clenching, commonly causes nighttime tooth pain. This activity, often during sleep, places significant pressure on teeth and jaw muscles. The sustained force can lead to tooth sensitivity, headaches, and a sore jaw, often worsening overnight or upon waking.
TMJ disorders can cause referred pain in the teeth, manifesting as a dull ache or sharp pain. This discomfort may mimic a toothache and worsen with jaw movements or clenching.
Sinusitis, inflammation or infection of the sinus cavities, can cause tooth pain, especially in upper molars. Their roots are close to the maxillary sinuses. When sinuses inflame and congest, pressure can be felt as tooth pain, intensifying when lying down or bending over.
The body’s physiology contributes to increased nighttime tooth pain. Lying flat increases blood flow to the head, leading to greater pressure in inflamed or infected tooth areas. This amplifies the throbbing sensation. Elevating the head with extra pillows can help reduce this pressure.
The absence of daily distractions at night makes pain more noticeable. During the day, activities divert attention from mild discomfort. At night, with fewer external stimuli, the body becomes more attuned to internal sensations, making even minor tooth pain seem more severe.
Hormonal fluctuations and circadian rhythms influence pain perception. Cortisol levels, which help control inflammation, naturally drop at night. This decrease can make existing inflammation and pain feel more intense. Pain sensitivity can be rhythmic, sometimes peaking at night.
When to Seek Help and What to Do
For temporary relief, use over-the-counter pain relievers like ibuprofen or acetaminophen. Applying a cold compress to the cheek can reduce swelling and numb the area. Rinsing with warm salt water also offers temporary relief by reducing inflammation and cleansing.
Avoid trigger foods and temperatures like very hot, cold, sugary, or acidic items, especially before bed, as they can aggravate cavities or sensitivity. While these measures provide short-term comfort, they do not address the underlying cause and are meant to bridge the gap until professional dental care.
Certain warning signs indicate an urgent dental visit. Persistent, severe pain not subsiding with home remedies or over-the-counter medication warrants immediate attention. Swelling in the face or gums, especially if spreading rapidly, signals a serious infection. A fever accompanying tooth pain also suggests an infection requiring prompt medical evaluation.
Difficulty swallowing or breathing with tooth pain are emergency symptoms requiring immediate medical intervention. Only a dental professional can accurately diagnose the root cause of nighttime tooth pain. They perform necessary examinations, including X-rays, to identify the issue and recommend treatment.
Preventing Nighttime Tooth Pain
Maintaining good oral hygiene prevents tooth pain, including discomfort at night. Regular brushing twice daily with fluoride toothpaste removes plaque and food particles, preventing decay and gum disease. Daily flossing cleans between teeth and under the gum line, areas brushing alone cannot reach.
Consistent use of antiseptic mouthwash further reduces bacteria and inflammation. These habits are foundational for overall dental health and significantly lower the risk of conditions leading to nighttime pain.
Regular dental check-ups and professional cleanings are important for early detection and prevention. Dentists identify and address small cavities or gum issues before they escalate. Professional cleanings remove hardened plaque and tartar, maintaining gum health and preventing decay.
Addressing bruxism is a key preventative measure. If teeth grinding or clenching is suspected, a dentist may recommend a custom-fitted nightguard. This appliance creates a protective barrier between teeth, absorbing grinding forces and reducing wear. Stress management techniques, like relaxation or mindfulness, can also help mitigate bruxism, as stress is a common trigger.
Dietary considerations play a role in preventing tooth pain. Limiting sugary and acidic foods and drinks reduces enamel erosion and cavity risk. These substances weaken tooth structure, making teeth more susceptible to pain. A balanced diet supports overall oral health.
Managing underlying medical conditions contributing to tooth pain can also help. For instance, managing recurring sinusitis with a healthcare provider can prevent referred tooth pain. Addressing TMJ disorders through appropriate treatments can alleviate jaw-related discomfort radiating to the teeth.