A dull ache or sharp throbbing in your teeth can intensify as evening approaches. Tooth pain often becomes significantly more noticeable and disruptive during the night hours. Understanding why this common issue occurs involves both physiological changes and specific dental conditions.
Why Pain Worsens at Night
Tooth pain often feels more severe at night due to physiological and environmental factors. When lying down, blood flow to the head increases, which can heighten pressure within the dental pulp. This increased pressure can intensify throbbing, particularly if the pulp is already inflamed. The absence of daytime distractions also plays a role, as the quiet of the night leaves less to divert attention from discomfort, making pain more pronounced.
Unconscious habits like teeth grinding or clenching, known as bruxism, frequently occur during sleep. This habit places significant stress on teeth and surrounding structures, exacerbating existing pain or creating new sensitivity. Saliva production also naturally decreases at night, reducing its protective buffering effect against acids and its ability to wash away food particles, contributing to discomfort. These combined factors can make dental pain feel considerably worse than during waking hours.
Underlying Dental Causes
Tooth Decay and Cavities
Tooth decay and cavities are common causes of nighttime tooth pain. As bacteria erode the tooth’s enamel and dentin, they can reach the dental pulp, causing inflammation known as pulpitis. The increased blood flow when lying down can then intensify pressure on this inflamed pulp, leading to a throbbing ache. Even small cavities can cause significant discomfort, especially as the nerve becomes irritated.
Gum Disease
Gum disease, including gingivitis and periodontitis, can also worsen tooth pain at night. Inflammation and infection of the gums can lead to heightened sensitivity and discomfort around the teeth. As blood flow increases in the supine position, inflamed gum tissues may experience greater pressure, amplifying the pain. Untreated gum disease can eventually lead to bone loss and tooth instability.
Bruxism
Bruxism, the involuntary teeth grinding or clenching, is a common nocturnal habit that exerts immense force on the teeth and jaw joints. This sustained pressure can lead to tooth sensitivity, fractures, and generalized jaw pain, which becomes more apparent without daily distractions. Many individuals are unaware they grind their teeth until symptoms like morning headaches or jaw soreness appear.
Cracked Teeth or Damaged Fillings
Cracked teeth or damaged fillings can expose sensitive dentin to external stimuli. Pain from these exposures can be more noticeable at night when the mouth is at rest and distractions are minimal. Even microscopic cracks can allow bacteria to enter, leading to inflammation and discomfort.
Dental Abscess
A dental abscess, an infection at a tooth’s root or in the gums, often causes severe, throbbing pain that intensifies when lying down. The pressure from pus buildup within the abscess is exacerbated by increased blood flow to the area, leading to intense pain. This type of pain is often persistent and can be accompanied by swelling.
Exposed Dentin
Exposed dentin, due to receding gums or enamel erosion, can also lead to tooth sensitivity. This exposure allows external stimuli, such as temperature changes or pressure, to directly stimulate the dentin’s nerve endings, resulting in sharp, fleeting pain that can be bothersome during quiet periods.
Beyond Dental Issues
Tooth pain felt at night can sometimes originate from conditions not directly related to the teeth. Sinusitis, an inflammation of the sinus cavities, is a common cause. The roots of upper back teeth are close to the maxillary sinuses. When these sinuses become inflamed or congested, pressure can be referred to the upper teeth, mimicking a toothache. This referred pain can worsen when lying down, as position changes can increase sinus pressure.
Referred pain from other head and neck areas can also manifest as tooth discomfort. Conditions affecting the temporomandibular joint (TMJ), which connects the jawbone to the skull, can cause pain radiating into the teeth, especially the molars. Similarly, ear infections or nerve conditions can sometimes present as tooth pain, becoming more pronounced during rest.
When to Seek Professional Care
Consult a dentist if you experience persistent or severe tooth pain, especially if it worsens at night. Other warning signs include swelling in your face or gums, a fever, or difficulty opening your mouth fully. Pain not relieved by over-the-counter medication or prolonged sensitivity to hot or cold temperatures also warrants professional evaluation. Prompt dental assessment can help identify the underlying cause and prevent potential complications.