Tooth pain that intensifies when lying down can be a confusing and uncomfortable symptom. This sensation often points to underlying dental or medical issues exacerbated by changes in body position. Understanding why this occurs can help guide you toward appropriate care.
Why Lying Down Causes Tooth Pain
When you lie down, the body’s fluid dynamics shift, leading to increased blood flow to the head and dental area. This rise in pressure within blood vessels can intensify pain in an already inflamed or compromised tooth. Elevating your head with extra pillows can sometimes offer temporary relief by reducing this blood flow.
Gravitational changes also play a role. When horizontal, fluid can accumulate in the sinus cavities, increasing pressure that can be referred to the upper teeth, which are in close proximity to the maxillary sinuses. Lying flat can also worsen symptoms of acid reflux, where stomach acid travels up to the mouth, potentially eroding enamel.
Potential Dental and Medical Conditions
Several conditions can cause or worsen tooth pain when lying down.
Pulpitis, inflammation of the tooth’s inner pulp, often intensifies when reclining due to increased internal pressure, stemming from decay, trauma, or a cracked tooth. Cracked Tooth Syndrome involves tiny, often invisible fractures causing sharp, intermittent pain, especially when biting; lying down can irritate the nerve.
Sinusitis, an inflammation of the sinus cavities, frequently causes referred pain to the upper teeth, worsening when lying down due to increased sinus pressure. This pain typically affects multiple upper teeth. Bruxism, the involuntary grinding or clenching of teeth during sleep, stresses teeth and jaw muscles, leading to pain, soreness, and headaches.
Gastroesophageal Reflux Disease (GERD) involves stomach acid flowing back into the esophagus and mouth, eroding tooth enamel and causing sensitivity exacerbated when lying horizontally. A dental abscess, a pus collection from bacterial infection, causes throbbing pain worsening when lying down, as increased blood flow makes it more pronounced.
When to Seek Professional Dental Care
Consult a dentist if you experience persistent or worsening tooth pain, especially if it intensifies when lying down. Urgent symptoms include swelling in the gums or face, or a fever, which can indicate a spreading infection.
Difficulty eating or sleeping due to pain also warrants a dental visit. Additionally, a foul taste or discharge around the affected tooth indicates an infection, such as an abscess.
How a Dentist Diagnoses and Treats
A dentist discusses your symptoms, including pain severity, duration, and what makes it better or worse. A clinical examination of your mouth, teeth, and gums follows, looking for signs of decay, cracks, or inflammation. Dental X-rays provide detailed images of areas not visible, helping identify deep decay, abscesses, or bone loss.
Pulp vitality tests, such as a cold test, assess the tooth’s nerve health. Percussion (gently tapping the tooth) and bite tests help pinpoint the pain source and identify cracked teeth or inflammation around the root.
Based on the diagnosis, treatment options vary. For decay, a filling or dental crown may be recommended. If the pulp is severely inflamed or infected, root canal therapy may be necessary to remove damaged tissue and save the tooth. For extensive damage or infection, tooth extraction may be the most suitable option.
For bruxism, a custom-fitted night guard can protect teeth from grinding and clenching. Antibiotics may be prescribed for bacterial infections. If non-dental conditions like sinusitis or GERD are suspected, the dentist may refer you to a medical specialist, such as an ENT or gastroenterologist, for further evaluation and management.