Toothache refers to pain in and around the teeth and jaws that’s usually caused by tooth decay. You may feel toothache in many ways. It can come and go or be constant. Eating or drinking can make the pain worse, particularly if the food or drink is hot or cold. The pain can also be mild or severe. It may feel “sharp” and start suddenly. It can be worse at night, particularly when you’re lying down. A lost filling or broken tooth can sometimes start the pain.
It can also sometimes be difficult to decide whether the pain is in your upper or lower teeth. When a lower molar tooth is affected, the pain can often feel like it’s coming from the ear. Toothache in other upper teeth may feel like it’s coming from the sinuses, the small, air-filled cavities behind your cheekbones and forehead.
Why do some toothaches hurt more at night?
Toothaches can be painful in the day, but they may seem to get worse at night. One reason that this may occur is because when a person is lying down, blood rushes to the head. This extra blood in the area may increase the pain and pressure that people feel from a toothache. Another reason why many aches feel worse at night is because there are fewer distractions. With little else to focus on but the toothache, a person may find it difficult to fall asleep.
When to see your dentist
If you have toothache for more than one or two days, visit your dentist as soon as possible to have it treated. The longer you leave it, the worse it will get. If your toothache isn’t treated, the pulp inside your tooth will eventually become infected. This can usually lead to a dental abscess, with severe and continuous throbbing pain.
Painkillers, such as paracetamol and ibuprofen, may reduce the pain and discomfort while you’re waiting for an appointment. Children under 16 years of age shouldn’t be given aspirin.
Toothaches have many causes, from gum disease to jaw clenching, but tooth root sensitivity can also cause a tooth to ache. The tooth root includes the lower two-thirds of the tooth, and it is usually buried in the jawbone. But when gum disease develops, the bacteria that cause the disease can also dissolve the bone around the tooth root. The combination of dissolved bone and receding gums means that more of the tooth root is exposed. Without protection from healthy gums and healthy bone, the root often becomes sensitive to hot and cold and to sour foods. In some cases, the sensitivity is so severe that you may avoid very hot, cold or sour foods.
The most common reason for a painful toothache is plain old tooth decay. Sure, it might not be all that exciting or new, but it’s something that can affect any of us. For the tooth and the surrounding area to hurt, the decay in the tooth would have to be significant enough to reach the inner layer of the tooth, a layer called the dentin. Once the dentin is damaged the tooth becomes very sensitive and a cavity, or cary, has developed.
If the pain becomes less of an ache and more of a sharp pain, the tooth decay may have reached the center of the tooth. This results in a very intense pain that makes it difficult to carry on with daily life. These issues need to be addressed as soon as possible as they are not only painful but can quickly lead to bigger dental issues.
Teeth can be cracked or chipped in many different ways, whether it’s through a fall, playing sports, or biting down on something hard or sticky. If you are feeling pain in a fractured tooth, that means that the fracture has made its way to the middle of the tooth where the nerve endings are and can result in excruciating pain.
This may not happen as soon as the tooth is chipped or damaged, but can develop over time as the tooth damage worsens. This is why all fractures and chips should be attended to by your dentist as soon as possible and before they have the chance to worsen.
Gum disease is characterized by a dull pain in the mouth, red, bleeding gums, and also sometimes tooth pain. A common cause of this is the oral bone and gums becoming inflamed. If left untreated, teeth, gums, and bones could be damaged or lost, and surgical measures may have to be taken to rid the mouth of infection.
When tooth decay advances to the point of affecting the root beneath the visible tooth there is a high chance that the root and the surrounding tissue have become infected. This will result in a widespread pulsating pain that may make it hard to determine which exact tooth is the culprit of the pain. This is a very serious issue and needs to be professionally dealt with as soon as possible as it can result in bone and tissue loss. Which, obviously, is no fun at all.
If you are experiencing sharp tooth pain during, or very soon after, eating or drinking something that is cold or hot, this is typically associated with tooth sensitivity. This can mean that your tooth enamel has worn down and your tooth’s dentin (the layer where the tooth’s nerves lie) is exposed, or can be a result of recent teeth whitening. To help protect these nerves and shelter them from extreme temperatures, try a toothpaste made for sensitive teeth.
Teeth grinding, or bruxism, is a very common reason for tooth, jaw, neck, and related muscle pain. People who grind their teeth generally do so while they’re sleeping or during stressful situations. Excessive teeth grinding involves violently clenching the jaw and grinding the top and bottom teeth back and forth against each other.
This can result in sore jaw bones and joints, headaches, and even cracked or chipped teeth, all of which are very painful. The best course of action to treat bruxism is to have a custom mouthguard made that is worn while sleeping to relieve the stress put on teeth and the jaw.
Improper Brushing or Flossing
Very often people do not pay attention to the pressure they are using when they brush and floss their teeth and end up pressing much too hard. This results in irritated, inflamed, and bleeding gums. If extreme pressure like this is constantly used, it can cause gums to recede and can make teeth unstable, resulting in more pain. Consult your dentist about proper brushing techniques and be sure to only use soft bristled toothbrushes.
Misaligned Teeth or Impacted Wisdom Teeth
Teeth that are misaligned can press against others, pushing them out of line as well, resulting in aches and pains. Impacted wisdom teeth, also known as wisdom teeth that have failed to break through the gum line, can also be extremely painful as they fester below the gum line and sometimes push against other teeth. These issues should be brought to the attention of your dentist, if they haven’t been addressed yet. For misaligned teeth, an orthodontic solution will likely be proposed, such as braces, and surgery will be needed to fix impacted wisdom teeth.
Braces, retainers, and other dental alignment systems are a common cause for oral discomfort and aching pain among teeth. Pain is usually fairly noticeable right after adjustments which tighten or move teeth, but typically subsides after a few days. If the pain is still extremely uncomfortable and persisting, discuss with your orthodontist about readjusting your orthodontic appliance so that it does not interfere with your daily life.
Damaged Fillings or Dental Sealants
Dental fillings that cover deep pits, grooves, or fractures in teeth often protect vulnerable parts of the tooth. When these protectants are damaged, the sensitive parts of teeth are exposed to extreme temperatures, food particles, and bacteria. This can result in a pain that is anything from a dull ache to a sharp, piercing sensation. If you have a damaged filling or sealant, be sure to book an emergency appointment with your dentist to have it fixed before the vulnerable parts of your tooth suffer further damage or decay.
How can you relieve the pain of toothache?
If you can’t get to a dentist straight away, taking a painkiller can relieve some discomfort. Over-the-counter pain relief medication can ease the pain if it’s distracting or you’re finding it difficult to sleep.
You could also try gargling salt water. Salt water helps to remove bacteria from the mouth and can reduce swelling. Add about half a teaspoon of salt to warm water and gargle for at least five seconds. Take care not to swallow the water. Applying ice can help to numb the pain. Place a cold compress or ice pack against your cheek. Don’t apply ice directly to your tooth, as toothaches often cause heightened sensitivity to temperature.
While you may be able to gain some temporary pain relief, it is still important to see a dentist. They will need to treat the cause of your toothache to eradicate the pain for good.
Ways to treat a toothache at night
Treating a toothache at night may be more difficult, as there is not much to distract a person from the pain. However, people can try the following methods to relieve pain:
Oral pain medication
Taking over-the-counter (OTC) pain medications such as acetaminophen (Tylenol) or ibuprofen (Advil) is a quick, simple way for many people to effectively reduce mild-to-moderate toothaches.
Using a cold compress may help ease the pain of a toothache. Applying a bag of ice wrapped in a towel to the affected side of the face or jaw helps constrict the blood vessels in the area, which can reduce pain to allow a person to fall asleep.
Applying a cold compress to the area for 15–20 minutes every few hours in the evening may also help prevent pain when going to bed.
Pooling blood in the head may cause additional pain and inflammation. For some people, elevating the head with an extra pillow or two may relieve the pain enough for them to fall asleep.
Salt water rinse
A simple salt water rinse is a common home remedy for a toothache. Salt water is a natural antibacterial agent, so it may reduce inflammation. This, in turn, helps protect damaged teeth from infection. Rinsing with salt water may also help remove any food particles or debris stuck in the teeth or gums.
Hydrogen peroxide rinse
Periodontitis is a serious gum infection that generally occurs as a result of poor oral hygiene. It can cause issues such as soreness, bleeding gums, and teeth that come loose in their sockets. This remedy is not suitable for children, as there is a risk they may accidentally swallow the mixture.
Swishing peppermint tea or sucking on peppermint tea bags may also help temporarily relieve pain from a toothache.
Researchers note that peppermint contains antibacterial and antioxidant compounds. Menthol, an active ingredient in peppermint, may also have a mild numbing effect on sensitive areas.
Eugenol, which is one of the main compounds in cloves, can reduce tooth pain. Eugenol acts as an analgesic, which means that it numbs the area. To use clove for a toothache, soak ground cloves in water to make a paste. Then, apply the paste to the tooth, or put it in an empty tea bag and place it in the mouth.
Alternatively, gently chewing or sucking on a single clove and then allowing it to sit near the painful tooth may help relieve pain. This is not a suitable remedy for children, as they may swallow too much clove. Single cloves can be spiky and painful if a person swallows them.
Garlic is a common household ingredient that some people use to relieve toothache pain. Allicin, which is the main compound in garlic, has a strong antibacterial effect that may help kill the bacteria in the mouth that lead to cavities and tooth pain.
Simply chewing a clove of garlic and allowing it to sit near the tooth may help relieve pain. That said, the taste of raw garlic can be too strong for some people, so this may not be the right solution for everyone.
The best way to avoid getting toothache and other dental problems is to keep your teeth and gums as healthy as possible. To do this, you should:
- limit your intake of sugary foods and drinks – you should have these as an occasional treat and only at mealtimes; read more about cutting down on sugar
- brush your teeth twice a day using a toothpaste that contains fluoride– gently brush your gums and tongue as well
- clean between your teeth using dental floss and, if necessary, use a mouthwash
- don’t smoke – it can make some dental problems worse
Make sure you have regular dental check-ups, preferably with the same dentist. The time between check-ups can vary, depending on how healthy your teeth and gums are and your risk of developing future problems.
Your dentist will suggest when you should have your next check-up based on your overall oral health. Children should have a dental check-up every six months so tooth decay can be spotted and treated early.