--- title: "Toothache at Night: Why It Gets Worse and What to Do" description: "Tooth pain often seems stronger at night and can keep you up. Learn the common causes, safe comfort steps for tonight and the signs that mean urgent care." url: https://towncenterdental.multisites.ai/blog/toothache-at-night-why-it-gets-worse publisher: Town Center Dental phone: +1-636-273-5866 quote: https://towncenterdental.multisites.ai/request-appointment --- # Toothache at Night: Why It Gets Worse and What to Do Tooth pain at night is a sign to see a dentist, not a reason to wait. Common causes are decay, a cracked tooth, an infection or grinding during sleep. Rinse with warm water, floss and use over-the-counter pain relief tonight. Go to an emergency room for swelling, fever or trouble breathing. PreventionPublished October 26, 20265 min read ## Why does a toothache seem worse at night? The sources we reviewed do not give one simple reason, so we will not guess. What they do show is useful. The American Association of Endodontists says tooth pain, whether sharp and throbbing or dull and achy, can make it hard to concentrate, get through the day, and even sleep at night. A second clue is grinding. The American Dental Association (ADA) says most people who grind their teeth do it while they sleep, and most are not aware of it. The American Association of Endodontists says grinding can cause a dull ache and pressure in the upper teeth and jaw. Either way, pain that keeps you up is a signal to see a dentist. ## What can cause tooth pain? Many things can. MedlinePlus says a toothache is often the result of cavities, or an infection or irritation of the tooth. Cleveland Clinic lists cavities, an abscessed tooth, a cracked tooth, a damaged filling or crown, teeth grinding or clenching, and gum disease. Your dentist finds the cause with an exam and often an X-ray. Not every toothache starts in the tooth. MedlinePlus says pain felt in a tooth can actually come from other parts of the body, such as a sinus infection. It also lists a heart attack, which can include jaw pain, neck pain or toothache. If you think your pain could be your heart, call 911. ## What does my symptom suggest? This table shows what the American Association of Endodontists says about common patterns. It is a guide for questions to ask, not a diagnosis. Symptom What it may point to Brief sensitivity to hot or cold Generally not serious unless it lasts a long time Sharp pain when you bite Decay, a loose filling or a crack in the tooth Lingering pain after hot or cold foods Pulp that may be damaged by deep decay or injury Constant, severe pain and pressure with swollen gum A possible abscess, which is an infection Dull ache in the upper teeth and jaw Grinding, or a sinus headache For more on the inner part of a tooth, see [tooth pulp](https://towncenterdental.multisites.ai/glossary/tooth-pulp). For brief sharp reactions, see [tooth sensitivity](https://towncenterdental.multisites.ai/glossary/tooth-sensitivity). ## What can I do tonight? You can take comfort steps while you wait for a dentist. None of them treat the cause. 1. **Rinse and floss.** The ADA says to rinse with warm water and gently floss to remove food caught between the teeth. 2. **Use a pain reliever.** Cleveland Clinic says you can take over-the-counter pain relievers such as acetaminophen or ibuprofen while you wait. Follow the label. 3. **Try a saltwater rinse.** Cleveland Clinic suggests mixing 1/2 teaspoon of salt into 8 ounces of warm water and swishing for 30 seconds. 4. **Use a cold pack.** Wrap ice in a clean towel and hold it against the outside of the jaw for about 20 minutes. 5. **Do not put aspirin on the tooth.** The ADA says not to put aspirin on the aching tooth or gum tissues. Cleveland Clinic warns that antibiotics and pain relievers can ease symptoms, but only for a time. If the cause is not treated, the pain will return. ## When is a toothache an emergency? Go to an emergency room for the signs Cleveland Clinic lists: - Swelling below your eye or a knot on your jaw - Unbearable tooth pain that does not get better with medication - Bleeding that will not stop with pressure - A fever over 101 degrees Fahrenheit (38.33 degrees Celsius) Cleveland Clinic also says unbearable tooth pain with fever and chills is a dental emergency. Call 911 or go to the nearest emergency room if you have difficulty breathing or swallowing. Read [swollen face and tooth abscess](https://towncenterdental.multisites.ai/blog/swollen-face-and-tooth-abscess-when-it-is-an-emergency) and [emergency dentist, urgent care or ER](https://towncenterdental.multisites.ai/blog/emergency-dentist-or-urgent-care-or-er) for more. ## When should I call the dentist? Call soon, even if the pain eases. Cleveland Clinic says to call a dentist right away if a toothache lasts longer than two days or comes with swelling in the face or jaw. MedlinePlus says to seek care for a severe toothache or one that lasts longer than a day or two. Town Center Dental is open Monday to Wednesday from 8am to 5pm and Thursday from 8am to 4pm. It is closed Friday to Sunday. If your pain starts at night or on a weekend and you have no danger signs, use the comfort steps above and call (636) 273-5866 when the office opens. If you have a danger sign, do not wait. ## What will the dentist do about a toothache? The dentist first finds the cause. Cleveland Clinic says a dentist will examine you and ask about your symptoms, and may take a dental X-ray to look for problems beneath the gums. Treatment depends on what is found. A larger cavity or fracture may need a crown. If bacteria from a cavity or crack reach the pulp, Cleveland Clinic says you will need a [root canal](https://towncenterdental.multisites.ai/services/root-canal). It adds that most dentists prefer to save natural teeth when they can, but sometimes that is not possible. A [toothache](https://towncenterdental.multisites.ai/glossary/toothache) is a symptom, not a diagnosis. Your dentist will explain what they find and what to expect before any treatment begins. ## What if I grind my teeth? Tell your dentist about any [bruxism](https://towncenterdental.multisites.ai/glossary/bruxism-teeth-grinding). If your dentist sees worn or chipped teeth, they may suggest a night guard. Read our guide to [toothache causes and relief](https://towncenterdental.multisites.ai/guides/toothache-causes-and-relief) for more. ## What will the dentist ask about my toothache? MedlinePlus lists the questions a dentist is likely to ask. They include when the pain started, where it is and how bad it is, whether the pain wakes you up at night, what makes it better or worse, what medicines you take, whether you have a fever or other symptoms, whether you have had any injuries, and when you last had a dental checkup. You can prepare by writing short answers before the visit. Pain that wakes you at night is useful information, so say so plainly. A clear history helps your dentist find the cause faster. ## Next step Do not let a toothache run for days. Read about [emergency dentistry](https://towncenterdental.multisites.ai/services/emergency-dentistry) at Town Center Dental, then call (636) 273-5866 during office hours or [request an appointment](https://towncenterdental.multisites.ai/request-appointment). ## Frequently asked questions ### Why does my toothache hurt more at night? The sources we reviewed do not give one cause. What they show is that tooth pain can make it hard to sleep, and that many people grind their teeth while asleep. Whatever the reason, ongoing pain needs a dentist's exam. ### What can I do for a toothache tonight? Rinse with warm water, gently floss out trapped food, and take an over-the-counter pain reliever such as acetaminophen or ibuprofen. A cold pack on the outside of the jaw may help. Do not put aspirin on the tooth or gums. Call a dentist when the office opens. ### When is a toothache an emergency? Cleveland Clinic says to head to an emergency room for swelling below the eye or a knot on the jaw, unbearable pain that medication does not ease, bleeding that will not stop, or a fever over 101 degrees. Call 911 if you cannot breathe or swallow. ### How long can I wait to see a dentist for a toothache? Do not wait long. Cleveland Clinic says to call a dentist right away if a toothache lasts longer than two days or comes with swelling in the face or jaw. Severe pain needs care sooner. ## Terms on this page - [Gum disease (periodontal disease)](https://towncenterdental.multisites.ai/glossary/gum-disease-periodontal-disease) - [Bruxism (teeth grinding)](https://towncenterdental.multisites.ai/glossary/bruxism-teeth-grinding) - [Cavity (dental caries)](https://towncenterdental.multisites.ai/glossary/cavity-dental-caries) - [Tooth sensitivity](https://towncenterdental.multisites.ai/glossary/tooth-sensitivity) - [Dental emergency](https://towncenterdental.multisites.ai/glossary/dental-emergency) - [Gums (gingiva)](https://towncenterdental.multisites.ai/glossary/gums-gingiva) - [Night guard](https://towncenterdental.multisites.ai/glossary/night-guard) - [Tooth pulp](https://towncenterdental.multisites.ai/glossary/tooth-pulp) - [Toothache](https://towncenterdental.multisites.ai/glossary/toothache) ## Sources 1. [American Association of Endodontists: Tooth Pain](https://www.aae.org/patients/dental-symptoms/tooth-pain/) 2. [American Association of Endodontists: Tooth Pain](https://www.aae.org/patients/dental-symptoms/tooth-pain/) 3. [American Association of Endodontists: Tooth Pain](https://www.aae.org/patients/dental-symptoms/tooth-pain/) 4. [American Association of Endodontists: Tooth Pain](https://www.aae.org/patients/dental-symptoms/tooth-pain/) 5. [American Association of Endodontists: Tooth Pain](https://www.aae.org/patients/dental-symptoms/tooth-pain/) 6. [American Association of Endodontists: Tooth Pain](https://www.aae.org/patients/dental-symptoms/tooth-pain/) 7. [American Association of Endodontists: Tooth Pain](https://www.aae.org/patients/dental-symptoms/tooth-pain/) 8. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 9. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 10. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 11. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 12. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 13. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 14. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 15. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 16. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 17. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 18. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 19. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 20. [MedlinePlus: Toothaches](https://medlineplus.gov/ency/article/003067.htm) 21. [MedlinePlus: Toothaches](https://medlineplus.gov/ency/article/003067.htm) 22. [MedlinePlus: Toothaches](https://medlineplus.gov/ency/article/003067.htm) 23. [MedlinePlus: Toothaches](https://medlineplus.gov/ency/article/003067.htm) 24. [MedlinePlus: Toothaches](https://medlineplus.gov/ency/article/003067.htm) 25. [American Dental Association (MouthHealthy): Dental Emergencies](https://www.mouthhealthy.org/all-topics-a-z/dental-emergencies) 26. [American Dental Association (MouthHealthy): Dental Emergencies](https://www.mouthhealthy.org/all-topics-a-z/dental-emergencies) 27. [American Dental Association (MouthHealthy): Dental Emergencies](https://www.mouthhealthy.org/all-topics-a-z/dental-emergencies) 28. [American Dental Association (MouthHealthy): Teeth Grinding](https://www.mouthhealthy.org/all-topics-a-z/teeth-grinding) 29. [American Dental Association (MouthHealthy): Teeth Grinding](https://www.mouthhealthy.org/all-topics-a-z/teeth-grinding) 30. [Cleveland Clinic: Ludwig's Angina](https://my.clevelandclinic.org/health/diseases/23457-ludwigs-angina) 31. [Cleveland Clinic: Ludwig's Angina](https://my.clevelandclinic.org/health/diseases/23457-ludwigs-angina) 32. [American Association of Endodontists: Tooth Pain](https://www.aae.org/patients/dental-symptoms/tooth-pain/) 33. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 34. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 35. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 36. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 37. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 38. [Cleveland Clinic: Toothache](https://my.clevelandclinic.org/health/diseases/10957-toothache) 39. [MedlinePlus: Toothaches](https://medlineplus.gov/ency/article/003067.htm) 40. [MedlinePlus: Toothaches](https://medlineplus.gov/ency/article/003067.htm) 41. [MedlinePlus: Toothaches](https://medlineplus.gov/ency/article/003067.htm) 42. [MedlinePlus: Toothaches](https://medlineplus.gov/ency/article/003067.htm) 43. [MedlinePlus: Toothaches](https://medlineplus.gov/ency/article/003067.htm) 44. [MedlinePlus: Toothaches](https://medlineplus.gov/ency/article/003067.htm) 45. [MedlinePlus: Toothaches](https://medlineplus.gov/ency/article/003067.htm) Written by Town Center Dental and checked against the sources above on October 26, 2026. Dental guidance changes, so check the linked page, and ask your dentist about your own care. ## Keep reading - [Toothache: Why Does My Tooth Hurt, and What Can I Do Until I See a Dentist?A toothache is pain in or around a tooth. Common causes are cavities, a cracked tooth, gum disease, grinding and infection. Home care such as a warm saltwater rinse and a cold pack may ease mild pain for a short time. A true toothache needs a dentist, and fever, swelling or trouble breathing needs an emergency room.](https://towncenterdental.multisites.ai/guides/toothache-causes-and-relief) - [Emergency Dentist or Urgent Care or ER? Where to GoCall your dentist first for most dental emergencies. Go to an emergency room, or call 911, for trouble breathing or swallowing, swelling that spreads to the neck, a fever with facial swelling, bleeding that will not stop, or serious facial injury. Urgent care is an option if you have no dentist.](https://towncenterdental.multisites.ai/blog/emergency-dentist-or-urgent-care-or-er) - [Swollen Face and Tooth Abscess: When It Is an EmergencyA swollen face with tooth pain can mean a tooth abscess, an infection that can spread. Call 911 or go to an emergency room for trouble breathing or swallowing, or swelling in the neck or under the jaw. With a fever and facial swelling, go to the ER if you cannot reach your dentist.](https://towncenterdental.multisites.ai/blog/swollen-face-and-tooth-abscess-when-it-is-an-emergency) - [Dental Emergencies: What Counts, What To Do First, and Who To CallA dental emergency is a mouth problem that needs care right away, such as uncontrolled bleeding, severe pain that medicine does not ease, or a knocked-out tooth. Call 911 or go to an emergency room for trouble breathing or swallowing. Otherwise, call your dentist. Town Center Dental is closed Friday to Sunday.](https://towncenterdental.multisites.ai/guides/dental-emergency-guide) - [Cavities explained: causes, decay without pain and treatmentYes, you can have a cavity without pain. NIDCR says early tooth decay usually has no symptoms, so dentists find it at checkups and on X-rays. Very early enamel damage can sometimes be stopped with fluoride. Once a hole forms, the usual treatment is a filling.](https://towncenterdental.multisites.ai/guides/cavities-explained) - [Your Child's First Dental Visit: When To Start, What To Expect, and When Teeth Come and GoThe ADA and the AAP say to schedule your child's first dental visit after the first tooth appears and no later than the first birthday. Most visits are short. The dentist checks the teeth and gums, talks about cleaning and habits, and plans future check-ups. Baby teeth start to come in around 6 months.](https://towncenterdental.multisites.ai/guides/childs-first-dental-visit) ## Ready when you are [Request an appointment](https://towncenterdental.multisites.ai/request-appointment)[Call (636) 273-5866](tel:+1-636-273-5866)