A tooth that only nags during the day can keep you awake at night. Why that happens, what helps until morning, what makes it worse, and how the dentist treats the cause at the first visit. Why a tooth hurts more at night
Lying down sends more blood to the head, and the pressure inside the tooth rises where the inflamed nerve has no room to expand. During the day work and conversation distract you; at night the pain is the only thing you feel. The third reason is that the painkiller you took in the afternoon has worn off by midnight. That is why "my tooth started hurting at night" is the most common sentence our reception hears in the morning.
What is usually behind it
| How it hurts | Most likely cause | What the dentist does |
|---|---|---|
| Throbbing pain that starts on its own, worse with heat, eased by cold | Pulpitis, an inflamed nerve | Anaesthesia, nerve removal, root canal treatment 120–320 EUR over two visits |
| Pain on biting, the tooth feels "taller", swollen gum | Infection at the root tip | X-ray 10–15 EUR, opening the canal or extraction if the tooth cannot be saved |
| Short sharp pain from cold or sweet, gone in 10–20 seconds | A cavity or exposed dentine | Filling 90–130 EUR in one visit |
| Painful swollen gum behind the last molar, hard to open the mouth | Wisdom-tooth inflammation | Irrigation, antibiotics if needed, wisdom tooth extraction 150–200 EUR |
| "All my teeth hurt" on one side, pain radiating to the ear or temple | One deeply inflamed tooth; less often the jaw joint or sinuses | Examination and X-ray; the painful tooth often can only be identified by the dentist |
What helps until morning
- A painkiller as directed. Ibuprofen (if you have no contraindications) also reduces inflammation; paracetamol for those who cannot take ibuprofen. Do not exceed the daily dose and do not combine products with the same active ingredient.
- Sleep with your head raised; a second pillow reduces blood flow and pressure.
- Rinse with warm salt water (a teaspoon of salt in a glass) to calm the gum and flush food out of the cavity.
- A cool compress on the cheek for 15 minutes if there is swelling.
- Avoid hot, sweet and very cold food; floss the gap next to the painful tooth, as trapped food is often part of the problem.
What not to do
- No aspirin, alcohol or garlic on the tooth or gum. They burn the mucosa and do nothing for the pain.
- No heat on the cheek. Heat widens the vessels and worsens inflammation; if pus is forming, heat spreads it.
- No leftover antibiotics from the cupboard; they do not reach the nerve and complicate later treatment.
- Do not stop brushing. Brush gently, but brush.
When to go to hospital at night
Call 113 or go to an emergency department if the swelling spreads to the eye, neck or lower jaw and makes swallowing or breathing difficult, if the temperature is above 38.5 °C together with swelling, or if a jaw fracture is suspected after an injury. That is maxillofacial surgery. In every other case the night is bridged with a painkiller and the dentist is called in the morning.
If the pain has stopped by morning
That is not good news. When severe throbbing pain suddenly disappears, the nerve has most likely died; the infection continues at the root and returns weeks or months later as an abscess, with swelling and far more complex treatment. A tooth that "got better on its own" still needs to be seen.
What we do at Laurus Dent plus
Call +371 22428688 on weekdays 8:00–20:00 and say that you are in pain; we offer the earliest available slot. At the first visit the dentist finds the cause (examination and X-ray 10–15 EUR), stops the pain with anaesthesia (10 EUR) and either finishes the treatment straight away or seals the tooth with a temporary filling and schedules the rest. Consultation 20–40 EUR; there is no urgency surcharge, prices are the same as on the price list. We treat in English. The clinic is open on weekdays only and is not a 24-hour service; we say so plainly so you do not waste time at night looking for us.
See also: pulpitis treatment · wisdom tooth pain · tooth extraction and aftercare · all prices.