A toothache is a common ailment with many different potential causes. It can involve pain in the gums, the teeth themselves, or around the upper and lower jaw. The type and severity of pain experienced can vary hugely.
For some people, it takes the form of a niggling discomfort. Others experience a sharp pain that only occurs when you try to eat. But for some people, a toothache can be constant, agonizing, and unbearable. It can make it difficult to work, eat, socialize, and concentrate. Above all, it makes it impossible to sleep.
Almost everyone is bound to experience a toothache at some point. So if you’re suffering, you’re not alone. But, when you’re lying awake at night because your teeth are in agony, it can certainly feel like it.
Today, we’ll examine the potential reasons why your teeth might hurt. We’ll also look at why the pain may worsen at certain times of the day. Finally, we’ll go through the various ways that you can ease your pain and get some much-needed sleep.
Why Do My Teeth Hurt While I Sleep?
A toothache is a general term that can have lots of different causes and implications. As with most types of pain, determining why you’re suffering is the first step towards finding a solution. However, it can sometimes be challenging to figure out why your teeth are hurting.
Here are the most common causes of tooth pain, and their associated symptoms.
Cavities, or caries, are holes that form in your teeth due to tooth decay. They start out small and gradually get bigger.
According to a study in the Journal of Clinical Microbiology, the mouth can contain over 700 different bacterial species. These bacteria feed on remnants of starchy and sugary food on your teeth.
Examples of such foods include:
- Sugary drinks, such as soda and fruit juice
When you eat these foods, the bacteria produce acid. This acid combines with bacteria and food debris to form plaque, a sticky film that covers the teeth.
You can remove plaque by brushing and flossing the teeth regularly (at least twice a day). If you don’t, the acid in plaque can start to decay the teeth. It dissolves the enamel, creating cavities.
Cavities look like small, dark spots on your teeth. However, depending on where the cavity is, you may not be able to see it. As the cavity gets bigger and reaches the nerve, you’ll start to experience a toothache. A toothache will start out mild, only occurring when you eat sweet, hot, or cold food. The pain will eventually get worse and persist even when you’re not eating.
A dental abscess is a pocket of pus. It can either occur in the tooth’s root or the gum underneath it.
Abscesses form when bacteria manage to get through the hard layers of the tooth (enamel and dentin). Underneath the dentin is soft, living tissue called pulp, which can become infected. There are two main ways in which bacteria can enter the tooth:
- Physical trauma. This could create a chip or crack in the tooth, by which bacteria can enter. Sometimes, the crack is so small that you may not even notice it’s there.
- Tooth decay. Plaque can wear away the enamel, leaving the dentin open to bacteria. Bacteria can find their way through microscopic pathways in the dentin, down to the pulp beneath it.
When bacteria reach the pulp, inflammation can occur. Your body fills the space with pus (white blood cells) to fight off the infection.
If you have an abscess, the affected tooth may be painful and sensitive. You may also feel throbbing in that tooth. You might also have bad breath and an aching or swollen jaw. If the infection is severe, you may also develop a fever.
Your teeth can become damaged in various ways. You might have had an accident, such as a fall or a blow to the mouth. Damage can also occur from biting down on something hard, such as an un-popped popcorn kernel. Whatever the cause, damage can result in teeth chipping, cracking, or even breaking.
The severity of the damage affects how severe the pain is. In some cases, the damage may be very slight. You may not be able to see or feel a crack. This type of damage can cause sensitivity – pain when eating hot, cold, or sweet foods. It can also cause pain when chewing or biting.
Severe damage to teeth is more painful. You may feel a constant ache in and around the damaged tooth, even when you’re not eating or talking. The pain may be so bad that you can’t sleep.
You may also experience pain from dental surgery. For example, having a cavity filled involves drilling into the tooth which can cause pain while it’s healing. If you’ve had a root canal or a tooth extraction, you’ll likely suffer pain in the jaw while recovering.
Impacted Wisdom Teeth
Most of our adult teeth are firmly in place by the time we’re around 13 years of age. However, the last four teeth don’t appear until the late teens or early twenties. These are called wisdom teeth, also known as third molars.
By the time our wisdom teeth start to come through, the mouth has already finished forming. For some people, this means that there isn’t enough room in the jaw for the wisdom teeth. In this case, they may get stuck, or come through at an odd angle. Wisdom teeth that don’t grow properly are known as impacted.
As wisdom teeth come through the gum, it’s normal to feel pain and soreness. However, sometimes, impacted wisdom teeth can push into other teeth, causing further pain. There’s also a risk of partially erupted wisdom teeth becoming infected, as they’re hard to brush. This can cause pain, swelling, bleeding, or bad breath.
If your teeth themselves are healthy but you still can’t sleep gum pain could be your problem. Periodontal disease is also known as gum disease. It doesn’t involve infection of the tooth itself, but rather the area surrounding your teeth.
Gum disease is caused by plaque. When plaque spreads to the gums, it introduces bacteria. This can cause infection in the gums, called gingivitis, which is the first stage of gum disease. If the gingivitis isn’t treated, it can lead to periodontitis. Periodontitis is the infection of further structures that surround the teeth, such as the jawbone.
If you’re suffering from periodontal disease, you’ll notice some or all of these symptoms:
- Red, swollen gums
- Gums bleeding when you brush your teeth
- Pain in your gums
- Sensitive teeth
- Bad breath
- Loose teeth
- Receding gums (your teeth may appear to be getting longer)
Pulpitis, as its name may suggest, is an infection of the pulp. The pulp is soft, living tissue inside the tooth, consisting of blood vessels and nerves. When an infection or tooth decay is left untreated, it can spread to the pulp.
If the pulp becomes infected, it can become inflamed (swollen). Pressure then builds up inside the tooth, which pushes against the nerves. The result is severe pain which can also be accompanied by throbbing. The pain of pulpitis often gets worse at night, making it difficult to sleep.
Sometimes, when you have a toothache, the problem isn’t with your teeth or gums at all. Surprisingly, you can also suffer from a toothache if your sinuses are infected.
The sinuses are pockets of air inside the bones that make up your face. They’re a part of your upper respiratory tract. Your sinuses can become infected, usually following a cold or flu. When this happens, they become swollen, and pressure builds up inside them.
Two of the biggest sinuses called the maxillary sinuses, sit just above your molar teeth roots. When infected, your sinuses can put pressure on nerve endings in these roots. This can cause a toothache, along with a sore jaw.
If you have a sinus infection, you may notice pain around the cheeks, eyes, and forehead. You may also have a blocked or a runny nose, a headache, and a reduced sense of smell.
My Tooth Hurts at Night but Not During the Day
Many people find that their toothache, which is on-and-off during the day, becomes worse at night while they’re trying to sleep. You may even find that your cavity, tooth damage, or tooth extraction only hurts at night and not during the day at all. But why is this? There are four main reasons:
- Less Active. During the day, we’re on the go. Whether we go to work, see friends, or tend to the house, daily activities keep us busy. When we’re busy thinking or keeping active, it’s easy not to notice the pain. It may be that you notice pain more easily at night.
- Evening Meal. According to a study in the Journal of Food Distribution Research, most people eat dinner in the evening, around 6 pm – 8 pm. The average American bedtime is 11 pm, according to research by the University of Michigan. The reason your toothache is worse at bedtime could be because your teeth are aggravated by your evening meal. You may have made your gums or teeth sore from eating hard food. If you didn’t brush before bed, food might still be stuck in your gums, causing further pain.
- Grinding or Clenching. Some people tend to grind their teeth or clench their jaw, throughout the day. This usually is unconscious, and usually due to stress. If you grind or clench all day long, it can put a strain on the jaw, causing pain at night.
- Blood Flow. We spend most of the day standing or sitting upright. When you lie down to sleep, blood flows towards your head. This can cause pressure around your jaw, and cause sensitive teeth and gums to feel more painful. This increase in blood flow around the face during the night could also result in pain upon waking. So if you’ve ever wondered “why do I wake up with a severe toothache?” this could be the reason.
How to Fall Asleep with a Toothache
So, now you’re familiar with the most common causes of toothache. You should have a rough idea, by now, of what’s causing your nightly pain. But what can you do about it?
If you’ve got an unexplained toothache, you should visit a dentist to get it checked out. They’ll be able to examine you professionally and figure out the cause of the pain. But sometimes, it’s not easy to get an appointment. You may have to wait several days before you’re able to see a dental professional. Here are 8 ways to ease your toothache, so that you can sleep at night.
Avoid Trigger Foods
If you have a crack, cavity, or infection, the sensitive nerve endings in your tooth might become exposed. This can lead to teeth sensitivity, or pain when consuming certain types of food and drink.
To prevent worsening your toothache, you should avoid eating or drinking the following things.
- Extremely cold food and drink. Examples include ice cream, iced drinks, slushes, and popsicles. If you want to drink a cold liquid, use a straw so that it doesn’t touch your teeth.
- Hot food and drink. Cool food to room temperature before eating. Avoid hot beverages entirely, or drink them with a straw.
- Rough, crunchy, and hard foods. Eating these can put your teeth at risk of even further damage. Avoid things like crackers, hard cookies, toast, and granola.
- Acidic food and drink. Acids can irritate the sensitive nerves in your teeth. Avoid citrus fruits, fruit juices, and tomato-based foods.
- Spicy foods. Be wary of Indian, Mexican, and Asian foods as these types of cuisine are often highly spiced.
Stick to soft, room temperature, or refrigerated foods. Cut food into small pieces before eating, so that you don’t have to chew as much.
Use Desensitizing Toothpaste
Depending on what kind of toothache you have, desensitizing toothpaste may help. This kind of toothpaste is specifically developed for sensitive teeth.
Most desensitizing toothpaste work by using numbing compounds such as potassium nitrate. These work by filling the tiny tubules in the dentin, blocking off the exposed nerve. Some desensitizing toothpaste also claims to help build a protective layer on your teeth.
Desensitizing toothpaste usually takes at least a week of continued use to produce any effect. This means that you may have already seen a dentist before it starts to work. However, it is worth a try.
Sleep on an Incline
A lot of nightly tooth pain is caused by excessive blood flow to the jaw and face. This blood flow puts pressure on the sensitive nerves, gums, and teeth, making pain worse. The flatter you lie in bed, the more blood is going to flow to the area.
To help ease the pain, sleep with your head raised higher than the rest of your body. There are a few ways to achieve this:
- Sleep upright in a chair
- Sleep propped up with extra pillows
- Insert wooden blocks or books under the head of your bed, to raise it up
Sleeping on an incline will reduce the amount of blood flowing into your head and face. This will help lessen the pain when you sleep.
Rinse with Salt Water
According to an article in the scientific journal Cell Metabolism, salt has antimicrobial properties. Its function as a natural antibiotic means it has the power to kill bacteria, and reduce infection. It can reduce swelling and pain, and help build an antimicrobial barrier.
So, rinsing your mouth with salt water regularly can help with a toothache. Of course, it can’t treat the actual problem. It’s not powerful enough on its own to get rid of the underlying infection. However, in the short term, it will help ease the pain.
Make a saltwater rinse by adding half a teaspoon of salt to a cup of warm water. Swill the saltwater around your mouth throughout the day, ideally every few hours. Repeat before bed for some pain relief at night.
Apply a Cold Compress
Cold compresses can help, depending on what kind of a toothache you have. Hold an ice pack against your jaw, in the area where a toothache is. The ice should help to numb the pain.
If you don’t have an ice pack, you can use a bag of frozen peas. Alternatively, use a plastic bag full of ice cubes wrapped in a washcloth or towel. The smaller the cubes, the better, as they’ll sit more comfortably against the skin.
If the pain is deep within your tooth or bone, an ice pack may not be able to relieve the pain entirely. However, it should numb your jaw slightly, making the pain more bearable.
Numbing gels are available without a prescription. You can buy them in pharmacies or online. They come in the form of pastes that contain pain relievers such as benzocaine or lidocaine. Some may also contain menthol, to provide a cooling feeling.
When applied directly to the problematic tooth or gum, they can provide instant pain relief. A numbing gel is an excellent option if you’re suffering from severe pain, and want to solve it quickly. Depending on the location of your toothache, the gel may wash away with saliva somewhat quickly. However, if applied just before bed, the pain relief will last long enough to allow you to fall asleep.
Standard, over-the-counter painkillers can be ideal for a toothache. The most commonly available are acetaminophen (Tylenol), ibuprofen (Motrin and Advil), and aspirin. They’re available in tablet or capsule form and should be taken with water. Ibuprofen and aspirin shouldn’t be taken on an empty stomach.
It’s ok to take acetaminophen at the same time as ibuprofen or aspirin, but you shouldn’t take aspirin with ibuprofen. This is because they belong to the same class of drug (NSAIDs), and combining them can cause unwanted side effects.
If you’re in need of a stronger painkiller, speak to your doctor. They may be able to prescribe something, such as Tramadol (Ultram).
If you don’t want to – or can’t – use medication for your toothache, you could try herbal remedies. Herbal remedies provide a more natural way of alleviating pain than modern medicine. Many of these remedies have been passed down for generations, and countless people swear by their efficacy.
Here are some of the most popular herbal remedies for relieving toothache. Use them around 20 minutes before going to sleep, so that the effect doesn’t have time to wear off.
- Peppermint. Either chew peppermint leaves or hold a soaked peppermint teabag to the painful tooth. You can also use peppermint oil soaked in a cotton ball and hold this against the area.
- Garlic. Many people believe that garlic has antiseptic and antibiotic properties. Simply chew on a fresh clove of garlic. Alternatively, apply a paste from salt and crushed garlic.
- Clove oil. Cloves are anesthetic, and also have anti-inflammatory properties. Apply clove oil to a cotton ball and hold this against the affected tooth. You can also make mouthwash from clove oil by adding a few drops to some water.
- Wheatgrass juice, used as a mouthwash, can help combat infection. It can also help to soothe inflammation.
How Do You Stop a Toothache at Home?
So, now you know some ways of easing tooth pain when you can’t sleep. By using a combination of the above methods, you should be able to ease your pain enough to fall asleep.
Of course, don’t rely on these methods alone to fix the problem. If you don’t know what’s causing the pain, it’s essential to visit a dentist. Although our methods relieve pain, they can’t address the root of the issue. If you don’t attend a dentist, the problem will only get worse over time. Most toothaches are caused by an underlying issue that must be addressed by a professional.
However, it is possible to reduce your chances of developing toothache in the first place. Brush your teeth at least twice a day with fluoride-containing toothpaste, and floss often. Avoid sugary food and drink as much as possible.
When you do indulge, brush your teeth as soon as possible afterward to prevent plaque buildup. And most importantly, visit a dentist for a checkup at least twice a year. This way, you can nip any problems in the bud before they become serious.