Why toothache gets worse at 2am
Patients describe the same thing constantly. They go to bed feeling fine, or with mild discomfort they figured they could manage, and then wake up at 2am with pain that paracetamol does nothing for.
The physiology of nighttime dental pain
Blood pressure to the head increases slightly when you lie down, increasing pressure within the pulp chamber of an inflamed tooth. At night in a quiet room, the pain that was present but manageable becomes the dominant sensory experience.
The most common causes
Irreversible pulpitis. The dental pulp becomes irreversibly inflamed from deep decay, a crack reaching the nerve, or trauma. This tooth almost always requires root canal treatment or extraction. Dental abscess. Abscess pain is typically severe and throbbing, requiring same-day dental attention. Cracked tooth syndrome. A crack through the enamel and dentine creates sharp pain on biting. Bruxism. Nocturnal grinding causes diffuse jaw muscle soreness across multiple teeth.
What to do tonight
Take ibuprofen 400mg with paracetamol 1000mg together. This combination is more effective for dental pain than either alone. Elevate your head with an extra pillow. Do not put aspirin directly on the gum as it causes a chemical burn.
When to go to hospital immediately
Call 000 or go to emergency if you have facial swelling spreading toward the eye, neck or floor of the mouth, difficulty swallowing or breathing, fever above 38.5 degrees, or inability to open your mouth.
Same-day emergency care at Lumi Dental
For toothache that won't wait, our emergency dentist at Melrose Central holds same-day slots every day and will almost always see you the same day you call. Open 7 days including weekends.
