Night-time toothache is a sign of a problem in the tooth or gum that needs to be examined. Its most common causes are tooth decay, pulpitis (inflammation of the tooth pulp) and abscess. A painkiller such as ibuprofen or paracetamol (acetaminophen) and gargling with warm salt water can ease the pain temporarily [1], but you should see a dentist if the pain lasts more than two days, and immediately if swelling, fever, or difficulty breathing or swallowing appears [2].
Why does tooth pain get worse at night?
Many people put up with the pain all day, then are woken by a throbbing pain in one tooth when they lie down. There are common explanations for this. Being busy with work and movement distracts you from the pain during the day, so when everything quiets down at night, the pain becomes more noticeable.
It is also thought that lying down increases blood flow to the head, which raises the pressure inside an inflamed tooth. Teeth grinding during sleep may also press on teeth that are already sore, and it is one of the causes of tooth pain listed in medical sources [1].
The key point is that the night does not cause the problem; it reveals it. The cause is in the tooth or gum, and it does not go away just by changing your sleeping position.
What are the common causes of tooth pain at night?
The UK National Health Service (NHS) notes that tooth pain can result from several causes [1]:
- Tooth decay.
- Tooth abscess.
- A cracked or damaged tooth.
- A loose or broken filling.
- Infection around a tooth that did not have enough room to erupt, such as a wisdom tooth.
- Orthodontic (teeth alignment) problems.
- Gum disease.
- Teeth grinding.
Sensitive teeth can also cause pain [1]. If the pain is at a wisdom tooth and is accompanied by swelling, you may find the article Pericoronitis around the wisdom tooth: causes of pain and swelling and treatment options helpful.
Pulpitis (inflammation of the tooth pulp)
The pulp is the living tissue inside the tooth, containing the nerves and blood vessels. When decay, a crack, or a leaking filling reaches this tissue, it becomes inflamed, causing a throbbing pain that increases with cold, heat or sweets. The pain may persist after the trigger is removed, and it often becomes worse at night.
In the early stages, treating the decay or restoring the tooth may be enough. If the inflammation has progressed, the tooth may need root canal treatment or extraction. Only the dentist can determine this after examination and imaging; it cannot be confirmed from symptoms alone.
Dental abscess
An abscess is a collection of pus in the tooth or gum caused by infection. It requires urgent treatment by a dentist and does not go away on its own [2]. It may arise, for example, from decay, gum disease, an injury to the tooth, or a trapped tooth that has not erupted properly [2].
How do I know if the pain may be an abscess?
An abscess is not limited to pain; its symptoms include [2]:
- Severe pain in the tooth or gum.
- Redness inside the mouth or on the face or jaw from the outside.
- Sensitivity to hot or cold food and drinks.
- A bad taste in the mouth.
- Difficulty opening the mouth and chewing.
- Swelling of the face or jaw.
- Swollen glands on both sides of the neck.
- Fever.
The NHS adds that pain with a high fever, pain when biting, red gums, or swelling of the cheek or jaw requires a visit to the dentist [1]. If the pain suddenly disappears after swelling, this does not necessarily mean recovery, as an abscess does not go away on its own [2].
What home first aid can I use for toothache until I see the dentist?
Home first aid only eases symptoms and does not treat the cause. The NHS recommends the following steps until you can see a dentist [1]:
- A suitable painkiller: such as ibuprofen or paracetamol, after consulting a pharmacist (details in the next section).
- An oral pain-relief gel: available from a pharmacy.
- Salt water rinse: dissolve half a teaspoon of salt in a glass of warm water, gargle, then spit out and do not swallow. Repeat as often as you like. It is not recommended for children because of the risk of swallowing it.
- Soft foods: such as yoghurt and scrambled eggs, and avoid chewing on the painful tooth.
- Gentle cleaning: a soft brush, avoiding flossing around the painful tooth.
Avoid sweets and foods or drinks that are very hot or very cold, and avoid smoking, as it may worsen some dental problems [1]. To learn the principles of first aid in general, or how to respond to dental injuries such as fractures and dislodged teeth, see Dental emergencies: first aid before you see a dentist.
If you want to learn about other symptoms related to the problem and their details, the toothache page in the directory provides simplified information.
Are painkillers safe? What about aspirin on the gums?
The NHS recommends ibuprofen or paracetamol to relieve tooth pain and abscess pain, and advises the person to consult a pharmacist [1][2]. The usual dose determined by the doctor or pharmacist is also printed on the medicine leaflet, so follow it.
Do not exceed the recommended dose, as a higher dose does not give a stronger effect but may be very dangerous [2]. Note that some cold remedies contain paracetamol itself, so do not combine two products that contain the same ingredient.
Points that require caution
- Do not place an aspirin tablet on the gum or tooth: it may burn the gum tissue and cause a painful ulcer, and it does not treat the cause. If aspirin is suitable for you, swallow it like any other medicine, as directed by the pharmacist.
- Children: aspirin should not be given to anyone under 16 years old [1][2]. The dose of any painkiller for a child is based on weight and must be prescribed by a doctor or advised by a pharmacist.
- Pregnancy, chronic diseases and other medications: if you are pregnant, have a stomach, kidney or asthma problem, or are taking blood thinners, ask a doctor or pharmacist before taking any painkiller, and do not delay the examination.
Do not start or stop a prescribed medicine on your own. If the pain does not settle with a painkiller, this is a signal to see a doctor, not a reason to increase the dose [1].
Do I need an antibiotic?
Not every toothache needs an antibiotic. The main treatment for an abscess is performed by the dentist, who drains the pus. The dentist may also add root canal treatment or extraction of the tooth if the cause of the abscess is a problem in the tooth itself. The patient is given a local anaesthetic so they do not feel pain [2]. The dentist may also prescribe an antibiotic [2].
An antibiotic is usually useful when the infection spreads beyond the tooth, such as when swelling appears in the face or neck, or there is a high fever. The doctor prescribes it after examination, together with treatment of the cause. Accordingly:
- Do not take an antibiotic left over from a previous illness, and do not buy one without a prescription.
- An antibiotic may temporarily mask the pain while the cause remains.
- If one is prescribed for you, complete the course the doctor specified.
When does toothache require an emergency dentist?
The following table summarises risk levels according to NHS guidance, which is British guidance that helps in understanding general warning signs:
| Situation | What it may mean | Appropriate action |
|---|---|---|
| Pain lasting more than two days, or not relieved by painkillers [1] | A problem in the tooth or gum that needs treatment of the cause | Book an appointment with a dentist as soon as possible |
| Pain with a high fever, pain when biting, red gums, a bad taste, or swelling of the cheek or jaw [1][2] | Possible abscess | Request an urgent appointment with a dentist the same day if possible |
| Swelling around the eye or neck, difficulty breathing, swallowing or speaking, large swelling inside the mouth, or difficulty opening the mouth [1][2] | An infection that may spread to dangerous areas | Call 911 or go to the nearest emergency department immediately |
Signs that require immediate emergency care
- Swelling of the area around the eye or neck [1].
- Swelling in the mouth or neck that makes breathing, swallowing or speaking difficult [1].
- A swollen or painful eye, or sudden vision problems [2].
- Large swelling inside the mouth, or severe difficulty opening it [2].
The emergency number in Jordan is 911, and you can find details on the page Jordan's unified number for ambulance and emergency services. If the situation is serious, do not drive yourself; ask someone to take you or call an ambulance, and bring the medicines you are taking [1].
For non-critical cases at night, call your dentist or their clinic, as the answering machine may direct you to what can be done. If you do not have a dentist, ask a nearby clinic about an emergency appointment [1].
What does the dentist do to treat the cause?
The dentist examines the tooth and gum and often requests an X-ray to identify the source of the pain. After that, treatment depends on the diagnosis:
- Abscess: the dentist drains the pus, and the tooth may need root canal treatment or extraction, with local anaesthetic [2].
- After treatment: painkillers may be prescribed for a few days, and an antibiotic may be given [2].
- Decay or a broken filling: the dentist treats the decay, restores the tooth or replaces the filling.
- Impacted wisdom tooth: it may require cleaning or treatment of the inflammation, and sometimes extraction. You can read about the painless wisdom tooth extraction service and surgical tooth extraction to learn about the procedure.
To learn about the service itself before your appointment, see the treatment of toothache page.
How do I find a suitable dentist in Jordan?
Start from the dentists in Jordan page, then narrow your search by governorate: dentistry in Amman, dentistry in Irbid, dentistry in Zarqa, or dentistry in Karak, and other governorates in the directory.
ClinicsJo is a directory that presents doctors and clinics, and it does not rank doctors by medical quality. Therefore, rely on the information shown in the profile:
- The specialty (general dentistry, oral surgery, or endodontics) according to your condition.
- The clinic's location and working hours, and the method of contact or booking if the profile provides it.
- The services listed, such as pain treatment or extraction.
- Years of experience and written qualifications, if available.
Useful questions when calling or at the appointment
- Do you see emergency cases today, and what is the earliest appointment?
- What will happen at the first visit? Is an X-ray required?
- What is the approximate cost, and does it change depending on the treatment needed?
- What signs should prompt me to contact you or go to the emergency department after treatment?
- Will I need follow-up or additional treatment after the pain is controlled?
How can I reduce the chances of toothache returning?
The best way to prevent it is to keep your teeth and gums as healthy as possible [1]:
- Have your teeth checked by a dentist regularly, as this detects problems early [2].
- Reduce sugars and sweetened drinks, and have them only with main meals.
- Brush your teeth twice a day for about two minutes with a fluoride toothpaste.
- Clean between your teeth daily with floss or interdental brushes.
The NHS adds, regarding abscesses: spit after brushing and do not rinse with water, do not use mouthwash immediately afterwards, replace your toothbrush every two to three months, and avoid smoking [2].
If you start to notice sensitivity, a change in tooth colour, or brief pain when chewing, do not wait until it wakes you at night, as early treatment is simpler and less painful.
Frequently asked questions
Why does tooth pain get worse at night?
Night does not cause the pain, but it reveals it. Fewer distractions make you more aware of it, lying down may increase pressure inside an inflamed tooth, and teeth grinding during sleep may press on teeth that are already sore. The cause remains in the tooth or gum, so a dentist's examination is needed.
Can I place aspirin on the tooth or gum?
No. Placing an aspirin tablet on the gum may burn the tissue and cause a painful ulcer, and it does not treat the cause of the pain. Painkillers are taken by swallowing them as directed by a pharmacist, and aspirin should not be given to anyone under 16 years old. Consult a pharmacist to choose the suitable painkiller for your condition.
How long can I wait before seeing a dentist?
If the pain lasts more than two days or is not relieved by painkillers, see a dentist. If fever or swelling of the cheek or jaw appears, or pain when biting, request an urgent appointment the same day if possible, because an abscess does not go away on its own.
Do I need an antibiotic for every toothache?
No. Treating the cause is the foundation, such as cleaning decay, draining an abscess, root canal treatment or extraction. The dentist may prescribe an antibiotic when there is a spreading infection, swelling or fever. Do not take an antibiotic without a prescription or one left over from previous treatment, as it may mask the symptoms without treating the cause.
Is rinsing with warm salt water helpful?
It may temporarily soothe the mouth. Dissolve half a teaspoon of salt in a glass of warm water, gargle, then spit out and do not swallow, and it can be repeated. It is not recommended for children because of the risk of swallowing it. It is a temporary measure and does not replace treating the cause at the dentist.
When does swelling of the mouth or face become an emergency?
Call 911 or go to the nearest emergency department if toothache is accompanied by swelling around the eye or neck, difficulty breathing, swallowing or speaking, large swelling inside the mouth, difficulty opening it, eye pain, or a sudden change in vision. Do not drive yourself; ask someone to accompany you.
Sources and references
- Toothache — NHS (UK National Health Service). Accessed: 2026-10-26.
- Dental abscess — NHS (UK National Health Service). Accessed: 2026-10-26.
