Toothache in general is a very troublesome feeling for a person, and if it starts at night after eating or while you lay down on your bed, it is the most worst thing to happen. It can hamper your peaceful sleep and your rest.

Why do toothaches always feel so much worse at night?

When we lie down, more blood flows to our head due to gravity. This increase in blood pressure puts extra pressure on the sensitive, inflamed nerve endings inside your tooth and thus it starts giving a throbbing pulsatile pain. Combined with the lack of daytime distractions, you will face a tough night time.

If we try to understand technically then there are reasons like:

• Pulpitis: There are two types of pulpitis (reversible and irreversible) which means inflammation of pulp. If the dental caries has progressed to the pulp part of a tooth, then extra pressure can cause pain at night.
  
  

• Trauma/Fracture: Any type of trauma to the teeth during eating can lead to fracture of the teeth which can also cause pain at night due to extra pulpal pressure.

Food accumulation: Sometimes improper rinsing or brushing can cause food lodging between on inside a tooth which can irritate the gums or the pulp and can cause pain at night.

What to do?

At night, when you don’t have any dentist available, what can we do?

• Firstly try to contact a dentist or a nearby hospital.

• Or if you have any painkillers/analgesics like Paracetamol or Ibuprofen, then you can take a tablet and try to sleep.

• We can keep some hot water or ice inside our mouth for some seconds or minute to release the extra pulpal pressure and then see if the pain gets relieved.

• In some cases, even hot water relieves a pulpal pain so we can try that.

• Avoid sleeping on the side where the tooth is paining.

• We can also wrap an ice pack in a towel or soak a towel in cold water and hold it against the outside of our cheek for 15–20 minutes at a time. The cold constricts the blood vessels in the area, decreases the blood pressure and thus reduces swelling and the pain signals.

What not to do?

• If one is experiencing swelling with pain, avoid any type of hot water immediately. It can accelerate the swelling and worsen the case.

• Don’t take any kind of strong painkillers with steroids as it can arise newer issues.

• We shouldn’t take any antibiotics at that time, as it start newer issues in our body.

• If one is having difficulty in breathing or fever and chills with a toothache, immediately consult a nearby hospital as it might need emergency treatments.