Toothache at night: what to do until you see a dentist

Toothache has a habit of getting worse at night. Lying flat sends more blood to the head, there is less to distract you, and a tooth that only grumbled during the day starts to throb. The steps below will not cure the cause, but they can make the hours until you see a dentist easier.

What you can do at home

• Rinse with warm salt water. Stir half a teaspoon of salt into a glass of warm water, swish it gently around the sore area and spit it out.
• Clean around the tooth. Brush gently and use floss to remove any food trapped beside the tooth. Trapped food is a common cause of sudden pain.
• Take a painkiller you normally use. Follow the instructions on the pack and do not take more than it says. If you are pregnant, have a stomach ulcer, kidney problems or asthma, or take other medicines, ask a pharmacist which painkiller is safe for you.
• Keep your head raised. Sleep propped up on an extra pillow.
• Use a cold pack on the cheek. Wrap ice or a cold pack in a cloth and hold it against the outside of the face for up to 15 minutes at a time.
• Avoid what sets it off. Very hot, very cold and sugary food and drinks usually make the pain worse. Chew on the other side.

What not to do

• Do not place aspirin or any other tablet against the gum or the tooth. It burns the gum and does not help the tooth.
• Do not put a hot cloth or hot water bottle on your face. If there is an infection, heat can make the swelling worse.
• Do not take antibiotics left over from another illness. They do not remove the cause of a toothache, and the wrong one can do harm.
• Do not assume the problem has gone if the pain stops by itself. The cause is usually still there and tends to return.

Signs that you should not wait

See a dentist straight away, at any hour, if you have any of these:

• swelling of the face, the jaw or the gum that is spreading
• fever together with tooth or jaw pain
• bleeding from the mouth that has not stopped after 20 minutes of firm pressure with a clean cloth
• an adult tooth that has been knocked out. Hold it by the white top, not the root, keep it in milk, and get to a dentist within the hour if you can
• pain that painkillers do not touch

Go to a hospital emergency department immediately if swelling makes it hard to breathe, swallow or open your mouth, or if swelling is spreading towards the eye or down the neck.

Then get the tooth looked at

Home care buys time. It does not treat decay, a cracked tooth or an infection, which are the usual causes. Even if the pain settles, have the tooth examined so the cause can be found and treated while it is still a small job.

Hopeful Smiles Dental Clinic 247 is open through the night, every night. You do not have to wait for morning.

This article is general information and not a diagnosis. If you are in pain, or worried about your teeth or gums, see a dentist.