A toothache has a special talent for showing up at the worst possible time—like 1:30 a.m., when everything is closed and your brain is already tired. The good news is that most nighttime tooth pain can be managed safely for a few hours with the right steps, so you can rest and get to a dentist as soon as possible.
This guide walks you through what to do (and what not to do) if you get a toothache at night. You’ll learn how to calm pain, reduce swelling, protect the tooth, and recognize the red flags that mean you shouldn’t wait until morning. Think of this as a practical “overnight plan” to get you from “I can’t sleep” to “I’m safely on my way to care.”
First, take 60 seconds to size up what’s going on
Before you reach for anything, pause and do a quick check. Tooth pain can come from a cavity, a cracked tooth, gum irritation, a failing filling, sinus pressure, grinding, or an infection. The steps you take at home are similar either way, but your symptoms can hint at urgency.
Ask yourself: Is the pain sharp and triggered by cold or sweets? Is it a deep throbbing that won’t let up? Is there swelling in the cheek or gum? Did you bite down on something hard earlier? Did a filling fall out? The details help you decide whether you can manage it overnight or need urgent help.
If you can, take a quick look in the mirror with a flashlight. You’re not diagnosing yourself—you’re simply checking for obvious issues like a broken tooth edge, something stuck between teeth, a popped-off crown, or a swollen gum “pimple” that could suggest an abscess.
Safe, immediate steps that help most nighttime toothaches
Rinse gently and clean the area (without overdoing it)
Start simple. Rinse your mouth with warm water to clear saliva and debris. If you suspect food is trapped, gently floss around the painful tooth. Many nighttime toothaches are made worse by a small piece of food pressing on an already irritated area.
Be gentle with flossing—don’t snap the floss down into the gums. Slide it in and out and curve it around each tooth. If the gum is already inflamed, aggressive flossing can make it bleed and feel even more tender.
If you have a saltwater rinse available, mix about half a teaspoon of salt into a cup of warm water and swish for 20–30 seconds, then spit. Saltwater can soothe irritated tissue and help reduce bacteria in the area, which may take the edge off while you wait.
Use cold therapy correctly to calm pain and swelling
For many toothaches—especially if there’s swelling—cold compresses help. Wrap an ice pack or a bag of frozen peas in a thin towel and apply it to the outside of your cheek for 10–15 minutes at a time, then take a break.
Cold therapy works best when it’s consistent but not constant. Doing short intervals helps reduce inflammation without irritating the skin or causing numbness that can make it harder to gauge changes in swelling.
A key tip: keep the cold on the outside of your face, not directly on the tooth. Holding ice water in your mouth can trigger intense pain if the tooth nerve is inflamed or if there’s a crack.
Choose pain relief options that are generally safer overnight
Over-the-counter pain relievers can help you rest, but use them responsibly and follow the package directions. Many adults do well with ibuprofen (an anti-inflammatory) if they can take it safely, while acetaminophen may be an option for those who can’t take NSAIDs. If you’re unsure what’s safe for you due to medical conditions, pregnancy, or other medications, it’s worth calling a pharmacy’s after-hours line if available.
Try to take pain relief with a small snack and water (if the medication instructions allow). This can reduce stomach irritation, especially with NSAIDs. And set an alarm if you need to stay on schedule—taking too much because you forgot you already took a dose is a common nighttime mistake.
Avoid placing aspirin directly on the tooth or gums. It can burn the tissue and make things worse. Also avoid doubling up on multi-symptom cold/flu products without checking ingredients—many already contain acetaminophen, and it’s easy to exceed the safe daily limit.
Keep your head elevated to reduce throbbing
Toothaches often feel worse when you lie flat because blood pressure in the head increases. If you’re trying to sleep, prop yourself up with an extra pillow or two, or rest in a recliner if that’s more comfortable.
Elevation won’t “fix” the tooth, but it can reduce that pulsing, heartbeat-in-your-tooth sensation that makes it hard to drift off. Pair it with cold therapy and appropriate pain relief for a stronger effect.
If you wake up and the pain has intensified, re-check for swelling and consider whether you’re developing signs of infection. Nighttime escalation is one of the big clues that you may need urgent care rather than waiting.
What not to do, even if you’re desperate
Don’t apply heat to a swollen face
Heat can feel comforting for muscle soreness, but for dental swelling—especially if infection is possible—heat may increase blood flow and worsen swelling. If your cheek looks puffy or feels hot, stick to cold compresses until you’re evaluated.
Some people alternate hot and cold out of habit. If the issue is inflammation from trauma (like biting down too hard), heat might feel okay later on. But at night, when you can’t easily assess what’s happening, cold is the safer default.
If you’re unsure whether you have swelling, compare both sides of your face in the mirror and gently feel along the jawline. If one side is tender, firm, or visibly larger, skip heat.
Don’t chew on the painful side “to test it”
It’s tempting to tap the tooth or bite down to see if it still hurts. But repeated pressure can worsen cracks, irritate the ligament around the tooth, and inflame the nerve even more.
Instead, treat the tooth like it’s injured: avoid chewing on that side, choose soft foods if you need to eat, and keep the area as calm as possible until you can be seen.
If you’re a nighttime clencher or grinder, you may also be adding pressure while you sleep. If you have a night guard, wear it. If you don’t, try sleeping on your back with your jaw relaxed and your tongue resting gently on the roof of your mouth.
Don’t use random “home remedies” that can damage tissue
Putting alcohol, hydrogen peroxide (undiluted), essential oils, or other harsh substances directly on gums can burn soft tissue and complicate treatment. Even natural products can be irritating when applied in concentrated form.
If you do use a rinse, stick with warm saltwater or a dentist-recommended mouthwash. The goal overnight is to reduce irritation and keep things stable—not to experiment with strong chemicals.
Also avoid trying to “drain” anything yourself. If you see a gum boil or feel a bump, that’s a sign to get professional care quickly, not a DIY project.
Different toothache scenarios—and what to do overnight for each
If the pain is sharp with cold, sweets, or air
Sharp, quick pain triggered by cold drinks, sweet snacks, or even breathing in cool air often points to exposed dentin, a cavity, or a tiny crack. At night, your best move is to protect the tooth and reduce triggers.
Avoid cold foods and drinks, and skip sweets. Sip room-temperature water instead. If brushing is painful, use a soft toothbrush and lukewarm water, and brush gently around the area to keep plaque from adding irritation.
If you have a desensitizing toothpaste, you can apply a small amount to the sensitive spot and leave it there (spit out excess, don’t rinse aggressively). This doesn’t replace treatment, but it can calm sensitivity enough to help you sleep.
If the pain is deep, throbbing, and won’t settle
A constant throbbing toothache that lingers and feels like it has its own heartbeat can mean the nerve is inflamed or infected. This is one of the most common “why is this happening at night?” patterns.
Use cold compresses, keep your head elevated, and take appropriate OTC pain relief as directed. Avoid heat, avoid alcohol, and avoid chewing on that side. If you notice swelling, fever, or a bad taste in your mouth, treat it as urgent.
Even if the pain fades by morning, don’t assume it’s “gone.” Dental pain can come and go as pressure changes inside the tooth. You still need an exam quickly to prevent a bigger flare-up later.
If a filling fell out or a crown feels loose
Losing a filling or having a loose crown can expose sensitive tooth structure and cause sudden pain. If you can’t see a dentist until the next day, the goal is to cover and protect the area.
Many pharmacies sell temporary dental filling material or temporary cement. If you have it, follow the instructions carefully. Keep the tooth clean and dry as best you can before placing the material, and don’t pack it aggressively into the tooth.
If a crown came off, you can sometimes gently place it back on for protection (again, only if it fits easily and you’re not forcing it). Don’t use superglue or household adhesives. If you can’t reseat it safely, store the crown in a small container and bring it to your appointment.
If you suspect a cracked tooth
Cracked teeth can be tricky because the tooth might look fine, yet biting causes a sharp “zap.” Some cracks are tiny and only show up with special tests. Overnight, your best strategy is to avoid pressure and temperature extremes.
Stick to soft foods, chew on the opposite side, and avoid very hot or cold drinks. If you grind your teeth, wear a guard if you have one. Grinding can worsen a crack and increase inflammation around the tooth.
Cracks are one reason dentists may recommend additional evaluation tools like dental imaging to check the tooth structure and surrounding bone. Even if the crack itself isn’t always visible on an X-ray, imaging can reveal signs of infection or other changes that guide treatment.
If your gums hurt more than the tooth
Sometimes the pain you feel “in the tooth” is actually gum inflammation. Food stuck under the gumline, aggressive flossing, a popcorn hull, or early gum infection can create a localized ache.
Rinse with warm saltwater, floss gently, and avoid poking the area with toothpicks or sharp tools. If you notice a flap of gum over a partially erupted wisdom tooth, keep the area clean and rinse after eating.
If gum pain is spreading, your face is swelling, or you have trouble opening your mouth, those are signs you should call for urgent dental advice rather than waiting several days.
When a nighttime toothache is an emergency
Signs you should seek urgent care right away
Some symptoms mean “don’t wait.” If you have swelling that’s getting worse, difficulty breathing or swallowing, fever, or swelling under the jaw or in the neck, seek emergency medical care. Dental infections can become serious if they spread.
Also treat it as urgent if you can’t control pain with appropriate OTC medication, you’re experiencing uncontrolled bleeding (especially after an extraction), or you’ve had facial trauma and suspect a fracture.
If you’re unsure, call an emergency dental line or local health advice service. It’s better to be told it can wait until morning than to wait and have symptoms escalate.
What to watch for with kids, seniors, and medically complex situations
Kids may not describe pain clearly, and they can go from “fine” to “miserable” quickly. If a child has facial swelling, fever, or is refusing fluids, it’s time to seek urgent advice. Dehydration and infection risks are higher when they won’t drink.
Seniors and people with diabetes, immune suppression, or certain heart conditions should be extra cautious with possible infections. If you have a medical condition that makes infections riskier, don’t “tough it out” for days.
Pregnancy also changes how you should approach medications and infections. If you’re pregnant and have significant dental pain, call a dentist or healthcare provider for guidance on safe pain control and timing of care.
How to make it through the night more comfortably
Set up a simple “toothache kit” at home
If you’re in pain right now, you can still gather a few basics that make the night easier: a cold pack, soft toothbrush, floss, salt, OTC pain reliever you can safely take, and a glass of water. If you have temporary filling material, keep it accessible.
Having everything in one place prevents the “wander around the house at 2 a.m.” cycle that makes you more awake and more stressed. Stress alone can amplify pain perception.
It can also help to write down what you took (and when), especially if you’re switching between day and night doses. When you’re tired, it’s easy to forget.
Choose tooth-friendly foods and drinks if you need a snack
If you need to eat, go for soft, bland foods: yogurt, scrambled eggs, oatmeal, smoothies (not icy cold), mashed potatoes, soup that’s warm—not hot. Avoid crunchy foods, sticky candy, and anything very sugary.
Drink water and avoid alcohol. Alcohol can irritate tissues and interact with medications. Very hot coffee or tea can worsen sensitivity if the nerve is inflamed.
After eating, rinse gently with water or saltwater. Keeping the area clean reduces the chance of additional irritation overnight.
Try to reduce clenching and jaw tension
A surprising amount of nighttime tooth pain is made worse by clenching. When you’re stressed or sleeping lightly, your jaw muscles can tighten, putting pressure on sore teeth and inflamed ligaments.
Before bed, try a simple jaw reset: place the tip of your tongue on the roof of your mouth just behind the front teeth, let your teeth separate slightly, and breathe slowly for a minute. You can also massage the cheeks and temples gently to relax the muscles.
If you wake up clenching, don’t panic—just reset your jaw position and reapply cold therapy if needed. The goal is to reduce repeated pressure on the tooth.
Getting ready for your dental visit: what to note so you get help faster
Track the details that matter to a dentist
When you call in the morning, you’ll get more useful advice if you can describe the pain clearly. Note when it started, what triggers it (cold, heat, biting, sweets), whether it’s constant or comes in waves, and whether pain medication helps.
Also mention any swelling, fever, bad taste, or drainage. If a filling fell out or a crown came off, tell them which tooth and whether you still have the piece.
Even small details—like “it hurts when I lie down” or “it’s worse when I bite and release”—can help the dental team narrow down likely causes and prioritize your appointment.
Expect that the dentist will focus on both relief and the root cause
Most people want the pain gone immediately (very understandable), but the best dental care also looks for why it happened. Sometimes that means treating decay, replacing a filling, adjusting a bite, or addressing gum inflammation. Other times it may involve more advanced care if the nerve is affected.
Don’t be surprised if your dentist asks about your recent habits—new stress, grinding, changes in diet, or missed dental visits. These aren’t judgment questions; they help connect the dots.
And if you’ve had repeated nighttime toothaches, it’s a sign your mouth needs a closer look overall, not just a quick patch on one tooth.
How to lower the odds of another 2 a.m. toothache
Make preventive care boring—in the best way
The most reliable way to reduce surprise tooth pain is consistent preventive care: brushing twice a day with fluoride toothpaste, flossing daily, and keeping an eye on sensitivity before it becomes a full-blown ache.
Professional care matters too because small cavities and minor cracks can be caught early, when treatment is simpler. Regular visits also help spot gum issues that can cause soreness and swelling around teeth.
If it’s been a while, scheduling a dental checkup and cleaning is one of the easiest ways to prevent the kind of problems that love to flare up at night.
Protect teeth that are more vulnerable
Some teeth are simply more at risk—especially the back molars with deep grooves. Kids and teens are prone to cavities in these areas because brushing those grooves perfectly every day is hard (even for adults).
Preventive treatments can add an extra layer of defense. For families, it’s worth asking a dentist about sealants for kids, which can help block bacteria and food from settling into the pits and fissures of molars.
Adults can benefit from prevention too: fluoride treatments, night guards for grinding, and addressing dry mouth (from medications or mouth-breathing) can all reduce the risk of sudden pain.
Don’t ignore “small” warning signs
Nighttime toothaches rarely come out of nowhere. Often there were hints: brief sensitivity to cold, occasional pain when biting, gum bleeding, a rough edge on a tooth, or food getting stuck in the same spot over and over.
If you notice these patterns, it’s worth getting checked sooner rather than waiting for a crisis. Early care is usually less invasive, less expensive, and far less stressful than an urgent visit after a sleepless night.
Even if you’re busy, think of it as protecting your future sleep. Nothing motivates preventive care like remembering what it feels like to stare at the ceiling at 3 a.m. with a throbbing tooth.
A quick overnight checklist you can follow right now
Do these steps in order
1) Rinse with warm water (or saltwater). 2) Floss gently to remove trapped food. 3) Apply a cold compress to the cheek in 10–15 minute intervals. 4) Take an OTC pain reliever you can safely use, exactly as directed. 5) Elevate your head when resting.
If you have a lost filling or exposed area, consider temporary filling material from a pharmacy if available. Keep the area clean and avoid chewing on that side.
If you see swelling, have fever, trouble swallowing, or pain that’s escalating quickly, don’t wait—seek urgent care.
Plan your morning so you get seen faster
When offices open, call early and describe your symptoms clearly. Mention swelling, fever, trauma, a lost filling/crown, or pain that kept you from sleeping—those details often help you get prioritized.
Have your medication list ready and note any allergies. If you took pain relievers overnight, tell them what you took and when so they can advise you safely.
Most importantly: even if you feel a bit better by morning, still keep the appointment. Toothaches are famous for “quieting down” just long enough to trick you—then roaring back at another inconvenient time.