Why does my tooth hurt so bad at night

Night toothache can become more noticeable when you lie down, but decay, pulp inflammation, a crack, or an abscess is usually the underlying concern.

Inflamed pulp inside the tooth can produce spontaneous throbbing and lingering responses to heat or cold. Lying down may make pressure and attention to the pain more noticeable, but the position itself does not explain away decay, a crack, a high filling, or infection.

Keep your head slightly raised, avoid very hot or cold foods, and chew on the other side until assessed. Follow the label for any pain medicine that is suitable for you, and do not place heat directly on facial swelling.

Arrange prompt care if pain wakes you, lasts after a trigger, hurts on biting, or returns repeatedly. Swelling, fever, or difficulty swallowing or breathing changes the situation to urgent care.

Ask whether the pulp is reversible or irreversibly inflamed, whether the tooth is cracked or decayed, and whether testing or an x-ray is needed. Ask which treatment preserves the tooth.