Toothache at night

Night toothache can be distressing, but the time of day does not diagnose the cause. Persistent or severe night pain should be assessed because several dental problems can worsen without treatment.

• Tooth decay, dental abscess or inflammation inside or around a tooth.
• A cracked, damaged or heavily restored tooth.
• Grinding, clenching, gum problems or referred pain from another area.
• Wisdom tooth inflammation or infection signs.

• Contact a dentist or NHS 111 if pain is severe or affecting sleep.
• Keep the mouth clean and avoid foods or drinks that trigger the pain.
• Sleep in a position that feels comfortable while waiting for advice.

• Do not place painkillers directly on the gum or tooth.
• Do not delay if swelling, fever or a bad taste develops.
• Do not use alcohol or repeated biting tests to manage the pain.

• Toothache lasts more than two days or keeps returning.
• Pain wakes you or affects daily life.
• Pain is linked with a broken tooth, filling, crown or wisdom tooth.

• Pain is severe and not settling with suitable self-care.
• There is swelling, fever, difficulty opening the mouth or a bad taste.
• The toothache follows injury or is linked with a loose or broken restoration.

• Assess the painful tooth, gum, bite and surrounding tissues.
• Use X-rays or other tests if needed to investigate the cause.
• Discuss dental treatment or urgent referral depending on findings.