Toothache at Night: What to Do Until You Can See a Dentist
Toothache always seems worse at night. Here's safe first aid to manage the pain, what to avoid, and when to call NHS 111 urgently.
NearbyDentist Editorial
Independent UK dental-access guide
What can I do about toothache at night until I see a dentist?
To manage toothache at night, take over-the-counter painkillers such as ibuprofen and paracetamol at the recommended doses (these can be alternated if needed, following the packet and pharmacist advice), and keep your head propped up with extra pillows, as lying flat increases blood flow to the area and worsens throbbing. Rinse with warm salty water, avoid very hot, cold or sugary foods, and use a cold compress on your cheek for swelling. Do not put aspirin directly on the gum. If you have facial swelling affecting your breathing or swallowing, call 999. For severe pain that you cannot control, contact NHS 111 for urgent dental care. These steps ease symptoms overnight, but they do not treat the cause, so you still need to see a dentist promptly.
Why toothache feels worse at night
There is a reason dental pain seems to peak the moment you lie down. When you lie flat, more blood flows to your head, increasing pressure around an inflamed tooth and making the throbbing worse. There are also fewer distractions at night, so the pain has your full attention. The result is a miserable, sleepless few hours. While you wait to see a dentist, there is plenty you can do to take the edge off.
Manage the pain safely
Over-the-counter painkillers are the most effective first step:
- Ibuprofen is particularly useful for dental pain because it reduces inflammation, provided you can take it safely.
- Paracetamol can be taken as well, and the two can be alternated for stronger relief if needed.
- Always follow the dose on the packet, and ask a pharmacist if you are unsure, pregnant, or take other medication.
Never place an aspirin tablet directly onto the gum or tooth, a common myth. It does not help and can burn the soft tissue.
Position and simple home measures
A few practical adjustments can make the night more bearable:
- Prop your head up with an extra pillow or two to reduce blood pressure around the tooth.
- Rinse gently with warm salty water (a teaspoon of salt in a glass of warm water) to soothe the area and help with infection.
- Apply a cold compress to the outside of your cheek for 15–20 minutes to numb pain and reduce swelling.
- Avoid very hot, very cold, or sugary food and drink, which can trigger sharp pain.
- Try to chew on the opposite side and keep the area clean.
When it's an emergency, not just pain
Most toothache is urgent but not dangerous. However, you should treat it as a genuine emergency and call 999 or go to A&E if you have:
- Swelling around the mouth, jaw or throat affecting your breathing or swallowing.
- Swelling spreading quickly towards the eye or down the neck.
- A high fever alongside facial swelling.
These can be signs of a spreading infection that needs immediate treatment.
Getting urgent dental help
If the pain is severe and you cannot control it, or you have no dentist of your own, contact NHS 111. They can direct you to an urgent dental service, and in England urgent NHS treatment is charged at the flat Band 1 rate of £27.40 (free if you qualify for an exemption). You do not need to be registered, as our guide to finding an emergency dentist when you have no NHS dentist explains.
The pain relief is temporary, the cause is not
It is vital to understand that everything above manages symptoms, it does not fix the problem. Toothache is usually a sign of decay, infection, a cracked tooth or a failing filling, and these only get worse without treatment. As soon as you can, arrange to see a dentist. If you do not have one, start with our practical method for finding an NHS dentist and our list of practices taking on new patients. Treating the underlying cause is the only way to stop the pain coming back, night after night.