Toothache has a way of getting worse at night: when you lie down, more blood flows to the head and the pressure in an inflamed tooth increases. Here is what you can safely do until you can see a dentist, and the signs that mean you shouldn’t wait.
First, the warning signs
Go to a hospital emergency department straight away if you have:
- swelling in your face or neck that is spreading quickly, or reaching towards the eye
- difficulty swallowing, breathing or opening your mouth
- fever with facial swelling
These can mean a spreading infection, which needs urgent treatment.
What helps tonight
- Take a painkiller that is safe for you, at the dose on the packet. Paracetamol or ibuprofen are commonly used; ask a pharmacist or doctor if you have stomach, kidney, liver or heart problems, are pregnant, or take other medicines.
- Rinse with warm salt water, half a teaspoon of salt in a glass of warm water. It soothes and cleans the area.
- Floss gently around the tooth. Sometimes a trapped piece of food is the whole problem.
- Keep your head raised on an extra pillow.
- A cold compress on the cheek (not directly on the tooth) for 15 minutes at a time can reduce throbbing.
What not to do
- Don’t put aspirin or tablets on the gum. It burns the tissue and doesn’t help the tooth.
- Don’t apply heat to a swollen face. It can make an infection spread.
- Don’t rely on clove oil or home remedies to fix the problem. They may numb briefly, but the cause is still there.
- Don’t take leftover antibiotics. Antibiotics alone don’t cure a tooth infection, and the wrong one or the wrong dose causes harm.
Why it happens
The commonest causes are:
- Deep decay reaching the nerve of the tooth, often a throbbing, lingering pain, worse with heat.
- A cracked tooth, sharp pain on biting or releasing.
- An abscess, constant, severe pain, sometimes with swelling or a bad taste.
- A wisdom tooth trying to come through, with swollen gum over it.
- Sinus congestion, which can make several upper back teeth ache together.
Each of these needs a different treatment, which is why seeing a dentist matters.
Next morning
Call us as early as you can. We keep time for emergencies during working hours and will tell you when to come. Most toothaches are relieved at the first visit, often with a filling or by starting root canal treatment, and the tooth can usually be saved.
