Patient question
Why does my tooth hurt at night
Tooth pain intensifies at night because of lying down (more blood flow to the head), fewer distractions, and a falling cortisol level. The most common causes are deep decay reaching the nerve, pulpitis, an abscess, or teeth grinding (bruxism). See a dentist within 24 hours.
Detailed explanation
Lying down raises the pressure in the blood vessels of the head by 15 to 30 percent, so inflammation around a tooth becomes more painful than when you are upright. During the day you are distracted by work and movement; at night the brain gets no competing signals and focuses on the pain.
The classic scenario is deep decay or pulpitis. The decay has reached the pulp (the nerve inside the tooth), which starts to swell. The pain is throbbing, dull or stabbing and may radiate to the ear, temple or jaw. Untreated, it progresses to an acute periapical abscess with facial swelling.
Bruxism. Grinding your teeth at night causes micro-cracks in the enamel, overloads the jaw joint and creates painful micro-fractures. Morning jaw pain, tired chewing muscles and worn canines all point to bruxism. The fix is a night guard (2,000 to 6,000 CZK).
What to do right now. Ibuprofen 400 or paracetamol 500 depending on tolerance, cold the cheek from the outside, sleep propped up (never apply heat). Rinse with warm salt water. Never put alcohol or aspirin directly on the tooth, it burns the soft tissue. First thing in the morning, call a dentist.
General information, not a substitute for an examination by a dentist. Updated 8 July 2026.