Tooth pain throbbing at night: why + How to treat?

If you have a tooth abscess or pain, you‘re likely to experience throbbing pain at night.

However, you may not have been adequately informed about this being a common occurrence among patients with tooth abscess, they always complain of throbbing pain at night.

For this article I rely on my own experience as a diagnostic radiographer who has x-rayed so many patients with tooth abscess and I have also had a toothache.

Of Course I have also consulted medical scientific publications on the subject.

Happy reading!😀

Any questions? remarks? Let’s meet in the comments section at the end of this article.🙏

Last updated: July 2024. Written by Juliet Semakula, a diagnostic radiographer.

Disclaimer: no affiliate links.

Summary: When you lie down to sleep, more blood can rush to your brain. More blood circulation means experiencing more tooth pain than if you were standing. This is because the increased blood flow exerts pressure on the painful tooth. Does this make sense?🧏

▶️What causes tooth inflammation (pulpitis) pain and is it reversible?

When you have a toothache caused by infection, it means the pulp tissue inside of your tooth has become inflamed.

Painful inflammation of the pulp results in a condition known as pulpitis.

Tooth pulp is the most vital part of the tooth, originating in the centre of the tooth, underneath the enamel layer (the top layer) and the dentin layer (the second layer), in the pulp chamber.

Image :wikidata.org

The pulp is made up of sensitive nerves and blood vessels. When you start feeling a toothache it sometimes means the pulp tissue inside of your tooth has been inflamed.

                Image of a pulp tooth infection.                                         

Inflammation (pulpitis) of the pulp may be caused by an infection that develops when a bacteria enters the pulp through the cavity or crack, worn tooth enamel, unsuccessful dental procedures or trauma to the tooth.

Your tooth may have some ability to recover from pulpitis on their own. But if left untreated pulpitis will eventually lead to pulp necrosis where your inner tooth pulp dies completely.

▶️How long does toothache inflammation last?

There is really no way to tell how long a toothache will last. If it is simply the result of biting or brushing too hard, it may subside immediately or shortly after.

Most toothaches go away after a few hours or days, but it can last up to a week. Some toothaches can last for months.

If it is caused by something more serious, the pain may come and go, but never really go away completely until you get treatment.

The sooner you treat a toothache, the quicker it will go away. Treating tooth pain can also immediately treat the cause of your pain, which can damage your natural teeth. 

 The stages of a pulp necrosis development.

1️⃣Reversible pulpitis: The tooth can heal on its own if a dentist repairs and seals it.

2️⃣Irreversible pulpitis: The inflammation progresses, and the tooth can’t heal on its own.

3️⃣Pulp necrosis: The pulp tissue dies completely.

The toothache and sensitivity may vary based on the stage. This can be very serious if not treated.

▶️What is the risk for prolonged inflammation of a toothache?

If you do not get your tooth checked and treated the infection can also spread beyond the pulp into your jaw, neck and chest.

The complications of tooth pain may include:

🔴Cavernous Sinus Thrombosis, this an infection of the blood vessels within the sinuses

🔴Submandibular Space Infection.

🔴Osteomyelitis: An infection of the bone surrounding the tooth.

🔴Cellulitis: An infection of the skin and fat directly beneath the skin.

These complications are rare and are a result of an untreated maxillary dental infection.

▶️Why does toothache pain throb at night?

⏭️More blood flows. The main reason why toothaches are more painful at night is our sleeping position.

When you are laying down more blood will rush to your head, putting extra pressure on sensitive areas, such as your mouth causing pain to your tooth. Usually you will not feel that throbbing sensation as much during the day because you are mostly standing or sitting.

⏭️You brain has fewer distractions at night.

At night, when you are sleeping, you are more aware of the sensations in your body because there are fewer distractions. You may think that your toothache is worse, but in truth, it is not, you just feel it more as you clear your mind to fall asleep.

⏭️Late night meals.

Avoid having sugary late snacks, some of that food gets stuck in between your teeth or gums. Because plaque thrives on sugar, forgetting to brush your teeth after a late night meal can aggravate a toothache.

⏭️Unconscious tooth grinding.

Some people unknowingly grind their teeth at night. It’s easy to  wake up from sleep, twisting in so much pain because teeth grinding puts a lot of stress on the jaws, teeth, and gums. This can be a severe condition which needs proper care and treatment.

▶️What can be done to Relieve throbbing nerve tooth pain at Night time?

If your toothache feels unbearable in the middle of the night, it means it’s too late to go to the dentist.🤷

There are some temporary pain relief remedies that will help you manage the pain and go back to sleep:

♊Eating cold, acidic, or sugary food before going to bed can aggravate any cavities that have formed in your teeth.

After brushing, rinse with a mouthwash that contains alcohol or salt. These have antibacterial components that help reduce inflammation caused by plaque and cavities.

♊Pain medication such as paracetamol can help with mild to moderate toothache. Just remember to stay within the recommended dosage indicated in the instructions.

♊You can also try using medicated ointments available at your local drugstore. These come in gels or creams that contain numbing ingredients to give you temporary relief.

♊A pack of ice on the affected side of your face or jaw can help to compress constricts the blood vessels in the area, numbing the pain for a while.

♊Try sleeping with your head elevated. Propping your head with pillows will lessen the blood flow going to your head. This may give you enough relief until you can finally fall asleep.

All these pain relief tips are only temporary, they will not cure your pain and they might not work for some people because pain is different for everyone.

Hopefully, they will get you through the night so you can call your dentist immediately in the morning.

▶️What are the treatments for Inflammation (pulpitis) of the tooth pulp caused by an infection.

Regarding what kind of toothache you have, you should contact your dentists as soon as you can because toothache can go away for a short period of time.

When it does, you may think the tooth is fine, yet it is decaying inside slowly.

 By the time you decide to go to the dentist you may end up losing your tooth, yet it could have been saved by the following treatments.

1️⃣Reversible pulpitis tooth treatment

If the cause of your toothache is caused by inflammation or decay in the tooth pulp and it has reached the nerve endings.

Your dentist will remove the decay and place a filling which will allow the pulp to recover and eliminate any further discomfort.

However, if the cause is not treated, the infection will worsen, leading to irreversible damage to the pulp.

2️⃣Irreversible pulpitis tooth treatment

Have you ever been to the dentists for a tooth filling but still feel a toothache after a few weeks.

What causes this? 

The inflammation causes the pulp tissue to die and in such cases the pulp is no longer able to heal itself even when your body’s immune system breaks down the dead tissue.

This is caused when there is still too much infection for the dead tissue for your immune system to handle.

In such cases an abscess can form, and the infection may spread to the surrounding bone or other areas of the body.

In these cases, a dentist will perform a root canal to remove the dying pulp, which will stop the pain.

3️⃣Pulp necrosis where the pulp of your tooth dies completely:

Then your tooth will be extracted or removed which is usually not the treatment of choice for many.

▶️What can you do to prevent tooth decay or inflammation of the tooth pulpal?

If your toothache is not caused by trauma, and the dentist has confirmed that you have a lot of cavities that need filling, there is a lot you can do to preserve your smile and avoid constant fillings, root canals and tooth removal.

➡️Follow a good oral care routine that includes cleaning between your teeth daily and twice-daily brushing to protect teeth against cavities and clean teeth thoroughly.

Proper oral care also helps preserve your existing fillings that protect your pulp.

➡️Schedule regular visits with your dentist, so any areas of decay can be identified while still small and far from the pulp.

➡️ If you grind your teeth, consider wearing a mouthguard while you sleep to protect your teeth from cracks or breaks.

➡️Reduce or eliminate sweets such as candy and sodas to keep your teeth safe from decay-causing sugar.

Point to take home: Pulpitis can be painful. But simple treatment may keep your pulpitis as a reversible condition rather than an irreversible one if caught early.

With a good oral care routine and help from your dentist, you can get back to enjoying a pain free smile.

This what i wanted to tell you, wishing you a quick recovery🙋 

📚Sources:

Yu Y, Zhou X, Zheng LW. [Advanced research on root canal therapy for primary teeth]. Hua Xi Kou Qiang Yi Xue Za Zhi. 2020 Apr 1;38(2):205-210. Chinese. doi: 10.7518/hxkq.2020.02.016. PMID: 32314896; PMCID: PMC7184287.

Farges JC, Alliot-Licht B, Renard E, Ducret M, Gaudin A, Smith AJ, Cooper PR. Dental Pulp Defence and Repair Mechanisms in Dental Caries. Mediators Inflamm. 2015;2015:230251. doi: 10.1155/2015/230251. Epub 2015 Oct 11. PMID: 26538821; PMCID: PMC4619960.

Farges JC, Alliot-Licht B, Renard E, Ducret M, Gaudin A, Smith AJ, Cooper PR. Dental Pulp Defence and Repair Mechanisms in Dental Caries. Mediators Inflamm. 2015;2015:230251. doi: 10.1155/2015/230251. Epub 2015 Oct 11. PMID: 26538821; PMCID: PMC4619960.

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