There’s nothing more frustrating than settling into bed, only to have your tooth start throbbing just as you’re ready to sleep. Many people find that their tooth pain feels significantly worse at night, even if it’s barely noticeable during the day. While it might seem like bad luck, there are actually several reasons why toothaches tend to flare up after dark — and understanding them can help you find relief until you can see your dentist.
Changes in Blood Flow
When you lie down, blood flow to the head and neck naturally increases. This shift can put more pressure on sensitive areas, including inflamed or infected teeth. During the day, gravity helps keep blood from pooling around the head, but at night, the added circulation can make any existing pain feel more intense. Propping your head up with an extra pillow may help reduce the throbbing sensation until you can get treatment.
Fewer Distractions
Another simple but powerful factor is awareness. During the day, work, conversation, and other activities keep your mind busy, so you might not notice mild discomfort. At night, when things are quiet and your attention is undivided, tooth pain becomes harder to ignore. This doesn’t mean the problem is worse — it’s just that you’re more tuned in to what your body is feeling.
Sinus Pressure and Allergies
If your toothache feels like a dull ache in your upper teeth, sinus congestion may be to blame. The roots of your upper molars sit very close to your sinus cavities, so pressure or inflammation from a sinus infection or allergies can create pain that mimics a toothache. Lying flat can make sinus pressure worse, which might explain why your discomfort peaks at night. If sinus issues are the cause, treating the underlying congestion will usually relieve the pain.
Teeth Grinding (Bruxism)
Many people grind or clench their teeth while they sleep without realizing it. This habit, known as bruxism, can strain your jaw muscles and wear down enamel, leading to tooth sensitivity and pain. If you often wake up with sore teeth or a tight jaw, your dentist may recommend a custom nightguard to protect your teeth and prevent further damage.
Tooth Infection or Decay
Sometimes, nighttime pain signals a deeper problem, such as an infection or advanced tooth decay. If bacteria have reached the tooth’s inner pulp, the resulting inflammation and pressure can cause severe, persistent pain that intensifies when you lie down. In these cases, over-the-counter pain relievers might offer temporary relief, but you’ll need professional care — such as root canal therapy — to resolve the infection and save your tooth.
If your toothache keeps you up at night, it’s best not to ignore it. The sooner you see your dentist, the sooner you can identify the cause and get lasting relief.
About the Practice
Beverly Rose, DMD, and her team at provide compassionate, comprehensive dental care to patients in Melbourne, FL. From preventive services to advanced restorative treatments, including emergency dentistry, Dr. Rose focuses on creating healthy, confident smiles in a welcoming environment. If you’re experiencing tooth pain that worsens at night, the team is here to help you find comfort and long-term solutions.
Call us at (321) 259-4666 or request an appointment online.