A severe toothache can begin at any time of the day or night. There may be some warning signs leading up to a constant and throbbing pain; however, it can also wake you during the night with no prior warning at all. There are several reasons a tooth can ache during the night, and determining the correct one is essential to proper treatment and alleviation of the pain.
Considerations
Tooth decay causes most toothaches, according to the University of Wisconsin School of Medicine and Public Health. Cavities are usually the result of poor oral hygiene, but there is also a genetic component. Dental decay causes inflammation and eventually infection of the dental pulp. This soft tissue within the tooth contains blood vessels, connective tissue and nerve fibers, according to the American Association of Endodontists.
Causes
In addition to decay, trauma, cracks, gum disease and multiple dental procedures can cause a toothache by damaging the dental pulp. Sinusitis, earache and even a heart attack can also refer pain to a tooth, according to the Loma Linda Medical Center. Another cause of pain in the teeth and jaws is grinding, which occurs primarily during sleep, according to the Cleveland Clinic. Toothaches at night caused by grinding may indicate a possible cracked tooth.
Diagnosis
One of the diagnostic questions posed by dentists is, “Does the pain wake you up at night?” according to the Loma Linda Medical Center. A spontaneous pain during the night strongly points to an irreversibly inflamed or infected dental pulp. The dentist will ask other diagnostic questions to determine when the pain started, whether hot or cold make the tooth hurt and if the tooth is painful when chewing. A dental X-ray reveals the health of the surrounding bone and ligament as well as the presence of tooth decay. Tapping on the tooth with a metal dental instrument can reveal the presence of an abscessed tooth, according to the American Academy of Family Physicians. Testing a tooth’s response to cold can diagnose the presence and severity of pulpal inflammation.
Treatment
When a tooth hurts during the night, over-the-counter pain medications can help with pain relief until you can see a dentist, according to the University of Wisconsin School of Medicine and Public Health. Warm salt water rinses also help sooth the affected area. Two options exist for a severely inflamed or infected dental pulp: tooth extraction or root canal treatment. Root canal treatment can save most abscessed teeth, according to the American Association of Endodontists. The dentist makes a small opening through the top of the tooth and removes the infected dental pulp. A root canal filling placed inside the root seals it from future infection.
Prevention/Solution
Regular dental checkups and proper oral hygiene help prevent most toothaches. Consult a dentist at the onset of any pain or swelling in or around the mouth.
