Toothache at night - what to watch out for

introduction

Toothache does not only occur during the day or during physical exertion. Many of the affected patients report the occurrence of toothache at night. In addition, many observe a worsening of the pain symptoms at night.

Toothache at night

You hardly notice it during the day, but as soon as you come to rest at night and want to fall asleep, the toothache becomes unbearable. The body goes down in the evening, pulse and blood pressure decrease. Hormone production is also different than during the day.

One reason for the intensification of toothache at night is the fact that inflammatory processes are to a certain extent temperature-dependent.
While cooling affected areas of the body can often help contain inflammation, warmth has a stimulating effect. At night, resting the head on a pillow can cause the oral cavity to overheat. The rising temperature, in turn, promotes blood circulation in the area of ​​the teeth and consequently also stimulates the release of inflammatory mediators.

The warmer the temperatures outside, the faster the body tends to increase inflammation. Therefore, unexpected toothaches are not uncommon, especially in midsummer.

Above all, the level of cortisol is particularly low in the evening, as it is only formed in the second half of the night and reaches its highest level in the morning after getting up. Cortisol is the hormone used to inhibit pain, which makes us appear particularly insensitive to pain in the morning. This effect decreases towards evening, as new cortisol is first formed and we feel pain more intensely. The result is an intensification of the toothache.

Furthermore, a psychological component plays another decisive role in the type and extent of any pain perception. During the day, the affected patients are often distracted and therefore perceive the toothache in a weakened form.
This is also one of the reasons why toothache is felt to be particularly severe and unpleasant at night. Patients who suffer from severe toothache, especially at night, can temporarily remedy the situation with a cooling pillow. In addition, the head should be kept high at night if there is a toothache.

Toothache while lying down

Many patients who suffer from acute toothache describe that they increase in intensity during the night and can sometimes be perceived as a strong throbbing. It is often discussed whether this perception is just imagination or whether there are actually factors that explain an increase in toothache during the night.

In order to be able to answer this question, one must realize that pain is closely causally related to inflammatory processes within the organism. Various inflammation mediators are able to couple to pain receptors and in this way transmit pain stimuli to the brain. Inflammatory processes, on the other hand, are promoted by a strong blood flow to the affected tissue.

Toothache can actually be worse at night than during the day. At night, the blood flow to the head increases because the person remains in a lying position while sleeping. At night, gravity has less of an influence on the distribution of blood volume within the body.
When standing, a large part of the blood volume is in the area of ​​the lower extremities. The head, on the other hand, has comparatively little blood flow. At night, however, while lying down, the total blood volume is distributed completely differently.

The result is increased blood flow to the head and the structure within the oral cavity that is responsible for the toothache. As a result of the increased blood flow, there is an increase in the inflammatory processes through the increased release of inflammatory mediators and thus an increased pain perception.

Read more about this under: Toothache while lying down

Causes of toothache

Toothache is uncomfortable and one of the most common problems in the oral cavity. There can be various reasons for the development of a toothache. In the case of toothache that persists over a longer period of time, it should always be noted that the annoying throbbing is a symptom of an illness that requires treatment and that a dentist must be consulted promptly

• Caries,
• Inflammation of the gums
• Periodontal diseases
• Sinus infection / general colds: Especially in cases where it can be observed that the pain is increased when bending over or bending forward, it can generally be assumed that this is not a disease of the teeth.
• Toothache after alcohol consumption: If the toothache occurs every night after you have consumed alcohol before, the toothache may also be a delayed reaction to it.

What should you do if you have a toothache at night?

Depending on the cause of the pain and its quality, there are many different ways to remedy it.

• Place in a cool place and do not cover with the warm duvet. Cold prevents the inflammation from spreading and the bacteria that cause it multiply, especially in a warm environment.
• Painkillers: Ibuprofen is always the drug of choice for toothache, as it also has an anti-inflammatory effect. Take care when taking Aspirin® or Thomapyrin®. The active ingredient acetylsalicylic acid works well against pain, but it also thins the blood.
  Read more at: Pain relievers for toothache
• Visit a dentist to clarify the cause
• Grinding splint: If the pain is more muscular or caused by pressing and grinding, the only lasting remedy is to wear a "grinding splint". This plastic splint prevents the teeth from coming together at night and thereby forcibly relaxes the muscles and the jaw joints
• Physiotherapy: Physiotherapy can also help, in which special exercises are done to relieve the muscles and joints and relieve tension. Physiotherapy can be prescribed by the dentist and is covered by health insurance.

Read more on the topic: Toothache- what to do

Toothache worse at night / better at night

Whether a toothache gets worse or better at night depends on the pain and its quality. In most cases the condition worsens and we feel it much more strongly at night than during the day. This often suggests inflammation. The better blood circulation when lying down, as well as the increased release of inflammatory mediators due to the warmth in bed, only make the signs of inflammation stronger. The affected area becomes hot, swollen, red and extremely painful.

It can often happen that the mouth opening is restricted.

Toothache can also be caused by a cold and not at all by the teeth themselves. The tooth roots in the upper jaw are in direct contact with the maxillary sinus and if this is infected by bacteria, this can radiate to the teeth and lead to severe discomfort when lying down. However, these should subside immediately after the cold.

Find out more about the topic: Toothache with a cold

If the toothache is less when the patient is at rest, it may well be bruxism (teeth grinding). One also speaks of crunching when one unconsciously presses both jaws against one another and mechanical abrasion of the tooth enamel further and further due to excessive force. This lowers the bite and the jaw joints have to adapt to the new condition.

Read more on the topic: Grinding teeth

This new condition is often incompatible with the anatomical conditions. This can lead to severe pain, which can also expand into jaw pain and headaches. When lying down, the muscles, which are permanently tensed by the crunch, are relaxed and the strain is reduced. This relaxed state does not last long, however, as many people actively process their stress and everyday events while sleeping and often grind even more while sleeping without being able to consciously control it. You wake up in the morning with strong muscle tension in the facial area combined with jaw joint pain and headache.