Toothache that is bearable during the day often becomes unbearable at night. There is a physiological reason: lying down increases blood flow to the head and pressure rises inside the tooth’s rigid chamber. Inflamed pulp is extremely sensitive to pressure. And at night there is nothing to distract you, so the pain feels stronger.
What helps until your appointment
- Sleep propped up. Raising the head reduces pressure and often helps surprisingly well.
- Cold on the outside. A cold compress on the cheek, 15 minutes at a time. Reduces swelling and numbs.
- Painkiller. Ibuprofen works better than paracetamol for toothache because it also reduces inflammation. Follow the dosage on the packet.
- Salt-water rinse. A teaspoon of salt in a glass of warm water, rinse gently.
- Clean the area. Food trapped between teeth can itself be the cause — try carefully with floss.
What not to do
- Do not put aspirin on the tooth. It does not act locally, it burns the mucosa.
- Do not apply heat. A warm compress dilates blood vessels and speeds the spread of a purulent infection.
- Do not rely on antibiotics alone. They may quieten the pain temporarily but do not remove the cause — the source of infection inside the tooth.
- Do not wait for the pain to stop. Pain disappearing often means the nerve has died, not that the problem has resolved.
What usually causes the pain
- Pulpitis. Deep decay has reached the nerve. Throbbing pain, worse lying down. Needs root canal treatment.
- Apical periodontitis. The tooth hurts when tapped and may feel “higher” than the others.
- Pericoronitis. Gum inflammation over a partly erupted wisdom tooth.
- A cracked tooth or filling. Sharp pain on biting.
- Exposed tooth neck. Brief sharp pain from cold, gone in seconds.
When it is an emergency
Seek help urgently if:
- Your face or neck is swollen.
- You have a temperature above 38 °C along with toothache.
- Swallowing or opening your mouth is difficult.
- Swelling is spreading towards the eye or neck.
These are signs of spreading infection that need immediate treatment — not waiting until morning.
What treatment costs
Most often the answer is root canal treatment: €125–205 under a microscope depending on the tooth, plus canal filling and restoring the tooth. First consultation with imaging €30.
If a tooth hurts, book an appointment at Unidenta in Tallinn — the sooner you come, the better the chance of saving it.