Why Does My Tooth Hurt Worse at Night?

Few things are as frustrating as a toothache that seems to flare up right when you’re trying to get some rest. You might go through your day feeling mild discomfort, only to find that once you lie down at night, the pain suddenly feels sharper and harder to ignore. If you’ve ever wondered why your toothache is worse at night, there are several explanations rooted in how your body works and how pain perception changes throughout the day.

Blood Flow Increases When You Lie Down

When you lie flat to sleep, more blood flows to your head. This increased circulation can put more pressure on sensitive areas in and around a damaged or infected tooth. Because the tooth’s nerves are enclosed within a rigid space, even slight swelling or pressure changes can intensify the pain sensation. Gravity plays a role here — when you’re upright during the day, blood drains more easily from your head, but at night, it tends to pool, amplifying inflammation and discomfort.

Fewer Distractions Make Pain Feel Stronger

During the day, your mind is occupied with work, conversation, and daily tasks, which can make tooth pain easier to overlook. At night, however, the world gets quiet. Without distractions, your brain focuses more on the discomfort, making it feel stronger and more persistent. This phenomenon, known as pain perception amplification, is common with many conditions but particularly noticeable with toothaches.

Clenching or Grinding Your Teeth While Sleeping

Many people unknowingly grind or clench their teeth at night, a condition called bruxism. This habit can put enormous pressure on your teeth and jaw, worsening any existing toothache or dental issue. Grinding can also wear down enamel, irritate nerves, and even cause tiny cracks that lead to more pain. If your toothache feels worse upon waking, bruxism may be the culprit.

Sinus Pressure or Infections Can Peak at Night

Tooth pain — especially in the upper jaw — can sometimes be linked to sinus problems. When you lie down, sinus congestion can increase, creating pressure that radiates into the roots of your upper teeth. This can make it difficult to tell whether the pain is from your teeth or your sinuses.

Temperature Sensitivity and Nighttime Habits

Late-night snacks or drinks, especially those that are very hot, cold, or sugary, can trigger sensitivity in a compromised tooth. If you have cavities, exposed roots, or worn enamel, these temperature changes can cause sudden bursts of pain. Brushing immediately after eating acidic or sugary foods may also irritate already sensitive areas.

Untreated Dental Problems Become More Noticeable

Tooth decay, infection, gum disease, or even a cracked tooth can all cause pain that worsens over time. At night, when you’re not moving or talking, your body’s natural pain signals become more

Your toothache feels worse at night due to changes in blood flow, fewer distractions, and sometimes grinding or infection. If your pain keeps you awake, don’t ignore it — your body is telling you it’s time to seek help.

About the Author

Dr. Daniel Lim is a graduate of Nova Southeastern University. Since graduating, he has completed more than 800 hours of continuing education focused on dental implant surgery and cosmetic dentistry. Today, Dr. Lim maintains memberships in the American Dental Association, the American Academy of Cosmetic Dentistry, and the American Academy of Implant Dentistry that help him stay current in the dental field. Are you experiencing a dental emergency? If so, we can help! Schedule an appointment online or call our Arlington office at (817) 375-0400.