If you have a toothache at night, rinse with warm salt water, apply a cold compress to your cheek, keep your head elevated, and take over-the-counter pain relief as directed on the label or by your pharmacist. Toothache usually signals decay, infection or a cracked tooth, so it needs a dentist. Sydney Smile Centre in Pagewood sees new and emergency patients — call us on 02 9349 2387.

A toothache that flares in the evening can make it impossible to sleep, and the throbbing often feels worse when you lie down because more blood flows to your head. The steps below help you settle the pain safely tonight, but they treat the symptom, not the cause. Below we explain what is likely going on, what to avoid, the warning signs that mean you should not wait, and how we find and fix the underlying problem in Pagewood.

Why does toothache feel worse at night?

Pain often intensifies at night for a few simple reasons. When you lie flat, blood pressure around the head and jaw increases, which can add pressure to an inflamed nerve or an abscess. There are also fewer distractions after dark, so you notice the ache more. Grinding or clenching during sleep can aggravate a sore tooth as well.

Common causes of a genuine toothache include:

• Tooth decay: a cavity that has reached the sensitive inner layers of the tooth.
• Dental infection or abscess: bacteria reaching the nerve, sometimes with swelling.
• Cracked or broken tooth: often triggered by biting down.
• Gum problems: inflammation, infection or food trapped below the gumline.
• A lost or leaking filling or crown: exposing the tooth underneath.

Safe ways to ease dental pain at home tonight

These general measures are designed to make you more comfortable until you can be seen. They are not a substitute for treatment.

• Warm salt-water rinse: dissolve a little salt in warm water and swish gently to help clean the area and calm irritated gums.
• Cold compress: hold a cold pack or wrapped ice against your cheek for around 15 minutes at a time to reduce swelling and numb the ache.
• Keep your head raised: prop yourself up with an extra pillow so blood does not pool around the sore tooth.
• Over-the-counter pain relief: take pain relief only as directed on the label or by your pharmacist, and check it is suitable for you.
• Gentle cleaning: keep brushing softly and floss carefully to remove any trapped food around the tooth.

What NOT to do with a toothache

Some popular remedies can make things worse. Please avoid the following:

• Do not place aspirin directly on the gum or tooth — it can burn the soft tissue.
• Do not apply heat to the outside of the face if there is any swelling, as warmth can spread infection.
• Do not ignore it hoping it will pass — pain that eases on its own often means a nerve has died, while the infection continues.
• Do not chew on the painful side or eat very hot, cold, sugary or hard foods.
• Do not attempt DIY dentistry such as prising at a tooth or using household glue on a broken piece.

Red-flag symptoms that mean urgent care

Most toothaches can wait for a same-day or next-day appointment, but some signs point to a spreading infection that needs prompt attention. Contact a dentist urgently, or seek medical care, if you notice:

• Facial or jaw swelling that is increasing, especially around the eye or under the jaw.
• Fever, feeling generally unwell, or swollen glands alongside the tooth pain.
• Difficulty swallowing, opening your mouth or breathing — this warrants immediate emergency medical attention.
• Pain that is spreading to your ear, neck or the other side of your face.
• A bad taste or discharge, which can indicate an abscess draining.

If you ever have trouble breathing or swallowing, do not wait for a dental appointment — go to your nearest emergency department.

How Sydney Smile Centre treats the cause

Relieving pain is only the first step. At our Pagewood practice we examine the tooth, take x-rays if needed, and identify exactly what is driving the ache before recommending treatment. Depending on the cause, this may involve:

• A filling to repair decay once the affected area is cleaned out.
• Root canal treatment to save a tooth where the nerve is infected.
• A crown to protect and strengthen a cracked or heavily restored tooth.
• Gum treatment where inflammation or infection is the source.
• Extraction where a tooth cannot be saved, with a discussion of replacement options.

Costs vary with the treatment you need. We offer HICAPS on-the-spot health-fund claiming, and payment plans and Afterpay are available.

Emergency and Saturday appointments in Pagewood

We welcome new and emergency patients from Maroubra, Mascot, Botany, Kingsford, Eastgardens and across the Eastern Suburbs. If you are in pain, call us early and we will do our best to see you promptly. We are open Monday to Friday 9am to 5pm and Saturday 9am to 1pm, so a weekend toothache does not have to wait until Monday. Call 02 9349 2387 or request an appointment online at our website.

How can I stop toothache pain fast at night?

Rinse with warm salt water, hold a cold compress against your cheek for about 15 minutes, prop your head up with an extra pillow, and take over-the-counter pain relief as directed on the label or by your pharmacist. These steps can ease the ache, but they do not treat the cause, so you still need to see a dentist promptly.

Is a toothache always a dental emergency?

Not always. Many toothaches can wait for a same-day or next-day appointment. However, facial swelling, fever, a spreading pain, or difficulty swallowing or breathing are red flags that need urgent care. If you have trouble breathing or swallowing, go straight to a hospital emergency department rather than waiting for a dental visit.

Why does my toothache hurt more when I lie down?

Lying flat increases blood flow and pressure around your head and jaw, which can add pressure to an inflamed nerve or an abscessed tooth and make the throbbing feel stronger. There are also fewer distractions at night, so you notice the pain more. Keeping your head elevated on an extra pillow can help.

Can a toothache go away on its own?

The pain may fade, but this often means the nerve inside the tooth has died rather than that the problem has healed. The underlying decay or infection usually continues and can worsen or form an abscess. It is best to have any toothache assessed by a dentist even if the pain settles.

What over-the-counter pain relief is safe for toothache?

Common pharmacy pain-relief options can help, but you should take them only as directed on the label or by your pharmacist, and check they are suitable for your health and any other medicines. Never place aspirin directly against the gum or tooth, as it can burn the tissue. If pain persists, see a dentist.

How do I book an emergency dental appointment in Pagewood?

Call Sydney Smile Centre on 02 9349 2387 and let us know you are in pain so we can prioritise you. We are open Monday to Friday 9am to 5pm and Saturday 9am to 1pm, and we welcome new and emergency patients. You can also request an appointment online at our website at any time.

Fees vary depending on your individual needs. See our fees page for current pricing, or book a consultation for an exact quote.