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ToothacheA tooth that hurts more at night?
Pain that gets worse at night often means the nerve inside the tooth has been affected, and that needs checking soon. Call the clinic, or first thing when we open if we are closed; here is what to do until morning, and when it can’t wait.
Why does it get worse at night?
When you lie down to sleep, more blood reaches your head than when you are sitting or standing. The inflamed nerve is trapped inside the tooth between hard walls, so the extra pressure has nowhere to go, and the pain grows. And at night there is nothing else to take your mind off it.
The hour itself is not the main sign: pain that comes on its own, even if it comes and goes, or wakes you at night, or lingers after the cold has gone, usually means the nerve has been affected. A painkiller may take the edge off, but it does not remove the cause, and if it doesn’t help, call.
What to do now, until morning
Signs that don’t wait until morning
Go to the nearest hospital emergency department now, not an appointment:
- Difficulty breathing or swallowing.
- Swelling that has reached the eye or the neck.
And let us know afterwards.
Call now:
- Swelling under the jaw.
- Fever with the pain.
- Difficulty opening your mouth.
If the clinic is closed or you can’t reach us: go to the nearest hospital emergency department. Don’t wait.
If you are not in Jordan, go to the nearest emergency service where you are.
If there is swelling or an abscess that has not reached the eye or neck, call. And if the clinic is closed and the swelling is growing, go to the nearest hospital emergency department, and let us know as soon as we open. More: Dental emergencies and abscesses.
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Rinse with warm salt waterHalf a teaspoon in a glass of water, and repeat every few hours. It cleans and soothes the gum. For a child, only if they can spit it out.
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A cold compress on the outside of the cheekFifteen minutes on, fifteen off. Cold reduces swelling and pain.
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An ordinary painkiller from the pharmacy, as its leaflet saysAnd ask the pharmacist first if you have a chronic condition, take blood thinners, or are pregnant. For a child: a children’s painkiller, with the dose worked out by the pharmacist, and never an adult tablet, not even half of one.
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If something is stuck between the teethFloss it out gently, and only gently. Sleep with your head higher than your body. Pain gets worse lying flat.
Don’t do this
- No painkiller tablet on the tooth or gum. It burns the tissue and makes the pain worse.
- No heat on the cheek from outside. A hot compress increases swelling.
- Don’t poke or pop an abscess. It gets infected and spreads.
- No leftover or self-prescribed antibiotics. They don’t stop tooth pain, and they hide the picture from the dentist.
And root canal treatment?
If the tooth can still be kept, a root canal removes the source of the infection and leaves your tooth in place, on its own root, instead of it being taken out. The examination and the x-ray decide. The earlier you come, the better the chance the tooth is kept.
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The examination and the x-rayThe tooth, its roots and the gum around it are looked at, and you hear whether it can be kept, exactly what it needs, and why, before anything starts.
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Local anaestheticThe area is numbed before we begin: you are told before the injection, not after it. The prick itself is short and you do feel it; then the area goes numb.
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Cleaning the root canals and sealing themThe inflamed or dead tissue is cleaned out of the inside of the tooth, the canals it ran through are disinfected and filled, and then the tooth is sealed from the top to keep bacteria out. In one visit or more, depending on the tooth.
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And afterwards, usually a crown for a back toothA back tooth after a root canal usually needs a crown to cover it and spread the load, while a front tooth is sometimes fine with a filling. It is a separate step, and the examination aims to make it known from the start. More on the crown itself: Dental crowns.
The details are in two articles: Extraction or root canal: how it is decided, and Your tooth after a root canal: how it stays with you.
Call and we will find you the earliest slot, and tell you what to do until you arrive. If we are closed, call as soon as we open.
Questions people ask
Does a root canal hurt?
It is done under local anaesthetic: the area is numbed before we begin, and you are told before the injection, not after it. The prick itself is short and you do feel it; then the area goes numb. Once it is numb, you feel pressure and movement, and if you feel pain, you raise your hand and we stop, and more anaesthetic is given if it is needed. An inflamed tooth sometimes needs more anaesthetic than usual; that is expected, not a sign something is wrong. The pain that brought you in usually comes from the inflamed nerve, and removing it removes its main source; the rest settles over the following days. Afterwards, tenderness when you bite for a few days is normal, and if it gets worse, you call. And if fear itself is the problem: When the visit is hard.
How long does it take?
One visit or more, depending on the tooth: a molar has more canals than a front tooth, and sometimes the inflammation has to settle between visits. The likely number for your case is given after the examination and the x-ray, as an expectation, not a promise. And if you are only in Amman for a short stay, tell us your dates before you book.
The pain went away on its own. Do I still need to come?
Yes. Pain that goes away on its own sometimes means the nerve has died, not that it has healed, and the examination and the x-ray show which. And the pain itself usually comes back, sometimes stronger. A regular check-up soon beats an emergency in two weeks.
Pages that go with this one
These are first-aid notes and general information, not a diagnosis. If your situation is different or you have a chronic condition, calling is faster and safer than reading.