Few things feel worse than a throbbing tooth at two in the morning. The house is quiet, nothing distracts you, and the pain seems to grow louder the longer you lie there. If you are dealing with severe toothache at night, the best thing you can do is stay calm, check for any signs that need medical help straight away, and then settle the pain as safely as you can until a dentist can see you.
This guide from Guildford Smiles Dental explains what to do tonight, why tooth pain so often flares after dark, and when it is time to get professional help. If you have swelling spreading across your face or neck, difficulty breathing or swallowing, or bleeding you cannot control, call 999 or go to A&E instead of reading on.
Call Guildford Smiles Dental on 0148 336 1739
Book your appointment online
Monday to Friday, 8am to 6pm. Appointments subject to availability.
What to do for severe toothache at night
For severe toothache at night, first check for emergency symptoms such as facial swelling, a high temperature or trouble swallowing. If there are none, rinse gently with lukewarm water, keep the tooth away from heat, cold and sugar, use pain relief as a pharmacist or the packaging advises, and arrange a dental assessment as soon as the practice opens.
Here is a sensible order to work through:
- Check for emergency symptoms first. Swelling spreading across your face, eye or neck, trouble breathing or swallowing, uncontrolled bleeding or a serious head or facial injury need 999 or A&E, not a dental appointment.
- Rinse gently. Swish lukewarm water, or a pinch of salt in a glass of warm water, around your mouth and spit it out.
- Clean around the tooth. Brush softly and use floss or an interdental brush to remove trapped food, which can cause pain on its own.
- Go easy on the tooth. Avoid very hot, cold or sugary food and drink, and do not chew on that side.
- Use pain relief carefully. Paracetamol or ibuprofen suit many adults, but not everyone. Follow the packaging, and ask a pharmacist or NHS 111 if you are pregnant, have asthma, stomach, kidney or heart problems, or take other medicines. Never place aspirin or any tablet directly on the gum.
- Raise your head. An extra pillow may ease the throbbing for some people, because lying flat increases blood flow to the head.
- Note your symptoms. Write down when the pain started, what sets it off and whether you have swelling or a bad taste. It helps the team when you call.
These steps are temporary comfort measures. They do not treat the cause.
Why does toothache get worse at night?
Pain often feels stronger after dark for two simple reasons. There is less to distract you, and lying down increases blood flow to the head, which can raise pressure inside an already inflamed tooth. Pain at night does not automatically mean infection, and only an examination can confirm the cause. Common possibilities include:
- Tooth decay that has reached the deeper layers of the tooth, causing sharp or throbbing pain.
- Pulpitis, which means inflammation of the pulp, the soft tissue inside the tooth that holds its nerves and blood vessels.
- A cracked tooth or damaged filling, often noticed when biting or with hot and cold drinks.
- A dental abscess, a pocket of infection around a tooth or in the gum, sometimes with swelling, a bad taste or a raised temperature.
- Gum problems or food trapped between teeth.
- Clenching or grinding, which can leave teeth and jaw muscles sore by morning.
- A recent extraction, where increasing pain a few days later could be dry socket and needs treatment.
When should you see a dentist for toothache?
The NHS advises seeing a dentist if toothache lasts more than two days. Do not wait that long if you notice any of the following:
- Pain that is severe, or stops you sleeping or eating
- Pain when biting, or sensitivity that lingers after hot or cold
- A swollen gum, a pimple-like bump on the gum or a bad taste
- A broken tooth, or a lost filling or crown
- Increasing pain after a recent extraction
When to seek emergency medical help
Dental pain becomes a medical emergency when it comes with difficulty breathing or swallowing, swelling that is spreading quickly across the face, eye or neck, bleeding that will not stop, or a serious head or facial injury. Call 999 or go to A&E. Do not wait for a dental appointment.
| Where to turn | Typical situations |
| Contact your dentist (opening hours) | Severe or lasting toothache, pain that wakes you, a broken tooth or lost filling, a gum swelling or bump, pain after an extraction |
| NHS 111 online (or call 111) | The practice is closed and you need urgent advice, pain you cannot control, swelling with a high temperature, or you are unsure what to do |
| 999 or A&E | Difficulty breathing or swallowing, swelling spreading rapidly across the face, eye or neck, uncontrolled bleeding, serious head or facial injury |
Call Guildford Smiles Dental on 0148 336 1739
Book your appointment online
Monday to Friday, 8am to 6pm. Appointments subject to availability.
How can a dentist treat severe toothache?
Your dentist will ask about your symptoms, examine the tooth and often take an intra oral X-ray to see what is happening beneath the surface. Treatment depends on the cause. White fillings repair decay or a damaged filling, and root canal treatment, offered within our general dentistry care, treats an inflamed or infected pulp. Crowns protect a weakened tooth, and extraction, including surgical extractions, is considered only when a tooth cannot be restored. Antibiotics are not always needed and are prescribed only when a dentist judges them appropriate.
Starting prices for common steps:
| Service | Starting price |
| Emergency appointment | from £85 |
| Intra oral X-ray | £19 to £22 |
| Abscess treatment | from £125 |
| White filling (1 to 3 surfaces) | from £185 to £295 |
| Root canal | from £495 |
| Extraction | from £200 |
These are separate starting prices, not a total cost. The emergency appointment fee and any treatment fee are charged separately, and further treatment may cost more. Our fee guide has the details, and the team can tell you about 0% APR finance through Tabeo.
Call Guildford Smiles Dental on 0148 336 1739
Book your appointment online
Monday to Friday, 8am to 6pm. Appointments subject to availability.
Can you wait until morning?
If you have none of the emergency symptoms above, many people manage overnight with the steps in this guide and call the practice when it opens. Do not keep waiting if swelling, a high temperature or worsening pain develops. Use NHS 111 online for urgent advice.
We are closed on Saturday, Sunday and bank holidays. If toothache starts at a weekend, NHS 111 can advise on urgent dental care while you wait to contact us.
Common mistakes to avoid
- Placing aspirin or any painkiller directly on the gum, which can irritate or burn the tissue.
- Taking leftover antibiotics. They may not suit the problem and can delay a proper diagnosis.
- Squeezing or puncturing a swelling on the gum.
- Assuming the problem has gone because the pain eased. Pain can fade if the nerve inside the tooth has died, while the underlying problem remains.
- Taking more pain relief than the packaging allows.
- Chewing on the sore tooth to “test” it.
Who should seek help sooner?
Contact a dentist or NHS 111 promptly, rather than waiting it out, if you are pregnant, have diabetes or a weakened immune system, or if the person in pain is a child. Anyone with swelling, a high temperature or feeling generally unwell should also seek advice without delay.
How to book at Guildford Smiles Dental
Please call during opening hours, describe your symptoms and confirm availability before you travel. Emergency appointments are available, subject to availability, and we cannot promise a same-day slot. If you are weighing up your options, our guide to finding an [emergency dentist in Guildford]([PILLAR PAGE URL]) explains how we approach urgent care.
- Address: 8 Phoenix Court, Guildford, Surrey, GU1 3EG
- Phone: 0148 336 1739
- Email: enquiries@guildfordsmiles.com
- Online booking: guildfordsmiles.portal.dental
- Opening hours: Monday to Friday, 8am to 6pm. Closed Saturday, Sunday and bank holidays.
Whether you live in Burpham or are travelling in from Woking or Godalming, please call first so we can confirm availability before you set off.
Get your toothache checked
Severe toothache at night is miserable, but it is usually manageable until you can be seen. Check for emergency symptoms, keep the tooth calm, avoid the common mistakes and arrange an assessment so the cause can be found and treated. If you are unsure, ask. Our team would rather hear from you early than late.
Call Guildford Smiles Dental on 0148 336 1739
Book your appointment online
Monday to Friday, 8am to 6pm. Appointments subject to availability.
Frequently asked questions
Rinse gently with lukewarm water, clean around the tooth, avoid hot, cold and sugary things, and prop your head up. Take pain relief only as the packaging or a pharmacist advises. These steps are temporary, and a dentist needs to find the cause.
Lying flat increases blood flow to the head, which can add pressure inside an inflamed tooth. There are also fewer distractions at night, so pain feels more noticeable. The underlying cause still needs an examination.
No. Decay, pulp inflammation, a cracked tooth, a damaged filling, gum problems or grinding can all cause night pain. Infection is one possibility, which is why only a dental examination can say for sure.
The NHS advises seeing a dentist if toothache lasts more than two days. If the pain is severe, stops you sleeping or comes with swelling or a bad taste, contact a dentist sooner.
Usually not. A&E is for symptoms such as difficulty breathing or swallowing, rapidly spreading facial or neck swelling, uncontrolled bleeding or a serious head or facial injury. For other dental pain, contact a dentist, or use NHS 111 online if the practice is closed.
The pain can ease for a while, but the cause rarely resolves without treatment. A sudden fade after a spell of severe pain does not guarantee the problem has gone, so an assessment is still worthwhile.
Guildford Smiles Dental is closed on Saturday, Sunday and bank holidays. NHS 111 online can advise on urgent dental care when we are shut. Call us on the next working day and we will confirm availability.
Emergency appointments start from £85. This is separate from treatment, such as abscess treatment from £125 or a white filling from £185 to £295, and further treatment may cost more. Our fee guide has the details.
Not necessarily. Many painful teeth can be treated with a filling, root canal treatment or a crown. Extraction is considered when a tooth cannot be restored, and your dentist will explain the options after an examination.
