A tooth that starts hurting at nine in the evening has a way of hurting more by midnight. Most of the time it can wait for a clinic to open; some of the time it cannot. Here is how to tell the difference, and what to do in the meantime.
Do not wait until morning if
- your face or jaw is swelling, or the swelling is spreading toward your eye or neck
- you have a fever alongside the pain
- you cannot open your mouth properly, or swallowing is becoming difficult
Those point to an infection that is spreading, and that is an emergency department problem tonight, not a dentist problem tomorrow.
What helps
Rinse with warm salt water. Keep your head raised — lying flat sends more blood to the tooth and the throbbing gets worse. Over-the-counter pain relief that you have taken safely before is fine; follow the packet. Cold on the outside of the cheek helps with swelling.
Never put a painkiller against the tooth or gum. It does not work that way, and it burns the tissue.
What makes it worse
Very hot or very cold food, sugar, chewing on that side, and alcohol — which thins the blood and makes any bleeding harder to stop. Smoking slows everything down.
In the morning
Call and say it kept you up. Most clinics hold a few same-day slots for exactly this, and a receptionist who hears “I did not sleep” will find one. A tooth that has stopped hurting on its own has not healed; the nerve has died, and the infection is still there.
