Toothache at 2 a.m.: what to do until you can be seen

Assuming none of the above applies, here is how to get through the night.

What helps

• Take pain relief on schedule rather than waiting for the pain to return. Ibuprofen is generally more effective than paracetamol for dental pain, and where it is safe for you, alternating the two works better than either alone. Follow the packet doses.
• Sleep propped up on an extra pillow. Lying flat increases blood pressure in the head and dental pain characteristically worsens at night for exactly this reason.
• Rinse gently with warm salt water — half a teaspoon in a cup of warm water — several times.
• Hold a cold compress against the outside of the cheek for 15 minutes at a time if there is swelling.
• Keep the area clean, brushing gently even if it is tender.

What does not help, or makes it worse

• Placing an aspirin against the gum. It is an acid and it burns the tissue. This one persists for generations and it has never worked.
• Heat on the outside of the face when there is swelling — it encourages the infection to spread.
• Clove oil applied repeatedly and undiluted, which irritates the gum.
• Old antibiotics from a previous course. They are unlikely to be the right drug or dose, and antibiotics never resolve dental infection on their own.
• Alcohol, which interacts badly with pain relief and does nothing for the pain.

In the morning

Call as early as you can. We hold emergency slots at Colombo and Nugegoda every working day and they are allocated by clinical urgency, so early callers with genuine urgency get seen.

Tell reception when the pain started, what makes it worse, whether there is any swelling, and whether it wakes you at night. That last detail matters clinically more than most people expect — pain that wakes you usually means the nerve is involved.