Why Do My Teeth Hurt When I Wake Up? 7 Common Causes

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Medically reviewed by Jennifer Archibald, DDS — Written by Corey Whelan on August 31, 2021

Sleep bruxism
Sinusitis
TMJ
Cavities
Gum disease
Impacted tooth
Tooth abscess
Home remedies
When to call a doctor
Medical treatment
Takeaway

It’s not uncommon to have tooth pain when you wake up. It can have many causes, including dental conditions or other health-related issues that can range from mild to severe.

Read on to learn about the seven most common causes of tooth pain in the morning and how to find relief.

1. Sleep bruxism

Bruxism is also known as teeth-grinding. People with sleep bruxism unconsciously clench their jaw and gnash or grind their teeth during sleep.

If you have bruxism, you may also clench your jaw while you’re awake. This is known as awake bruxism.

Frequent bouts of bruxism can result in:

toothache
earache
jaw pain
headache
tooth damage

The exact cause of sleep bruxism isn’t known. But stress and sleep-related disorders, including sleep apnea, may often be a major factor.

A 2016 study published in the journal Sleep also found that genetics may play a large role.

2. Sinusitis

If you wake up with pain in your upper back teeth, a sinus infection may be to blame.

Your sinuses are located directly above your teeth. If you have an infection in your sinuses, fluid may collect there while you’re lying down, including during sleep.

This can cause pressure and pain to occur, especially in an upper molar or premolar (maxillary posterior teeth).

Other common symptoms of sinusitis include:

headache
cough
nose is stuffy or runny
not being able to smell well
fatigue
fever

3. Temporomandibular joint (TMJ) disorder

The temporomandibular joint connects your jawbone to your skull on each side of your face. Inflammation and irritation in the temporomandibular joint can cause referred pain in your:

face
neck
teeth
joint

Causes of TMJ include bruxism and arthritis in the jaw.

Common symptoms of TMJ include:

tooth pain
headache
face pain
ear pain
jaw pain while eating or speaking
tightening or locking of the jaw
clicking or popping sounds

4. Cavities (tooth decay)

Cavities are a common cause of tooth pain.

When left untreated, cavities can expand into the tooth’s inner layer (pulp). This is where the tooth’s nerves and blood vessels are located.

Untreated tooth decay can cause pain that’s aching, intense, or sharp in frequent intervals.

5. Gum disease

Early, mild gum disease is known as gingivitis. Gingivitis can cause red, swollen gums that bleed when teeth are brushed. When plaque builds up along the gumline, toothaches can occur.

Untreated gum disease can turn into periodontitis, a severe form of gum disease. Periodontitis is a long-term gum infection that can adversely affect the gums, teeth, tissues, and jawbone.

Periodontitis causes tooth pain and sometimes tooth loss.

6. Impacted tooth

An tooth becomes impacted when it can’t erupt through the gumline.

Teeth become partially or fully impacted when there isn’t enough room in the mouth to accommodate them. This can result from crowded teeth and genetics may play a role.

Impacted teeth can cause:

red, swollen, and painful gums
dull, aching pain or intense, sharp pain

Molars are most likely to be impacted. Maxillary canines (upper eyeteeth) may also be affected.

7. Tooth abscess

An abscess is a pocket of pus that results from a bacterial infection. A tooth abscess can occur in a tooth’s root or in the gums surrounding the tooth.

Abscesses can cause throbbing, intense tooth pain as well as gum swelling and fever.

What are some home remedies for tooth pain?

There are several at-home remedies that may help you reduce or eliminate mild tooth pain that you feel primarily in the morning.

First, try to determine the cause of morning tooth pain by reading through the descriptions of the conditions above.

Now, try one or more of the following to find out what works for your pain:

Wear a mouth guard at night if you grind your teeth or have TMJ. Try an over-the-counter (OTC) mouth guard, or have your dentist mold one that fits your teeth exactly.
Take an OTC decongestant if you suspect you have a sinus infection, or see your doctor.
Use a toothpaste designed for sensitive teeth if your teeth hurt when you eat or drink something hot or cold.
Apply a cotton ball dipped in clove oil to the affected tooth several times daily.
Swish with warm salt water around the tooth several times daily.
Use a cold compress on the outside of your face for 15 minutes at a time, several times daily.
Take an OTC pain medication, such as ibuprofen or acetaminophen, to help relieve pain that doesn’t go away with any other home treatments.

When should I call a doctor?

Symptoms that should be assessed by a doctor or dentist include:

severe tooth, sinus, or gum pain
pain that doesn’t respond to treatment or abate after several days
facial swelling
signs of gum infection such as redness, swelling, or leakage of pus
fever

Cavities, impacted teeth, abscesses, and gum disease must be treated by your dentist. This will help stop or reduce any damage done and lower the risk of further infection or tooth loss.

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What are some medical treatments for tooth pain?

Here are some possible medical treatments for tooth pain depending on the cause:

Cavities that are large enough to cause tooth pain need to be filled. Severe cavities may require more extensive dental work, such as a crown or root canal.
Gingivitis is typically treated with good oral hygiene and dental support, such as regular professional cleanings.
Early periodontitis may be treated with scaling and root planning. This procedure removes plaque below the gumline and smooths out the tooth root’s surface. Severe periodontitis may require dental surgery.
A tooth abscess typically requires drainage and antibiotics to stop the infection. You may also need a procedure, such as a root canal or tooth extraction.
Impacted teeth that cause pain usually need to be extracted. This procedure is typically done by an oral surgeon.
A short-term (acute) sinus infection may be best treated by antibiotics to help eliminate bacteria. A long-term (chronic) case of sinusitis may require removal of polyps that have grown in the nasal cavity. Surgery can also help open up the sinus cavities or remove blockages that restrict air passing through the sinuses.

The takeaway

Many causes of mild tooth pain in the morning may respond to at-home treatments. But some causes that result in long-term, persistent morning tooth pain may require a dentist’s care.

Signs of tooth infection, such as pus, fever, and swelling, should always be assessed quickly by a medical professional.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Jang JK, et al. (2017). Anatomical relationship of maxillary posterior teeth with the sinus floor and buccal cortex.https://pubmed.ncbi.nlm.nih.gov/28547776/
Khoury S, et al. (2016). Sleep bruxism: Tooth grinding prevalence, characteristics and familial aggregation: a large cross-sectional survey and polysomnographic validation.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070759/
Martinez-Canut, P. (2015). Predictors of tooth loss due to periodontal disease in patients following long-term periodontal maintenance.https://doi.org/10.1111/jcpe.12475

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Medically reviewed by Jennifer Archibald, DDS — Written by Corey Whelan on August 31, 2021

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