Dr Umar Munir

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Fact 👍

Why Toothache Gets Worse at Night — The Real Reason Behind It.

Many people notice their toothache feels more intense when they lie down — especially at night. It’s not psychological. It’s biological.

When you lie flat, gravity shifts blood flow toward your head. This increases blood volume around the infected tooth, raising internal pressure in the pulp chamber — a closed space that can't expand.
The result? Throbbing, pulsing pain that worsens even if you’re resting.

In cases of irreversible pulpitis or deep decay, the inflamed nerve tissue reacts more aggressively when the body is in a horizontal position. Add to that the lack of distractions at night, and the pain feels magnified.

If your tooth hurts more when lying down, it's a red flag that the pulp may be severely inflamed or infected — and likely needs immediate dental treatment such as root canal therapy.
Delaying may lead to abscess, bone infection, or facial swelling.
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This post is for public awareness. It does not replace professional dental advice. If you notice any symptoms—pain, swelling, sensitivity—please consult your dentist promptly.

The longer you delay, the more you pay. ⏰💸

Internal root resorption is a rare but clinically significant condition characterized by the progressive loss of intraradicular dentin due to clastic activity originating within the pulp space. It usually results from chronic pulpal inflammation—often following trauma, caries, or extensive restorative procedures. Radiographically, it presents as a well-defined, round to oval radiolucency centered within the root canal, typically symmetrical and continuous with the canal walls. Unlike external resorption, the outer root surface remains intact in early stages.

The pathogenesis involves activation of odontoclasts in response to inflamed vital pulp tissue, particularly when necrosis is partial and the coronal portion remains infected while the apical pulp stays vital. This creates a permissive environment for resorptive activity, often progressing silently unless it reaches the external surface or perforates the root.

Clinically, internal resorption is usually asymptomatic and diagnosed incidentally on radiographs, but it may present with a "pink spot" in advanced coronal cases due to granulation tissue. Early diagnosis is critical. Once identified, immediate endodontic therapy is indicated to remove the vital inflamed pulp and arrest further destruction. Thermoplasticized obturation techniques are often required due to the irregular canal shape.

Internal root resorption is irreversible, but its progression can be completely halted with timely and appropriate intervention. Advanced or perforated cases may require surgical management or extraction, emphasizing the importance of regular radiographic follow-up in high-risk teeth.