A toothache describes pain in or around a tooth. To manage pain and reduce swelling, a person may consider using medications such as pain relievers, antibiotics, or drug-free alternatives.

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Toothache is a common symptom of many dental issues. It can cause discomfort and may make eating and drinking difficult. Many options, including medications, are available to help reduce pain. If a person has a toothache lasting more than a few days, it is advisable to consult a dentist.

This article discusses appropriate medications for toothache, how to prevent toothache, and when to contact a dentist.

Toothache can occur due to various reasons, such as:

Identifying the cause of pain is essential for choosing an appropriate treatment option to relieve discomfort.

A primary care physician can determine if the pain originates from the tooth — known as odontogenic pain — and select a suitable treatment option. Some options that can alleviate dental pain include the below.

People can classify analgesics, or pain relief medication, as opioids or nonopioids. This term refers to whether they interact with the opioid receptors in the brain.

Nonopioid analgesic options include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).

These drugs are very effective for relieving mild or moderate dental pain and are some of the most frequently recommended analgesics by dentists.

Acetaminophen can temporarily relieve mild to moderate pain and fever.

Although researchers are unsure exactly how acetaminophen reduces pain, it may also inhibit the COX pathways through a different mechanism. However, it is not an NSAID as it does not have anti-inflammatory properties.

NSAIDs

The American Dental Association suggests that NSAIDs are often more effective than other options for reducing dental pain. As such, they typically recommend them as first-line therapy for treating toothache.

These drugs usually work similarly by blocking the cyclooxygenase enzyme to treat pain and inflammation. This is why doctors refer to these drugs as COX inhibitors.

NSAID types

Examples of NSAIDs a person can take for tooth pain include:

NSAIDDosageRisks
IbuprofenThe recommended dose is 400 mg every 4–6 hours. People should not exceed more than 3,200 mg daily.Ibuprofen may impact the heart, gastrointestinal health, and kidneys. It may also cause skin reactions. These drugs are not advisable for pregnant people from 30 weeks.
AspirinThe recommended dose is 1–2 325 mg tablets every 4 hours, or 3 tablets every 6 hours. People should not exceed 12 tablets, or 3,900 mg, daily.Some people may experience an allergic reaction to aspirin, and it can cause stomach bleeding in some individuals.
NaproxenDoctors recommend a starting dose of 500 mg, then 250 mg every 6–8 hours as necessary. A person should not exceed a daily dose of 1,250 mg.This drug may impact heart, gastrointestinal, kidney, and liver health and result in skin reactions. Doctors do not advise these for pregnant people from 30 weeks.
DiclofenacThe recommended dose is 100 mg per day. People should not exceed unless a doctor advises. Research suggests that taking diclofenac may increase the risk of heart problems. It may also impact gastrointestinal, kidney, and liver health.

A 2018 systematic review suggests that combining NSAIDs with acetaminophen is an effective option for managing dental pain.

Opioids are a class of painkillers that can reduce pain by binding to opioid receptors. When this occurs, opioids block the body’s pain messages sent through the spinal cord. Dental pain is often the reason for a person’s first encounter with opioids.

These drugs are effective for relieving pain and are generally safe when people use them for a short time, as a doctor prescribes.

However, opioid analgesics can lead to use disorders, overdose incidents, and death. As such, the Centers for Disease Control and Prevention (CDC) suggest that a person only takes this medication in circumstances where the benefits for pain outweigh the risks.

As opioid analgesics require a prescription, a medical professional will advise the dosage that a person requires. Some examples of opioid analgesics that a dentist or doctor may prescribe for dental pain include:

  • Codeine: This option is available as a tablet, and people can take 15–60 mg every 4 hours as necessary, but it should not exceed 360 mg in 24 hours. However, research suggests that codeine is less effective for managing dental pain than nonopioid analgesics. People can also use co-codamol, which contains both codeine and acetaminophen.
  • Oxycodone: It is advisable to use oxycodone at the lowest effective dosage for the shortest duration. The recommended dosage is 5–15 mg every 4–6 hours as necessary for pain.
  • Hydrocodone: This option is also available as a tablet that can contain acetaminophen. Depending on the strength of the tablet, a person can take 1–2 tablets every 4–6 hours as necessary. They should not exceed a daily dosage of eight 2.5–5 mg tablets or six 7.5–10 mg tablets.
  • Morphine: People can take morphine as an oral solution. It is often available in three concentrations: 2, 4, and 20 mg per milliliter. The recommended dosage to start treatment in adults is 10–20 mg every 4 hours.

If the cause of the tooth pain is a bacterial infection, then a person will likely receive a course of antibiotics to clear the infection.

However, it is important that dentists follow proper guidelines and only prescribe necessary antibiotics to prevent the risk of antibiotic resistance. Some antibiotics that a dentist may commonly prescribe include:

Topical anesthetics describe creams or gels that can help reduce pain by numbing a sore area. People can apply them directly to the sore tooth. Traditional topical anesthetics often contain lidocaine or benzocaine as active ingredients.

Benzocaine can help reduce toothache by blocking nerve signals around the painful area. A person can apply benzocaine gels up to 4 times daily or as per the instructions of their dentist or doctor. Lidocaine is another local anesthetic a person can use to relieve oral pain.

A person may want to address their toothache with natural remedies. Some options may include:

  • Saline solution: Using salt water as a mouthwash can help loosen debris between the teeth, which may aggravate the sore tooth. As salt is a natural disinfectant, it can help reduce inflammation.
  • Cold compress: Wrapping a cold pack in a cloth and then placing it against the side of the face can help to reduce swelling and pain.
  • Elevation: Resting with the head propped up on a pillow can help to reduce dental pain when lying down.
  • Garlic: This plant contains many compounds, such as allicin, that may possess antibacterial properties. Therefore, using garlic may help with a toothache that occurs due to bacteria.

A person may also consider eating foods that are soft and easy to chew to prevent discomfort with a sore tooth. They may also want to avoid food and drinks at extreme temperatures and try to limit smoking, if applicable.

Learn more about other toothache remedies and how to treat toothache at night.

The best way to prevent toothache is to keep teeth and gums healthy. Good oral hygiene is an important step in maintaining oral health. The American Dental Association recommends the following tips to keep teeth healthy:

  • brushing teeth twice a day with a fluoride toothpaste
  • cleaning between teeth daily using floss or sticks
  • eating a balanced diet that limits sugary beverages and snacks
  • visiting a dentist regularly
  • avoiding tobacco products

While medications and other remedies can help reduce toothache, it is sensible to seek dental help.

Regular dental appointments are important as they can identify dental problems early. Health experts recommend visiting a dentist at least once a year. However, some individuals may require more regular appointments.

A toothache is a common reason for requiring a dental visit. A dentist can help determine the issue and prevent potential complications. Experts strongly advise people book an appointment with their dentist as soon as possible if they experience any of the following symptoms:

Toothache is a painful symptom that people may experience for various reasons.

Many medications, such as analgesics, antibiotics, and anesthetics, are available to help alleviate discomfort.

Home remedies can also help reduce pain. To prevent tooth pain, it is advisable that people practice good oral hygiene and regularly attend their dental appointments.