Teeth Pain Medicine: Which Painkillers Work for Toothache, and What They Cannot Do

Toothache is a symptom. Behind it is usually decay that has reached the nerve, a crack, an infection at the root tip or a gum problem. A painkiller dulls the signal for a few hours. It does nothing to the decay or the infection that is producing it.

That is why pain that settles with a tablet and comes back when it wears off is not getting better. It is a sign that the tooth needs to be examined. The wider picture of causes and what treatment involves is on the toothache page.

Use a painkiller to get through the night and to get yourself to an appointment, not as a way of living with the tooth.

Paracetamol and ibuprofen are the two commonly used for dental pain. Both are sold without a prescription in India. Take either one exactly as directed on the label of the pack you have, and do not exceed what the label allows in a day.

Ibuprofen also reduces inflammation, which is why dentists often favour it for pain that comes from an inflamed tooth or gum, where a person can safely take it. Paracetamol works differently, does not reduce inflammation, and is the gentler option on the stomach.

Some people take the two together or alternate them. That is something to ask a pharmacist or doctor about before you do it, because it depends on your health and on what else you take. Many cold and flu tablets also contain paracetamol, so check the label of anything else you are taking to avoid doubling up.

Taking a dose on a regular schedule, as the label allows, often works better than waiting for the pain to become severe and then chasing it.

Ibuprofen is not suitable for everyone. Avoid it, or speak to a doctor or pharmacist first, if you have a history of stomach ulcers or stomach bleeding, kidney disease, or asthma that gets worse after anti-inflammatory tablets. The same applies if you are on a blood thinner, because ibuprofen can raise the risk of bleeding.

In pregnancy, do not take any painkiller without checking with your doctor. Dental pain in pregnancy is a reason to be seen promptly, and our guide on dental treatment during pregnancy explains what can safely be done.

Paracetamol needs care if you have liver disease or drink alcohol regularly, because the liver processes it. Staying within the label limit matters more, not less, in those cases.

If you are unsure whether either is safe for you, ask a pharmacist or doctor. That includes children, where the right product and amount depend on age and weight and must come from the label or a clinician.

Antibiotics do not relieve toothache pain. The pain from an inflamed nerve comes from tissue inside the tooth that antibiotics cannot reach. Taking leftover or pharmacy-bought antibiotics on your own delays the treatment that works and adds to antibiotic resistance. A dentist or doctor prescribes them when there is a spreading infection, alongside treating the tooth.

Do not place an aspirin tablet against the gum. It burns the soft tissue and leaves a painful ulcer, and it does nothing for the tooth.

Pain that is only partly eased, or that needs a tablet every few hours, means the cause is active. Home measures such as warm salt water rinses, an elevated head at night and a cold pack on the cheek can support a painkiller, and the clove oil guide covers the remedies people commonly try and how far they go.

Seek care the same day if the pain comes with swelling of the face or jaw, fever, or a bad taste with a discharge from the gum. These point to infection that is spreading, and painkillers will mask it while it gets worse. Our page on face swelling due to tooth infection explains why this is the dental problem most likely to turn serious.

Go to a hospital emergency department straight away if the swelling is closing the eye, spreading under the jaw or into the neck, or if you have difficulty swallowing, opening your mouth or breathing.

Pain after a blow to the face, a tooth that has become loose, or pain that keeps you awake and throbs when you lie down also needs prompt attention. The dental emergency guide lists which situations cannot wait until morning and which can.