Which painkiller works for toothache? Paracetamol, ibuprofen and what to watch out for

Most toothache comes from inflammation inside or around the tooth, so anti-inflammatories (ibuprofen, naproxen) give many people clearer relief than paracetamol. Studies have shown that ibuprofen and paracetamol taken together work well for dental pain; check with your pharmacist or doctor before combining them.

• People with stomach ulcers, gastritis or a history of stomach bleeding: ibuprofen and naproxen can irritate the stomach; paracetamol is usually more suitable.
• People on blood thinners: anti-inflammatories and aspirin increase the risk of bleeding. We cover dental care for heart patients in dental treatment for heart patients.
• People with kidney disease, heart failure or high blood pressure: don't take anti-inflammatories without medical advice.
• Pregnant women: painkillers in pregnancy should be chosen with your doctor; anti-inflammatories are generally avoided, especially in the second half of pregnancy. See dental treatment in pregnancy.
• Breastfeeding mothers: most painkillers are compatible with breastfeeding, but check dose and duration in dental treatment while breastfeeding and with your doctor.
• Children: aspirin is not given to children; doses are based on weight, so always ask a paediatrician or pharmacist.

Many cold and flu remedies also contain paracetamol. Taking them with a painkiller can push you over the daily maximum without realising.

• Putting aspirin on the tooth: it doesn't relieve the pain and causes a chemical burn and sore on the gum.
• Trying to stop the pain with antibiotics: antibiotics are not painkillers and don't treat inflammation inside the tooth on their own. We explain when they are needed in antibiotics for toothache.
• Raising the dose or switching medicines often: if the pain doesn't go, the answer is treating the cause, not more medicine.
• Putting off treatment because the pain stopped: severe pain that suddenly stops can mean the nerve is dying; infection can progress quietly. See what is a dead tooth?

• Hold a cold compress on the outside of your cheek for 10–15 minutes; heat can make swelling worse.
• Don't chew on the painful side; avoid very hot, very cold and sugary food.
• Raise your head slightly when lying down; it can help pain that gets worse at night.
• To tell whether the pain is coming from the tooth, sinus or ear, see can toothache cause ear pain? and can sinusitis cause toothache?

We've gathered the general steps in how to relieve toothache.

In these situations don't try to manage with painkillers; see a dentist the same day:

• swelling of the face, under the jaw or around the eye;
• fever, feeling unwell, difficulty swallowing or opening your mouth;
• pain lasting more than 2–3 days despite painkillers, or pain that wakes you up;
• a pimple-like bump on the gum or a bad taste in the mouth.

Swelling spreading quickly across the face and neck, or difficulty breathing, needs emergency care. We explain swelling in dental abscess.

At Dent32 we find the source of the pain with an examination and X-ray and, where needed, carry out first treatment the same day to relieve it; we share the options for a lasting solution in writing. For evening and weekend options, see emergency toothache.

Dent32 is at Barış Mah., Ginza Lavinya, E-5 Yanyolu No:30 D:179, 34520 Beylikdüzü, Istanbul and is open seven days a week. To book, call or WhatsApp +90 555 011 33 68, or use our contact page. At the examination we share the findings, the options and the approximate cost in writing; you are under no obligation to start treatment afterwards.