The Most Effective Toothache Medicine

When you have a toothache, finding an effective over-the-counter (OTC) toothache medicine is typically the first step you'd take while awaiting an appointment with a dentist.

Over-the-counter (OTC) analgesics like Tylenol (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) are among the first-line OTC options. There are also natural home remedies that can help if you'd rather not take drugs or don't have immediate access to them.

This article reviews four OTC painkiller options, including their side effects and drug interactions, and other ways to manage your toothache pain at home.

Ibuprofen

Ibuprofen, marketed under the brand names Advil, Motrin, Nuprin, and others, is one of the most-used OTC painkillers for tooth pain.

It belongs to a class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs) which are anti-inflammatory, analgesic (pain-reducing), and antipyretic (fever-reducing). NSAIDs work by blocking enzymes called COX-1 and COX-2 that are involved in the synthesis of prostaglandins, a group of hormones that induce fever and inflammation and increase pain sensitivity.

Ibuprofen is available in tablets, liquid gel capsules, and oral suspensions.

Side Effects

Common side effects of ibuprofen include:

• Headaches
• Dizziness
• Nausea or vomiting
• Indigestion
• Gas

Ibuprofen can cause stomach ulcers if you take it for a long time or in large doses. If you need to take it for an extended period, your healthcare provider may prescribe a medicine to help protect your stomach. Never take more than the dosage listed on the product label.

Seek immediate medical care if you experience rare but potentially serious side effects, including:

• Black or tarry stools (a sign of gastrointestinal bleeding)
• Swollen ankles or feet
• Difficulty urinating
• Painful urination
• Discolored or bloody urine

Drug Interactions

Ibuprofen is known to interact with certain drugs. Speak with your healthcare provider if you take any of the following while taking ibuprofen:

• Antibiotics such as ciprofloxacin, levofloxacin, and moxifloxacin
• Anticoagulants (blood thinners) like Coumadin (warfarin) and Plavix (clopidogrel)
• Antidepressants like Prozac (fluoxetine) and Paxil (paroxetine)
• Antihypertensives (high blood pressure medications) like ACE inhibitors and calcium channel blockers
• Diabetes medicines such as gliclazide and glimepiride
• Other NSAIDs
  

Naproxen

Naproxen, marketed under the brand names Aleve, Anaprox, Naprosyn, and others, is another NSAID frequently used for tooth pain. It comes in tablets, caplets, gel caps, and liquid solutions.

Research suggests naproxen may be as effective for post-surgical dental pain as the narcotic pain reliever Vicodin (hydrocodone/acetaminophen).

Naproxen is also linked to a high risk of stomach ulcers, particularly when overused. The risk may even be higher as it has a longer drug half-life (meaning the rate at which the drug is eliminated from the body) than other NSAIDs.

Side Effects

Common side effects of naproxen include:

• Upset stomach and nausea
• Heartburn
• Constipation or diarrhea
• Gas or bloating
• Headache
• Dizziness or lightheadedness
• Drowsiness
  

Seek immediate medical care if you experience:

• Bloody vomit or vomit that looks like coffee grounds
• Black or tarry stools
• Fainting
• Irregular or slowed heartbeats
• Yellowing of the skin or eyes
• Sudden high temperature

Drug Interactions

The drug interactions associated with naproxen are largely the same as those with ibuprofen. The one exception may be the drug methotrexate used to treat rheumatoid arthritis and other autoimmune disorders. The interaction between methotrexate and naproxen appears to be more significant than with other NSAIDs.

Aspirin

Aspirin (acetylsalicylic acid) is an older NSAID marketed under dozens of brand names, including Anacin, Bayer, Bufferin, Excedrin, and others. Studies suggest that it may be effective for pain from dental problems.

Aspirin comes in many forms, such as chewable tablets, delayed-release and extended-release tablets, and suppositories.

Side Effects

Aspirin can cause digestive side effects in some people, including:

• Nausea
• Vomiting
• Stomach pain
• Heartburn
  

Seek immediate medical care if you develop:

• Severe joint pain in your hands or feet
• Vomit that is bloody or looks like coffee grounds
• Black, tarry stools
• Yellowing of the skin or eyes
• Swollen feet and ankles

Drug Interactions

The drug interactions associated with naproxen are largely the same as those with ibuprofen. The one exception may be the drug phenytoin used to treat epilepsy. The interaction between phenytoin and aspirin appears to be more significant than with other NSAIDs.

Also, watch for cold & flu remedies, many of which contain aspirin. If you take aspirin with a cold & remedy also containing aspirin, you may be at an increased risk of side effects due to the double dose.

Acetaminophen

Acetaminophen, popularly sold under the brand name Tylenol, Actamin, Feverall, and others, is not an NSAID and does not exert anti-inflammatory effects. It is thought to act on COX-1 and COX-2 differently than NSAIDs, delivering strong analgesic and antipyretic (fever reduction) effects.

Acetaminophen may not be as effective in treating certain types of tooth pain (like dental infections that cause inflammation) but may be suitable for other types (like a cracked tooth that aren't inflammatory). It is especially useful if you can't take NSAIDs due to a stomach ulcer or other concerns.

Acetaminophen comes in many forms, including tablets, gel caps, and oral suspensions.

Side Effects

Acetaminophen can cause side effects in some people, including:

• Nausea
• Vomiting
• Headache
• Insomnia
• Constipation
• Dizziness
• Diarrhea
• Agitation

Signs of liver injury include left upper abdominal pain, fatigue, dark urine, pale stools, and yellowing of the skin and eyes (jaundice).

In rare cases, acetaminophen can cause a severe allergic reaction known as anaphylaxis that requires immediate emergency medical assistance.

Call 911 if you experience the signs and symptoms of anaphylaxis, including

• Red, blistering, or peeling skin
• Rash or hives
• Swelling of the face, tongue, or throat
• Difficulty breathing or swallowing
• Sudden severe diarrhea
• Irregular or rapid heartbeats
• A feeling of impending doom

Home Remedies for Toothache

If you'd rather not take OTC painkillers or don't have any close at hand, there are a number of home remedies that may be able to ease toothache pain.

Among them:

• Clove oil, an active ingredient in many dental products, has natural antiseptic properties and may also help ease tooth pain and inflammation.
• White willow bark is a naturopathic remedy that contains salicin, a compound similar to acetylsalicylic acid used in aspirin. It is often applied as a paste to affected gums.
• Peppermint oil has antiseptic properties and may help ease toothache pain. Some people will treat toothache by applying a wet peppermint tea bag to the affected tooth and gum.
• Fresh garlic has antibacterial and anti-inflammatory properties due to a compound known as allicin. Dried garlic deactivates allicin and may be of little benefit if you have tooth pain.

Other Options

There are several other options for relieving tooth pain until you can see your dentist:

• Apply a cold compress against your cheek for 20 minutes several times a day.
• Avoid very cold or hot foods and beverages.
• Avoid foods and beverages that are high in sugar or acid (such as orange juice).
• Rinse your mouth with warm saltwater.
• Floss around the affected teeth to remove any food particles that may be irritating them.
• Elevate your head while sleeping. This can reduce blood pressure to the head which can add to your pain.
  

Summary

Ibuprofen, naproxen, and aspirin are over-the-counter NSAID pain relievers often used to treat toothache pain. Acetaminophen can also help, but it doesn't lower inflammation.

Natural remedies like clove oil, white willow bark, peppermint oil, fresh garlic, cold compresses, and gargling with salt water may also help ease toothache pain.