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Got Unbearable Tooth Pain? Here's What To Do

The only way to permanently get rid of an unbearable toothache is to see a dentist and treat the source of the tooth pain directly. However, while you're waiting for your appointment there are steps you can take to temporarily relieve the tooth pain at home.


This is our step by step guide on what to do when you're having severe tooth pain.


What to do for unbearable tooth pain:


OTC medications

The first thing you should do to manage an unbearable toothache is to take OTC medications for systemic pain relief. This involves taking painkillers and anti-inflammatory drugs.


Benefits of using OTC medicine for pain relief:

  • Taking pain relieving pills provide systemic pain alleviation, which bypasses a tooth's enamel and dentin which protect the aching tooth nerve.

  • Tooth pain relief is delivered via the bloodstream directly to the pulp.

  • An anti-inflammatory will reduce inflammation which in turn decreases your misery.


  • Ibuprofen (Advil, motrin)

  • Acetaminophen (Tylenol)

  • Aspirin

  • Naproxen (Aleve)


Most of the over the counter anti-inflammatory medications also have pain relieving properties. The most common class of this medicine is NSAIDs (non-steroidal anti-inflammatory drugs).

  • Ibuprofen

  • Aspirin

  • Naproxen


As you may have noticed, the list overlaps with the painkillers with the exception of acetaminophen which isn't a NSAID. Due to the lack of anti-inflammatory characteristics, acetaminophen is less favored when compared to an NSAID.


Best pain reliever for toothache

Currently, the strongest OTC tooth pain medicine is Advil Dual Action, which is formulated with ibuprofen AND acetaminophen into one pill. If you were taking painkillers before and they did nothing for your toothache, it's because you were taking the wrong one.


advil dual action

Advantages of taking ibuprofen and acetaminophen together:

  • Ibuprofen relieves pain and reduces inflammation.

  • Acetaminophen is another painkiller but it relieves pain via a different mechanism.

  • Since they block pain in different ways, taking them together provides a synergistic effect.


Studies have shown that taking acetaminophen and ibuprofen simultaneously provides greater tooth pain relief than taking only one of them. Below is a chart showing the effects of its efficacy when compared to ibuprofen or acetaminophen alone.


acetaminophen with ibuprofen pain relief chart
Credit: Paul A. Moore, DMD, PhD, MPH; Hersh Elliot V., DMD, MS, PhD

In fact, the relief you may get from taking this combination is comparable to taking opioids which are prescription only. Therefore if you haven't been able to get sleep due to this aching tooth, perhaps you should give this a try.


Topical analgesics

The second thing you should do for dental pain is to apply a topical analgesic to your aching tooth for topical pain relief. Yes, this is in addition to already taking a systemic pain reliever because this helps to combat your discomfort topically rather than systemically.


There are different types of analgesics that work topically, OTC medications and home remedies.


OTC Topicals

There are two major OTC topical pain relievers that come in the form of gels, creams, and liquids.


Orajel 4x

These will definitely cause your mouth to feel numb and tingly after a minute or two.


Topical Home Remedies

What we mean by topical home remedies as opposed to OTC ones is that these are purported remedies suggested online. They're not meant for dental purposes but someone heard from someone that they might work.


List of home remedies:

  • Essential oils - cloves, oregano, thyme, basil, tea tree oil

  • Tea bags - peppermint tea

  • Toothache plant

  • Willow bark

  • Foods - vanilla extract, garlic


Cold compress

Applying a cold compress to the affected side of your face can help decrease the unbearable tooth pain.


Cold compress benefits:

  • The cold numbs the area and provides a cooling relief.

  • If you've swelling, the pressure from holding the compress will help manage it.


How to use it:

  1. Place compress on affected side of face.

  2. Hold for 15 minutes.

  3. Remove for 15 minutes to give your face a break.

  4. Repeat steps #1-3 as needed.


You must alternate the cold compress on and off your face in order to prevent frostbite.


Salt water rinse

Rinsing with salt water is the most gentle mouth rinse which you can use to help reduce tooth irritation from external stimuli.


How salt water rinse helps with toothaches:

  • Cleanses your mouth by washing away food, plaque, and bacterial acids.

  • Rebalances mouth pH by raising it back to neutral from acidic. Bacteria thrive in lower pH so keeping it higher will reduce their activity, thus resulting in less pain.


How to use it:

  1. Pour half a cup of water into a glass.

  2. Add a teaspoon of salt.

  3. Stir the mixture for a couple seconds.

  4. Rinse and swish around your mouth for 1-2 minutes.

  5. Spit back out and repeat after every meal.


Eliminate irritants

An important step in not making your toothache worse is to identify what triggers your pain and avoid them at all cost.

  • If eating sweet or acidic food makes the pain worse, then you need to stop doing it!

  • If chewing on that side hurts, try to chew more on the opposite side!


What helps a lot is to keep your mouth, gums, and teeth as clean as possible. You can do that by brushing and flossing after each meal. What this accomplishes is, it removes any type of food irritants that may make your toothache worse.


Sleep elevated

Sleeping with an extra pillow to elevate your head may help reduce your toothache and give you better sleep. Oftentimes, when people are suffering extreme tooth pain the discomfort gets amplified when they're laying flat. However, the discomfort is not as bad if they simply just elevate their head with another pillow.


The reasoning behind why it hurts more to lay flat is that the blood rushes towards the head. When you elevate your head, it drains some of the blood away from your head and mouth area.


See a dentist

All of the at home remedies which we've provided above may help temporarily alleviate your unbearable tooth pain but at the end of the day, you still need to see a dentist. Only they can give you permanent pain relief because they're able to treat the source of what is causing you pain.


The home remedies only help mask the pain for a short while and once it wears off, the pain will return because nothing was done to treat the source.

  • Cavity filling - Remove the decayed part and restore with a composite filling.

  • Root canal - Remove the infected nerve.

  • Tooth extraction - Remove the entire tooth.

  • Dental abscess drainage - Drain the abscess and deflate the swelling.

  • Antibiotics - Adjunctive therapy to ensure that the infection is eliminated.


When you see your dentist, the type of treatment you need will depend on the condition of your tooth. Below are a list of procedures that are used to eliminate dental pain.


Which one do you need... we wouldn't know because there could be a million and one things causing you tooth nerve pain. However, you'll find out once you schedule your dentist appointment! Our dentists in Long Island City can help you if you're in the NYC area.

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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