If you've an unbearable toothache while pregnant, the only way to get permanent pain relief immediately is by getting treatment with a dentist.
However, if you're unable to get a dentist appointment immediately, you can try OTC products or home remedies for temporary pain alleviation.
To reiterate, the tooth nerve pain will not fully go away until you finally get professionally treated. Whatever you do at home will only be palliative in nature and you can't indefinitely delay the inevitable.
Yes, it is safe to get dental procedures while you're pregnant and we will explain why. Although you probably need some relief right now so let's start with that first.
How to alleviate a toothache while pregnant
While you're waiting for your dentist appointment, you can use a combination of OTC medication and home remedies to alleviate some of the pain.
How to reduce the pain:
Take pain medication. Take 2 tablets of Advil dual action every 8 hours as needed, as instructed on the label. This is different from your regular advil.
Brush with desensitizing toothpaste. Floss first and then brush with sensodyne pronamel to desensitize the nerve. Do this after ever meal.
Apply extra desensitizer. Place the sensodyne pronamel directly on the affected tooth and leave it for 10 minutes before rinsing out. Do this up to 3x a day.
Use orajel. Dry the tooth and place orajel on the affected tooth or gum, depends on where the pain is originating from. Use up to 4x a day.
Salt water rinse. Rinse frequently with salt water to keep the mouth free of bacteria and to balance out the pH.
Cold compress. The cold compress may help numb the area with the cold. 15 mins on and 15 mins off.
Last but not least, just to remind you that all of the above are temporary measures. You still need permanent treatment with your dentist so be sure to schedule that appointment.
Purpose of each of the home remedies
We will describe the purpose of each of the steps and why we recommend using them.
Advil Dual Action
Advil dual action is probably the most effective over the counter pain medication but most people are unaware of it. It is not your typical advil which contains ibuprofen. The dual action version contains ibuprofen WITH acetaminophen.
There has been many studies which have demonstrated that taking ibuprofen with acetaminophen is more effective than taking them separately. In fact, they are equivalent to taking opioids for acute post-operative pain management after wisdom teeth removal.
The chart above is from the JADA study mentioned above, which demonstrates the efficacy of using ibuprofen with acetaminophen for pain relief. To be quite honest, the advil dual action is almost a well kept secret but it works extremely well.
Note of caution: Please follow the dosing schedule on the label. The dosages in the chart and study were meant for surgical extraction of third molars and were experimental in nature.
Brushing with desensitizing toothpaste
Brushing and flossing your teeth reduces bacterial load in your mouth. It also increases the mouth pH which makes bacteria less active. You can combine the effects by using sensodyne pronamel to desensitize the symptomatic tooth.
Apply nerve desensitizer
Sensodyne pronamel contains potassium nitrate (KNO3) which is a nerve desensitizer. Yes, it is commonly used for teeth sensitivity but it can help reduce some of the nerve sensitivity that may be accompanying your toothache.
KNO3 prevents the nerves from within the tooth from firing, thus blocking some of the pain signals. It may not get rid of your pain completely but it can somewhat alleviate it.
While orajel is NOT recommended for long term treatment of tooth pain, temporarily using it for a day or two is okay. Yes, you can use orajel while pregnant but only if its not for an extended period of time. Otherwise you're simply avoiding the problem.
Salt water rinse
Bacteria are most active when the pH in the mouth descends into the acidic level. Frequently rinsing with salt water can neutralize the acids and bring the pH of the mouth back to neutral. That should slow down bacterial activity in your mouth. It may help decrease the pain.
Cold compresses are typically used after surgical procedures like the dreaded wisdom tooth extraction. It can reduce swelling and numb the area since it is so cold. For your particular situation, you will be using it to numb your face with the cold.
However, if the compress irritates the pain even more, you shouldn't use it. Everyone responds differently so listen to your body.
How to get better sleep with a toothache
There are times where the tooth pain can be so bad that it'll wake you up at night. You can increase the chances of being able to get better sleep if you follow these steps.
How to sleep well with a toothache:
Take pain medication right before bed.
Make sure you brush, floss, rinse, and desensitize the teeth.
Sleep with your head elevated with an extra pillow.
The pain may wake you up once the pain medication starts to wear off in the middle of the night. That is a normal part of the process.
Only your dentist can offer you permanent pain relief from tooth pain if you're pregnant. The reason is because the causes of an unbearable toothache are usually due to a dental abscess, infected tooth nerve, or impacted wisdom teeth.
Sources of unbearable toothaches:
Dental abscess. Abscess will need to be drained first and then either a root canal or extraction afterwards.
Infected tooth nerve. A raging toothache that wakes you up from your sleep is a tell-tale sign of an unhealthy tooth nerve. This will definitely require a root canal at a minimum.
Impacted wisdom teeth. Impacted third molars can cause severe pain and even headaches. The only way to get rid of them is to remove the teeth.
All of these conditions require treatment from a dentist because any home remedy that you use on them will only be temporary in nature.
Are you able to drain your own abscess?
Can you do your own root canal?
Can you pull your own tooth?
You probably can't do any of those, which means the assistance of your dentist is required.
Is it safe to get dental treatment while pregnant?
A common misconception is that it is unsafe to get dental treatment while you're pregnant but that is false. According to the guidelines by The American College of Obstetricians and Gynecologists (ACOG), it is safe to receive dental treatment when pregnant.
Here is a direct quote from their guideline:
Inform women that conditions that require immediate treatment, such as extractions, root canals, and restoration (amalgam or composite) of untreated caries, may be managed at any time during pregnancy. Delaying treatment may result in more complex problems.
There you have it, it is safe to receive necessary treatment such as extractions, root canals, and fillings at any time during the pregnancy. However, we would like to emphasize two points and that is what is considered necessary treatment and treatment at any time during pregnancy.
The American Dental Association (ADA) directly references the guideline by the ACOG. Therefore, their stance is identical to what the College of Obstetrician and Gynecologists have said.
The guidelines do state that any necessary treatment should be done but that elective procedures should be postponed to after giving birth.
Necessary. Any procedure that is meant to prevent infection is considered necessary. That means if your dentist anticipates a cavity that may result in pain or an infection, the procedure is valid.
Elective. These are cosmetic procedures which do not improve the health of the patient. What falls into this category would be teeth whitening and dental veneers.
The reasoning is that postponing needed treatment will only lead to further complications.
Treatment at any trimester
The ACOG guidelines does state that it is safe to receive treatment regardless of the trimester that you're in. That means dental work during the first trimester, second trimester, and third trimester are all safe to get done.
Previously in the past, the recommendation used to be that only the second trimester was safe to see the dentist. That has changed and is no longer the stance of the ACOG.
The only way to get permanent relief from unbearable tooth pain while you're pregnant is by getting treated by a dentist. All OTC products and home remedies can temporarily relieve the pain but will do nothing to treat the source to make it go away. The pain will return once the remedy wears off.