The best painkillers for tooth nerve pain

In this article:

• What is the best painkiller for tooth nerve pain? 
• Alternatives and home remedies for tooth pain
• How long does it take to get rid of tooth pain?

In this article

• What is the best painkiller for tooth nerve pain? 
• Alternatives and home remedies for tooth pain
• How long does it take to get rid of tooth pain?

Tooth enamel is the hardest substance in the human body—for good reason. It protects some extremely sensitive nerves. Even though enamel is a shield while eating, drinking, and brushing our teeth, it’s not completely impenetrable. Cavities, infections, chipped or fractured teeth, abscesses, gum disease, fillings, and bruxism can all cause pain in dental nerves.

Whether it’s a dull ache or feels like shooting electricity, tooth nerve pain can send you to the pharmacy or dentist, looking for immediate relief. Fortunately, there are several over-the-counter (OTC) drugs and prescription painkillers that can help. 

What is the best painkiller for tooth nerve pain? 

“Best” is subjective here since the best pain reliever typically depends on the individual and what’s causing their tooth pain. Treating the underlying condition is the only way to get rid of it for good, but in moments of discomfort, fast pain relief is the priority. Since they have anti-inflammatory effects, NSAIDs like ibuprofen can work well for irritated or exposed nerves. In fact, as of early 2024, guidelines by the American Dental Association (ADA) officially recommend non-steroidal anti-inflammatory drugs (NSAIDs) to manage dental pain. While OTC options are often effective, dentists may prescribe stronger medications for severe cases.

OTC medications for toothache

“I usually start by recommending over-the-counter options like acetaminophen and ibuprofen for mild-to-moderate discomfort,” says Dr. Jasveen Singh, DMD, founder of Pediatric Dentistry and Beyond. “Alternating Motrin (ibuprofen) and Tylenol (acetaminophen) every six hours is effective for dental pain because they work through different mechanisms: Ibuprofen reduces inflammation, while acetaminophen acts as an analgesic.”

OTC pain relievers can be just as effective as opioids, according to an overview of systematic reviews. These are some of the most common.

• NSAIDs: Once again, non-steroidal anti-inflammatory drugs are the go-to for many dentists and patients. Ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin are some of the most common choices. A 20-year review of NSAIDs showed that they’re all fairly equal in effectiveness, so it largely comes down to personal circumstances and dentist recommendations. 
• Analgesics: Another non-opioid pain reliever, acetaminophen (Tylenol) can also work well for oral pain. However, it’s not an anti-inflammatory like NSAIDs, so it won’t be as effective for the discomfort caused by inflammation.
• Benzocaine: This typically comes as a topical gel (like Orajel and Lanacane). When applied, it numbs sections of the mouth, temporarily relieving discomfort. Benzocaine doesn’t interact with other OTC painkillers, so some people can use them simultaneously. However, it’s best to consult a healthcare provider before doing so. This is not recommended for small children.

After in-office procedures like root canals, dentists may send you home with a prescription, but in many other cases, OTC medications are the first treatment for tooth pain. Most dentists also have an after-hours emergency line in case you need to get a hold of your dentist. 

Prescription painkillers for tooth pain

“Severe pain responds better to prescription medications, such as prescription-strength (800 mg) ibuprofen or other NSAIDs,” says Dr. Zev Shulhof, DMD, of Iconic Implant Institute. “However, I only prescribe painkillers for short-term situations, such as while recovering from dental surgery or if immediate relief is needed before a procedure/appointment.” 

Likewise, Dr. Singh says, “I find a high dose of 600 mg ibuprofen to be very effective while also being more conservative compared to other prescription drugs, but I steer clear of narcotics as much as possible to avoid the risks of addiction or other serious side effects.” 

Here are a few of the most common prescription pain medications for dental pain.

• Prescription NSAIDs: Prescription NSAIDs are typically more potent than over-the-counter options, offering greater relief from pain and inflammation. Dentists will usually want to see how a patient has responded to OTC NSAIDs before prescribing one of these. Examples include Celebrex (celecoxib), Frotek (ketoprofen), and Flector (diclofenac).
• Corticosteroids: Dentists may prescribe these powerful anti-inflammatory drugs after procedures like root canals or if NSAIDs aren’t a good option for the patient. Studies suggest they can relieve endodontic pain within just a few hours of dental surgery. 

• Antibiotics: “If dental pain is due to an infection, I may prescribe antibiotics, informing patients that it can take 24-48 hours for the antibiotics to become effective in relieving the pain,” Dr. Singh says. “During this period, I recommend the alternating cycle of Motrin and Tylenol for continued pain management.” These drugs can help prevent a severe infection from spreading or taking hold after a dental procedure. 
• Opioid analgesics: Dentists have traditionally used opioids like oxycodone, hydrocodone, and codeine to manage dental pain. A 2018 study revealed that dentists account for 8.6% of all opioid prescriptions in the United States. However, they carry a black box warning for addiction, abuse, and severe side effects.

Note: Considering the pervasiveness of opioid addiction and overdose in the U.S., the Centers for Disease Control and Prevention (CDC) also recommends NSAIDs as the first-line treatment for dental pain. They also note that research shows NSAIDs to be more effective than opioids for surgical dental pain.

Alternatives and home remedies for tooth pain

Medications can quickly relieve dental pain, but sometimes, home remedies are all you need. The following methods might help. 

Saltwater rinse

Saltwater has several oral health benefits. Studies show that it effectively reduces plaque, and it also works as a natural disinfectant and anti-inflammatory. It might help relieve pain that stems from inflammation or decay. Mix a teaspoon of salt in a glass of warm water and swish it for 30 seconds before spitting it out. 

Cold compresses

This is the same idea as icing a sprained ankle. The cold will numb the affected area and reduce swelling. Place an ice pack on the cheek or jaw near the tooth that hurts and hold it there for around 20 minutes. 

Peppermint tea bags

Natural peppermint has pain-relieving and anti-inflammatory properties, which is why people use it for headaches, abdominal pain, and muscle aches. Some might find that it works well for dental pain, too. Steep a peppermint tea bag in hot water for five minutes, then remove it, allow it to cool, and apply it to the painful area. Peppermint oil may also work.

Hydrogen peroxide rinse

Hydrogen peroxide has antiseptic qualities and can help reduce pain and inflammation in the mouth. Research suggests it might decrease plaque, gingivitis, and oral bacteria. Mix two parts water with one part 3% hydrogen peroxide solution and swish it around in your mouth for 30–60 seconds, then spit it out. 

Clove oil

Clove oil, also called eugenol, has natural analgesic properties, and it’s shown promise as a pain reliever in animal studies. This has led to its prominence as a remedy for toothaches. Using a cotton ball or swap, apply clove oil to the gums around where you feel pain. You can also mix a couple drops of clove oil with water and use it as a rinse. 

Garlic

Most people love garlic for its versatility in the kitchen, but its medicinal properties appear in documentation as far back as ancient Egypt, Greece, and China. It has antibacterial and antimicrobial properties, which may help treat certain cases of toothache pain, depending on the cause. Make a paste from raw garlic and apply it around the painful tooth. Leave it for around 10 minutes before rinsing it away.

How long does it take to get rid of tooth pain?

The length of a toothache depends almost entirely on its cause. For example, tooth pain from tooth decay or gum disease might not go away until the issue gets fixed, while discomfort from a recent dental procedure may subside within a couple of days. 

If pain from a dental procedure does not subside in a few days, return to your dentist to check the occlusion of the restoration. Sometimes a small adjustment will take care of the discomfort. Regardless, if you take ibuprofen, it typically takes 20–30 minutes to work, and naproxen can take 30–60 minutes, while opioids can work in just 10–20 minutes. It’s most important to see a dentist to address the underlying cause of your tooth pain so they can prescribe the safest and most effective medicine and treatment.