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Drug Info

Is tramadol good for tooth pain?

Tramadol can be used for tooth pain, but it is not often prescribed - here’s why
Rebecca Rovenstine writer headshot
By | Jan. 15, 2025 Medically reviewed by Catherine Chien, DDS
Spilled bottle of white tablets: Is tramadol good for tooth pain?

Key takeaways

  • Tramadol is a good option for treating tooth pain in adults, but it’s rarely used for this purpose due to its addictive nature.

  • Non-addictive pain medicines like ibuprofen and acetaminophen are often the first choice by dentists to treat tooth pain.

  • Dentists may prescribe a more potent analgesic, like tramadol, in extreme cases of tooth pain, like a major dental surgery.

In this article:

Whether flashing a smile or chewing a delicious meal, we use our teeth frequently throughout the day. In a recent survey, researchers found that one out of four adults ages 30 or older had experienced tooth pain in the past year. 

When tooth pain strikes, a trip to the dentist can help diagnose the problem. In addition to dental procedures, dentists occasionally prescribe painkillers, like tramadol, to help remedy toothaches.

Does tramadol help with tooth pain?

“I’ve found tramadol to be a real huge help for managing moderate to severe tooth pain when basic over-the-counter meds just don’t cut it,” said Dr. Avi Israeli, a dentist at Sage Dental in New Jersey. 

Tramadol belongs to a group of drugs called opiates, which are typically stronger pain relievers compared to analgesics like Tylenol (acetaminophen, paracetamol) and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. They can be used to treat acute pain (sudden pain) and chronic pain (long-term pain). 

Dr. Israeli explained how opioids work, “Tramadol targets opioid receptors in our brains, changing how we perceive pain.” 

Opioid analgesics, which work via the central nervous system (CNS), are a class IV controlled substance, meaning they have a high likelihood of misuse or abuse. Other opioids include hydrocodone and oxycodone. Healthcare providers are less likely to prescribe these medications, even more so in recent years, due to patient risk and the possibility of addiction.

There are also side effects of tramadol to consider, with some including constipation, drowsiness, feeling of sedation or fatigue, and serotonin syndrome. Tramadol also has interactions with several drugs, like monoamine oxidase inhibitors (MAOI) for depression. While tramadol would be a good treatment for tooth pain and toothaches, due to the addictive nature of narcotics like tramadol, it’s not the first line of treatment.

Typically, dentists will perform dental procedures to address what’s causing the tooth pain and recommend over-the-counter pain relievers like ibuprofen or acetaminophen for pain management. If the toothache is causing severe pain, it is possible your dentist may prescribe tramadol. If tramadol alone doesn’t address the tooth pain, tramadol can be taken with Tylenol for extra pain relief. It is important to address the underlying issue to relieve tooth pain.

In addition to the downsides of tramadol, NSAIDS may work better for oral pain compared to other treatments. A 2023 system review looked at pain from tooth extractions in adults. When it came to treating tooth pain, the researchers concluded, “NSAIDs with or without acetaminophen result in better pain-related outcomes than opioids with or without acetaminophen.” 

How fast does tramadol work for tooth pain?

“As with any opioid taken orally, it usually takes about 10 to 20 minutes to relieve pain,” said Dr. Nadia Rodriguez, a cosmetic and restorative dentist at No Limits Dental in New York City.

In general, tramadol will work for most people. However, genetic factors may make some people poor metabolizers of tramadol. This characteristic is mostly found in a small percentage of African American and Caucasian populations, with Asian populations having the lowest instances of this trait.

Tramadol dosage for tooth pain

“I always think about a person’s age, overall health, and pain severity to change the dosage appropriately while being mindful of dependency risks and side effects,” said Dr. Israeli.

The standard prescribing dosage for tramadol for adults experiencing tooth pain is a 50 mg to 100 mg tablet once every 4 to 6 hours as needed for pain. The maximum dosage of tramadol is 400 mg per day. Tramadol is not typically used for pediatric dental patients.

Tramadol is the generic name for the drug, but it’s also sold under Ultram. Ultram is prescribed in instant-release (IR) and extended-release (ER) forms. The Ultram IR dosage is the same as regular tramadol. The starting dosage for Ultram ER is 100 mg to 300 mg once daily, with a maximum dose of 300 mg.

Why would a dentist prescribe tramadol?

“I could see a dentist prescribe tramadol if there was a major surgery that required full mouth reconstruction, but for most tooth pain, dentists would not prescribe tramadol,” said Dr. Rodriguez.

Dr. Israeli agreed, “I turn to tramadol for really intense, sharp pain, especially after dental surgery or when an infection won’t respond to simpler treatments.”

While tramadol is a strong painkiller, it’s typically not the first line of defense against low to moderate pain. When considering a painkiller for tooth pain, most dentists would agree there are better choices with fewer risks than tramadol. 

Tramadol alternatives for tooth pain

“It’s important to know that tramadol isn’t my first choice,” said Dr. Israeli. 

Typically, the first choice for dentists is over-the-counter (OTC) pain medications, including NSAIDS like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). NSAIDs work by blocking the enzyme prostaglandin, which gives the body pain signals. Acetaminophen is believed to work in a similar way. 

Over-the-counter pain medications are the best painkillers for tooth pain as they’re non-addictive, affordable, and readily available at your local pharmacy. The dentist can prescribe prescription-strength ibuprofen if the over-the-counter dosage isn’t enough to combat tooth pain. 

NSAIDs can also be used in combination with acetaminophen for relief. A 2013 review that looked at patients who underwent oral surgery for third-molar extractions (wisdom tooth removal) found a combination of ibuprofen and acetaminophen “may be a more effective analgesic, with fewer untoward effects” when compared to formulations with opioids.

“For tougher cases, I might suggest a combination of acetaminophen with codeine or another non-opioid painkiller,” added Dr. Israel. When that doesn’t cut it, a doctor may prescribe an opioid painkiller like tramadol, as it’s stronger for most individuals than ibuprofen. 

However, if you want relief, there is one thing even more critical than treating tooth pain. Dr. Israel advised, “Addressing the root of the problem if it’s an infection or inflammation, is always important.

It’s also common for dental practices to apply local anesthetic during dentistry procedures to help provide relief for tooth pain and any uncomfortableness from the operation itself.

When you have tooth pain for longer than a couple of days, it’s important to seek treatment from a dentist to find the underlying cause. If you experience facial swelling or fever as a result of your tooth pain, you should seek medical care promptly.