If your tooth hurts, start with over-the-counter pain relief and a saltwater rinse while you figure out the cause. Most toothaches stem from decay, a crack, gum infection, or inflammation of the nerve inside the tooth. Some resolve with simple care, but persistent or severe pain almost always means something needs professional treatment.
Quick Pain Relief at Home
The most effective over-the-counter approach for dental pain is combining ibuprofen and acetaminophen. These two drugs work through different pathways, and together they outperform either one alone or even some prescription painkillers for tooth-related pain. A combination tablet (125 mg ibuprofen and 250 mg acetaminophen) is taken as two tablets every eight hours, with a maximum of six tablets per day. If you’re using separate bottles, stay under 4,000 mg of acetaminophen in 24 hours, and follow the ibuprofen label for its own limits. Take ibuprofen with food to avoid stomach irritation.
A warm saltwater rinse can reduce swelling and draw fluid away from inflamed tissue. Mix half a teaspoon of salt into a cup of warm water, swish it gently around the sore area for 30 seconds, and spit. You can repeat this several times a day.
Topical numbing gels containing benzocaine (brands like Orajel and Anbesol) can temporarily dull the area. Apply a small amount directly to the gum around the painful tooth. One important caveat: the FDA warns against using benzocaine products on children for teething pain because of a rare but serious condition that reduces the blood’s ability to carry oxygen. For adults, short-term use on a specific sore spot is generally considered safe.
Clove Oil as a Natural Option
Clove oil contains a compound called eugenol that acts as a mild local anesthetic and antiseptic. It’s been used in dentistry for decades. To apply it, put a drop or two on a cotton ball and hold it against the painful tooth and surrounding gum for a minute or so. The relief is temporary but can take the edge off while you wait for a dental appointment.
Use it sparingly. In low doses, side effects are mostly limited to local irritation, but there are documented cases of painful gum ulcers developing after prolonged or repeated exposure. If the area feels more irritated after applying clove oil, stop using it.
How to Sleep With a Toothache
Toothaches famously get worse at night, and there’s a straightforward reason. When you lie flat, gravity sends more blood into your head and neck. The nerve inside your tooth sits in a tiny chamber surrounded by hard tooth structure, so any extra blood flow increases pressure in that confined space and amplifies pain. Elevating your head 30 to 45 degrees above horizontal, using an extra pillow or a wedge, reduces that pressure and often makes sleep possible. Taking a dose of pain medication about 30 minutes before bed helps too.
What Different Types of Pain Mean
The character of your toothache tells you something about what’s going on. A sharp, brief sting when you bite down or drink something cold often points to a crack, a cavity, or receding gums that have exposed the root surface. This kind of sensitivity is common and usually treatable with a filling, crown, or desensitizing treatment.
A deep, throbbing ache that lingers after hot or cold exposure, or that shows up without any trigger at all, suggests the nerve inside the tooth is inflamed or dying. This type of pain tends to escalate over days rather than improve, and it typically means the tooth needs a root canal or extraction.
Pain that radiates into your ear, jaw, or temple can come from an infected tooth, but it can also be referred pain from clenching, a sinus infection, or a problem with the jaw joint. If you can’t pinpoint which tooth hurts, that’s worth mentioning to your dentist, since it changes how they evaluate you.
Signs You Need Urgent Care
Most toothaches warrant a dental visit within a few days, but certain symptoms mean you shouldn’t wait. Get seen the same day, or go to an emergency room if a dentist isn’t available, if you notice any of the following:
- Rapid facial swelling, especially on one side, which signals active bacterial spread
- Fever, chills, or fatigue, meaning the infection has moved beyond the tooth into your system
- Difficulty swallowing or breathing, which can happen when swelling reaches the throat
- Pus or a foul taste in your mouth, a clear sign of an active abscess
- Pain that keeps getting worse despite over-the-counter medication, particularly if it radiates to your ear or neck
A dental abscess that spreads can become life-threatening. The treatment is drainage of the infection, not just antibiotics. In fact, the American Dental Association does not recommend antibiotics alone for a localized dental abscess. The source of infection has to be physically addressed, whether that means draining the pus, performing a root canal, or removing the tooth.
If a Tooth Gets Knocked Out
A knocked-out permanent tooth is a true dental emergency with a narrow window. According to the American Association of Endodontists, you should ideally get to a dentist within 30 minutes, though saving the tooth is still possible even after an hour or more. Pick the tooth up by the crown (the white part you can see in the mouth), not the root. If it looks clean, try gently placing it back in the socket and biting down on a cloth to hold it in place. If you can’t reinsert it, keep it moist at all times: place it in a glass of milk, tuck it between your cheek and gum, or use a tooth preservation kit if you have one. Do not let it dry out, and do not scrub the root surface.
What Happens at the Dentist
Your dentist will take an X-ray and test the tooth to figure out how deep the problem goes. A cavity that hasn’t reached the nerve gets a filling. If the nerve is inflamed or infected, you’ll need a root canal, which removes the damaged tissue inside the tooth and seals it. The procedure sounds intimidating, but with modern anesthesia it’s comparable to getting a filling. Recovery usually takes a few days of mild soreness.
If the tooth is too far gone to save, extraction is the remaining option. Your dentist will discuss replacement options like an implant or bridge afterward, but the priority is eliminating the source of pain and infection. For abscesses, the dentist may make a small incision to drain trapped pus, which provides near-immediate pressure relief. Most localized infections resolve quickly once drainage is achieved and the underlying cause is treated.
Things That Make a Toothache Worse
While you’re managing the pain at home, avoid very hot or very cold foods and drinks if temperature triggers your pain. Don’t chew on the affected side. Skip sugary foods, which can feed bacteria in a cavity and intensify sensitivity. Avoid pressing on the area or poking at it with a toothpick, even if something feels stuck. If you suspect a crack, biting down to “test” it can extend the fracture and turn a repairable tooth into one that needs extraction.
Applying aspirin directly to the gum is an old home remedy that actually causes chemical burns to soft tissue. Take pain relievers by swallowing them normally.