The single most effective option for a toothache is ibuprofen combined with acetaminophen, taken together. This combination outperformed every other pain relief approach in a review of over 58,000 patients, including prescription opioid regimens. If you only have one of the two on hand, ibuprofen on its own is the stronger choice because toothache pain is driven by inflammation, and ibuprofen targets inflammation directly while acetaminophen does not.
Why the Combination Works So Well
Ibuprofen and acetaminophen relieve pain through completely different pathways. Ibuprofen is an NSAID, meaning it reduces inflammation right at the source, in the tissue around your tooth. Acetaminophen works in your central nervous system, blocking pain signals before they reach your brain. Taking both at the same time means you’re stopping the pain at both ends of the chain. The American Dental Association’s clinical practice guideline, published in 2024, specifically recommends this combination as the first-line treatment for acute dental pain in adults and adolescents 12 and older.
The effective dose studied is 400 mg of ibuprofen plus 1,000 mg of acetaminophen. There is also a combination tablet available over the counter containing 125 mg ibuprofen and 250 mg acetaminophen per tablet, taken as two tablets every eight hours (no more than six tablets per day). Either approach works. If you’re using separate bottles from your medicine cabinet, just take a standard dose of each at the same time.
If You Can Only Take One
Ibuprofen is the better solo option for dental pain. Because toothaches almost always involve inflamed tissue, whether from a cavity, a crack, or an infection, a drug that reduces inflammation will do more than one that only blocks the sensation of pain. Acetaminophen alone still helps, but it won’t address the swelling that’s pressing on nerves inside and around the tooth.
One thing to know: NSAIDs like ibuprofen have a ceiling effect. Once you hit the recommended dose, taking more won’t give you more relief, it will just increase the risk of stomach irritation. Stick to the dose on the label and add acetaminophen if one drug isn’t cutting it on its own.
Numbing Gels and Topical Options
Over-the-counter numbing gels containing benzocaine can dull the surface pain around a sore tooth, but the relief is temporary and limited to the surface tissue. They don’t reach inflammation deeper in the tooth or jawbone, so they work best as a short-term supplement alongside oral painkillers rather than a replacement.
Benzocaine products carry an FDA safety warning. They can cause a rare but serious condition called methemoglobinemia, which reduces the amount of oxygen your blood can carry. This risk is highest in young children, and benzocaine oral products should never be used on children under 2 years old. For adults, follow the label directions carefully and don’t exceed the recommended number of applications.
Home Remedies Worth Trying
Clove oil is the home remedy with the most evidence behind it. The active compound, eugenol, makes up 70 to 90 percent of clove essential oil and works as a local anesthetic by blocking sodium channels on sensory nerves, essentially stopping pain signals from traveling. It also interacts with temperature-sensing receptors in your teeth, which can reduce sensitivity to hot and cold. To use it, put a small drop on a cotton ball and hold it against the painful area. The taste is strong and the sensation can be intense for the first few seconds before the numbing kicks in.
A warm saltwater rinse is another simple option. Dissolve half a teaspoon of salt in a cup of warm water and swish it gently around the affected area for 30 seconds before spitting it out. This helps clean debris from around the tooth and can temporarily soothe irritated tissue. It won’t match the pain relief of ibuprofen, but it’s a useful step you can repeat several times a day, especially after eating.
What a Toothache Is Telling You
Pain relief buys you time, but it doesn’t fix the underlying problem. A toothache that lasts more than a day or two typically means something structural is going on: a deep cavity, a cracked tooth, or an infection at the root. These don’t resolve on their own, and the longer they go untreated, the more complicated (and expensive) the fix becomes.
Certain signs mean the situation has moved beyond a routine dental visit. If you develop a fever along with facial swelling, that suggests the infection may be spreading beyond the tooth into surrounding tissue. Difficulty breathing or swallowing is a signal that infection has reached the throat or neck, and that requires emergency care, not a dentist appointment. The same goes for swelling that’s visibly getting worse or spreading toward your eye or under your jaw.
What to Avoid
Placing aspirin directly on your gum tissue is an old home remedy that actually causes chemical burns. Aspirin is acidic, and holding it against soft tissue damages the surface rather than treating the pain. If you want to take aspirin for dental pain, swallow it normally, though ibuprofen is generally a better NSAID choice for this purpose.
Avoid very hot or very cold foods and drinks on the affected side. Temperature extremes can trigger sharp spikes of pain, especially if the tooth’s inner nerve is exposed through a crack or deep cavity. Chewing on the opposite side and sticking to lukewarm foods can keep your pain more manageable while you wait to be seen.