A toothache usually responds to a combination of over-the-counter pain relievers, cold therapy, and simple rinses you can do at home right now. These won’t fix the underlying problem, but they can bring the pain down from unbearable to manageable while you arrange to see a dentist. Here’s what actually works and how to do each step correctly.
Take the Right Pain Relievers
For acute dental pain, the most effective over-the-counter approach is combining ibuprofen and acetaminophen. The American Dental Association’s 2024 guidelines recommend non-opioid pain relievers as the first line of treatment for acute dental pain, and this combination outperforms either drug alone. A combined tablet (125 mg ibuprofen and 250 mg acetaminophen) is available over the counter: two tablets every eight hours, no more than six per day. If you don’t have the combination product, you can take standard ibuprofen and acetaminophen separately at their normal doses, since they work through different pathways and don’t interfere with each other.
If you can only take one, ibuprofen is generally the better choice for tooth pain because it reduces both pain and inflammation. Take it with food to protect your stomach. Acetaminophen alone is the alternative if you can’t use ibuprofen due to stomach issues or other medications.
Apply a Cold Compress
Hold a cold compress against the outside of your cheek, on the side where it hurts. Keep it on for 10 to 20 minutes at a time with a thin cloth between the ice and your skin, then take a break before reapplying. Cold reduces swelling and temporarily dulls pain by slowing nerve signals in the area. If you don’t have an ice pack, a bag of frozen vegetables wrapped in a towel works fine.
This is especially useful if your cheek or jaw looks swollen. Avoid using heat, which can increase blood flow to the area and make inflammatory pain worse.
Rinse With Salt Water
Dissolve a few teaspoons of salt in a cup of warm water, swish it around your mouth for 30 seconds, and spit. Salt water is a mild natural disinfectant that can loosen food debris trapped between teeth or around the gumline, which is sometimes the sole cause of the pain. It also helps reduce bacteria around an irritated area. You can repeat this several times a day.
A hydrogen peroxide rinse is another option: mix equal parts 3% hydrogen peroxide (the kind sold at pharmacies) and water, swish for 30 seconds, and spit. Do not swallow either rinse.
Try Clove Oil for Targeted Numbing
Clove oil contains eugenol, a compound that works as a natural anesthetic by numbing nerve endings on contact. It also has anti-inflammatory properties. To use it, put a small amount of clove oil on a cotton ball or swab and dab it directly on the painful tooth or gum area. Always dilute it with a carrier oil like olive or coconut oil first, because full-strength clove oil can burn soft tissue and irritate your mouth.
The taste is strong and not pleasant for everyone, so try a tiny amount first. Never swallow clove oil. Keep it away from children, as ingesting it can cause breathing difficulties and stomach problems.
Manage Nighttime Pain
Toothaches famously get worse at night, and there’s a straightforward reason: when you lie flat, more blood flows to your head, which increases pressure around an inflamed or infected tooth. That’s why a dull ache during the day can turn into intense throbbing the moment you go to bed.
Prop yourself up with an extra pillow or two so your head stays elevated above your heart. This uses gravity to reduce blood pooling around the affected area. Take your pain reliever about 30 minutes before you plan to sleep so it’s fully working by the time you lie down. Avoid eating anything very hot, cold, or sugary right before bed, since these can trigger fresh waves of sensitivity.
Figure Out What’s Causing It
The type of pain you’re feeling offers clues about what’s going on, which helps you gauge how urgently you need professional care.
Sharp, brief sensitivity to cold drinks or sweets that fades within a few seconds usually points to reversible pulpitis, meaning the nerve inside your tooth is irritated but not permanently damaged. This is often caused by a new cavity, a cracked filling, or receding gums exposing the root surface. A dentist can typically fix this with a filling or other straightforward treatment, and the nerve recovers.
Pain that lingers after the trigger is removed, throbs on its own, or responds to heat is more concerning. This can signal irreversible damage to the nerve, which usually requires a root canal or extraction. If untreated, the infection can spread beyond the tooth into the surrounding bone and tissue, forming an abscess.
A persistent, deep ache combined with visible swelling, a bad taste in your mouth, or a small bump on the gum near the tooth often means an abscess has already formed. This won’t resolve on its own and needs dental treatment.
Signs You Need Urgent Care
Most toothaches warrant a dental appointment within a few days, but certain symptoms mean the infection may be spreading beyond your mouth. Seek emergency care if you notice:
- Fever alongside your tooth pain, which indicates the infection is triggering a systemic immune response
- Swelling that spreads to your eye, neck, or under your jaw
- Difficulty swallowing or breathing, which can happen when swelling extends into the throat
- Swollen neck glands on the same side as the painful tooth
These are signs of a dental infection that has moved beyond what home remedies or oral antibiotics alone can manage. A spreading dental infection is a genuine medical emergency. Go to an emergency room if your dentist isn’t available, because this type of infection can worsen quickly over hours.
What to Avoid
Don’t place aspirin directly on the tooth or gum. This is an old home remedy that actually burns the soft tissue and creates a painful ulcer without helping the tooth itself. Aspirin only works as a pain reliever when swallowed.
Avoid chewing on the affected side. Skip very hot or very cold foods and drinks, since temperature extremes can trigger sharp pain in an exposed or inflamed nerve. If you’re using clove oil or any numbing product, don’t eat until the numbness wears off so you don’t accidentally bite your cheek or tongue.
Resist the urge to poke at the tooth with a toothpick or sharp object. If you suspect food is trapped, gentle flossing or a water rinse is safer. Aggressive probing around an infected area can push bacteria deeper into the tissue.