Taking ibuprofen and acetaminophen together is the single most effective thing you can do for tooth pain at home right now, and it works better than either drug alone or even some prescription opioids. Beyond that, a few other strategies, including cold packs, salt water rinses, topical numbing gels, and clove oil, can layer on additional relief while you arrange to see a dentist. Some popular folk remedies, though, can make things worse. Here is what actually works, what helps a little, and what to skip.
The Best Over-the-Counter Option
If you have both ibuprofen and acetaminophen in your medicine cabinet, take them together. A fixed-dose combination of ibuprofen and acetaminophen provides faster and greater pain relief than either drug alone after dental procedures such as wisdom tooth removal.1PubMed. Analgesic Efficacy of an Acetaminophen/Ibuprofen Fixed-dose Combination in Moderate to Severe Postoperative Dental Pain Across multiple studies, this combination has performed as well as or better than opioid painkillers, with fewer side effects and less need for stronger rescue medication.2PubMed. Ibuprofen/acetaminophen fixed-dose combination as an alternative to opioids in management of common pain types
The reason this works so well is that ibuprofen and acetaminophen attack pain through different pathways. Ibuprofen reduces inflammation at the site of the problem, while acetaminophen works on pain signaling in the brain. Using both covers more ground than doubling down on either one.3PubMed. The efficacy of combination analgesic therapy in relieving dental pain A common adult approach is 400 mg of ibuprofen alongside 500 mg of acetaminophen, taken every six hours. Do not exceed the maximum daily dose on either label, and avoid ibuprofen if you have stomach ulcers, kidney problems, or are in the third trimester of pregnancy.
If you only have one of the two, ibuprofen is generally the better solo choice for tooth pain because dental pain almost always involves inflammation. Acetaminophen alone still helps, just not as much for the swelling component. Naproxen (the active ingredient in Aleve) is another option and lasts longer per dose, but it has not been studied as extensively in combination with acetaminophen for dental pain specifically.
Topical Numbing Gels
Over-the-counter benzocaine gels, sold under brand names like Orajel, can numb the area around a painful tooth within minutes. In a large clinical trial, both 10 percent and 20 percent benzocaine gels significantly outperformed a placebo gel for toothache relief, with the 20 percent concentration working faster and producing slightly more responders. Side effects were rare and mild.4PubMed Central. An evaluation of 10 percent and 20 percent benzocaine gels in patients with acute toothaches
Apply a pea-sized amount directly to the gum tissue around the painful tooth with a clean finger or cotton swab. The numbing effect typically lasts 15 to 30 minutes, so this is more of a bridge measure than a long-term solution. You can reapply as directed on the packaging, but do not swallow large amounts or use it excessively throughout the day.
One safety note worth knowing: benzocaine has been associated with a rare but serious condition called methemoglobinemia, where the blood’s ability to carry oxygen drops. A review of adverse event reports found that the vast majority of these cases involved benzocaine sprays rather than gels, and deaths were extremely rare.5JAMA Internal Medicine. Reported Adverse Event Cases of Methemoglobinemia Associated With Benzocaine Products Gel formulations applied in small amounts to the gums carry far less risk than sprays, which deliver higher doses to larger surface areas. Still, do not use benzocaine products on children under two years old, as they are more vulnerable to this complication.
Cold Packs and Ice
Pressing a cold pack or a bag of ice wrapped in a cloth against your cheek on the painful side is one of the oldest home remedies, and there is some evidence behind it. A randomized trial found that patients who used ice compression after wisdom tooth surgery reported better quality of life and reduced pain compared to those who did not, with meaningful pain reduction appearing by the third day after surgery.6PubMed. Effect of ice compression on pain after mandibular third molar surgery A meta-analysis looking across multiple trials found a small benefit for pain reduction in the days following surgery, though the overall quality of evidence was graded as low.7PubMed. Cryotherapy in reducing pain, trismus, and facial swelling after third-molar surgery
The honest assessment is that cold compresses will not dramatically knock out tooth pain on their own, but they do help take the edge off and are completely safe. Apply for 15 to 20 minutes at a time with breaks in between to avoid skin irritation. Cold works best for pain that involves swelling or inflammation, such as an abscessed tooth or post-extraction soreness. For a cavity-related toothache without much swelling, you may not notice as much relief.
Salt Water Rinses
Dissolving about half a teaspoon of table salt in a glass of warm water and swishing it gently around your mouth is a simple measure that does a couple of useful things. The warm salt water can help draw some fluid out of swollen tissue through osmosis, temporarily reducing pressure around an inflamed area. A clinical study found that salt water rinsing after periodontal surgery led to significant improvements in gum inflammation over the follow-up period.8PubMed. Anti-inflammatory effect of salt water and chlorhexidine 0.12% mouthrinse after periodontal surgery
Salt water rinses are not going to fix the underlying problem, but they are free, safe, and can be repeated several times a day. They are especially helpful if you have a sore or open area in your mouth where food debris tends to collect, since the rinse flushes irritants away. Avoid rinsing too aggressively if you have a fresh extraction site or surgical wound, as the goal is gentle flushing, not pressure washing.
Clove Oil
Clove oil has been used for tooth pain for centuries, and the science behind it is surprisingly solid. The active compound, eugenol, works through several mechanisms at once: it blocks inflammatory messengers like prostaglandins, interferes with nerve signal transmission, and inhibits pain-related receptors in the nervous system.9PubMed Central. Analgesic effect of the aqueous and ethanolic extracts of clove Eugenol is actually used in professional dentistry as a component of some temporary filling materials and surgical dressings, so this is not purely a folk remedy.
To use it at home, dab a tiny amount of clove oil onto a cotton ball or cotton swab and apply it directly to the painful area. The taste is intense and somewhat numbing. Use it sparingly because concentrated eugenol can irritate soft tissue if you soak the area. Some people dilute it in a carrier oil like olive oil before applying. Over-the-counter toothache drops, such as Red Cross Toothache, are essentially eugenol in a controlled concentration and are easier to dose correctly.
One thing to keep in mind: if you are headed to the dentist soon for a permanent restoration involving bonding materials, eugenol residues on tooth surfaces can interfere with how certain dental adhesives set up. A study found that cavities previously filled with eugenol-containing temporary cements showed markedly increased gaps when bonding agents were later applied.10PubMed. Influence of temporary filling materials on effect of dentin-bonding agents This is mostly relevant to dentists choosing temporary filling materials, but it is worth mentioning if you are dousing a broken tooth in clove oil right before a composite filling appointment.
What Not to Put on Your Tooth
The internet is full of suggestions for home toothache remedies, and some of them can genuinely harm you. Two common offenders stand out.
Placing a crushed aspirin directly on the gum next to a painful tooth is a persistent myth. Aspirin is acidic, and when left in direct contact with soft tissue, it causes chemical burns. Case reports describe patients developing painful white necrotic lesions on their gums and cheek lining after pressing aspirin tablets against a sore tooth.11Saudi Endodontic Journal. Chemical burn from direct application of aspirin onto a painful tooth Aspirin relieves pain by being absorbed through your stomach and circulating in your bloodstream, not by sitting on the gum surface. Swallow it normally.
Raw garlic pressed against the gum is another folk remedy that can backfire. A case report documents a patient who developed a mucosal burn in the upper gum area after applying crushed raw garlic to try to treat tooth pain. Chemical burns from self-applied home substances are actually a recognized pattern in dental literature, and garlic and aspirin are two of the most common culprits.12PubMed. Garlic burn of the oral mucosa: A case report and review of self-treatment chemical burns
Also avoid placing any kind of alcohol (whiskey, vodka) directly in the mouth for prolonged contact with a painful area. While alcohol can briefly numb tissue, it dries out and irritates the gums and does nothing to address the source of the pain. And heating pads applied to the face over a potential abscess are risky because heat can increase blood flow to an infected area and make swelling worse.
Layering Your Strategies
The most effective home approach is not picking one remedy but combining several that work through different mechanisms. Here is a reasonable sequence for someone dealing with a bad toothache tonight:
- Take ibuprofen and acetaminophen together. This is your heavy hitter. Give it 30 to 45 minutes to kick in.
- Apply a cold pack. While waiting for the pills to work, hold ice wrapped in a towel against the outside of your cheek for 15 to 20 minutes.
- Rinse with warm salt water. This helps flush the area and can reduce some swelling.
- Apply benzocaine gel or clove oil. If pain is still breaking through, a topical numbing agent directly on the gum tissue around the tooth provides an additional layer of relief.
These measures are complementary, not redundant. The oral painkillers work systemically, the cold reduces local inflammation and swelling, the rinse cleans the area, and the topical agents numb the nerve endings at the site. Together they cover multiple pain pathways at once.
Positioning and Sleep
Tooth pain tends to get worse at night, and there is a straightforward reason for this. When you lie flat, blood pressure in your head increases, which puts more pressure on already inflamed tissue around a painful tooth. Propping yourself up with an extra pillow or two so your head stays elevated can reduce this pooling effect and genuinely make the pain more manageable while you sleep. It is a small thing, but people who have endured a night of throbbing tooth pain will tell you it matters.
Avoiding very hot, very cold, or very sweet foods and drinks is also helpful in the interim. If you have an exposed nerve from a cavity or crack, temperature extremes and sugar will trigger sharp spikes of pain. Sticking to lukewarm, bland foods on the opposite side of your mouth reduces the chance of aggravating things further.
When Children Have Tooth Pain
Managing tooth pain in children requires more caution with medications. The pharmacologic options for kids are essentially limited to non-opioid analgesics, with dosing adjusted for age and weight.13PubMed Central. Common Selfcare Indications of Pain Medications in Children Codeine and tramadol are specifically contraindicated for managing acute pain in children, according to both the FDA and clinical guidelines from the American Dental Association.14PubMed Central. Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in children
Children’s ibuprofen and children’s acetaminophen are the go-to options. The same combination approach that works for adults applies to children, but you need to dose by weight, not by age, and use the formulations designed for kids. Do not give adult-strength tablets to a small child. Benzocaine gels should not be used on children under two, and even in older children, use the minimum effective amount. Cold packs and salt water rinses are safe for kids old enough to swish and spit without swallowing.
Pregnancy and Tooth Pain
Tooth pain during pregnancy is common, partly because hormonal changes increase the risk of gum inflammation and partly because morning sickness-related acid exposure can worsen existing dental problems. Managing that pain requires careful medication choices. Dentists treating pregnant or breastfeeding patients need to weigh the risks and benefits of analgesics and anti-inflammatory drugs specifically for this population.15PubMed Central. Pregnancy, breast-feeding and drugs used in dentistry
Acetaminophen is generally considered the safest oral pain reliever during pregnancy. Ibuprofen and other NSAIDs should be avoided in the third trimester because they can affect fetal heart development and reduce amniotic fluid. In the first and second trimesters, short-term NSAID use may be acceptable, but this is a conversation to have with your obstetrician or midwife rather than a decision to make from a medicine cabinet at midnight. Non-drug strategies like cold compresses, salt water rinses, and head elevation become even more valuable during pregnancy because they carry no fetal risk.
When Home Remedies Are Not Enough
Everything described above is a stopgap. Home treatment manages pain while you arrange professional care, but it does not fix the underlying problem. Some situations call for urgent rather than next-available-appointment care.
A dental infection that spreads can become dangerous. Untreated cavities and gum disease can lead to abscesses, which in serious cases carry risks of complications like bone infections, deep neck space infections, and in rare instances, spread to the brain.16The Review of Diabetic Studies. Acute Dental Conditions In Emergency Departments Signs that you should seek same-day care include fever, visible swelling that extends beyond the gum line into the cheek or under the jaw, difficulty swallowing or breathing, pus draining from the gum area, or pain that does not respond at all to maximum doses of over-the-counter medications.
If your face is visibly swollen and you have a fever, go to an emergency room or urgent care. A spreading dental infection can compromise your airway, and that is a genuine medical emergency. For less dramatic situations where the pain is severe but there are no red flags, an emergency dental clinic or your regular dentist’s after-hours line is the right call.
Not All “Toothaches” Come From Teeth
It is worth knowing that not every pain felt in a tooth actually originates there. Sinus infections can cause aching in the upper back teeth because the roots of those teeth sit very close to the floor of the maxillary sinus. Clenching or grinding your teeth at night (bruxism) can produce dull, widespread tooth soreness that feels like a cavity but is not. Jaw joint problems, certain headache disorders, and even cardiac events can occasionally present as tooth pain. Dental professionals recognize that the complaint of toothache does not always indicate a need for dental treatment, and proper diagnostic testing should be performed even when the diagnosis seems obvious.17ScienceDirect. Endodontics THE DIFFICULT DIFFERENTIAL DIAGNOSIS
If you are treating what you think is a toothache at home and it does not behave like you expect, consider whether the source might be elsewhere. Pain that affects multiple teeth on one side, worsens when you bend forward, and comes with nasal congestion is likely sinus-related. Pain that is worst in the morning and involves jaw stiffness may be from nighttime grinding. Pain in the lower left jaw accompanied by chest tightness or shortness of breath warrants an immediate call to emergency services, not a dentist. Home remedies for tooth pain assume the pain is actually dental in origin, and if the usual measures are not helping, that assumption is worth questioning.