Taking ibuprofen and acetaminophen together is the single most effective thing you can do at home for a toothache before you can get to a dentist. Multiple clinical trials confirm that the combination outperforms either drug on its own, and it works faster and lasts longer than most people expect. Beyond painkillers, a handful of genuinely useful home measures can take the edge off, but the list of things that actually help is shorter than the internet suggests, and a few popular remedies can make things worse.
Why Over-the-Counter Painkillers Are Your Best First Move
If you only do one thing, take ibuprofen and acetaminophen at the same time. The two drugs work through different pathways: ibuprofen dials down inflammation at the source, while acetaminophen blunts pain signals in the brain. Taken together, they consistently beat either one alone in trials on dental pain after tooth extraction, which is the gold-standard model researchers use to test acute pain relievers.1PubMed. Combining ibuprofen and acetaminophen for acute pain management after third-molar extractions: translating clinical research to dental practice A randomized trial found that 400 mg of ibuprofen plus 1,000 mg of acetaminophen produced significantly better pain relief than either drug alone at every measured time point over eight hours.2Clinical Therapeutics. Comparison of the analgesic efficacy of concurrent ibuprofen and paracetamol with ibuprofen or paracetamol alone in the management of moderate to severe acute postoperative dental pain in adolescents and adults Another study using a fixed-dose combination at a lower dose found the effect kicked in quickly and lasted more than eight hours on a single dose.3The Clinical Journal of Pain. Efficacy and Safety of Single and Multiple Doses of a Fixed-dose Combination of Ibuprofen and Acetaminophen in the Treatment of Postsurgical Dental Pain
A practical approach: take 400 mg of ibuprofen and 500–1,000 mg of acetaminophen together, repeating every six to eight hours as needed. Do not exceed the maximum daily dose for either drug (typically 1,200 mg of ibuprofen and 3,000–4,000 mg of acetaminophen for most adults, though you should check the label). This combination is now widely recommended as a first-line nonopioid option for acute dental pain. If you have stomach issues, kidney problems, or liver disease, or if you take blood thinners, talk to a pharmacist before reaching for ibuprofen.
Topical Numbing Gels
Over-the-counter benzocaine gels (sold under brand names like Orajel) can numb the tissue around a painful tooth for temporary relief. A clinical study found that applying a 20 percent benzocaine gel to both the tooth and the surrounding gum tissue helped reduce toothache pain.4PubMed Central. An evaluation of 10 percent and 20 percent benzocaine gels in patients with acute toothaches: Efficacy, tolerability and compliance with label dose administration directions The key detail is that benzocaine works by numbing the soft tissue, not by penetrating into the tooth itself, so applying it just to the surface of a cavity may not help as much as also rubbing it on the gum around the tooth.
One caution worth knowing about: benzocaine has been linked in rare cases to a condition called methemoglobinemia, where the blood’s ability to carry oxygen drops. Most reported cases involved spray products used in hospitals, and the two self-treatment cases reported for toothache both involved significant overdoses. Still, the FDA has flagged the risk, particularly for children under two, and benzocaine products for teething are no longer recommended for infants.4PubMed Central. An evaluation of 10 percent and 20 percent benzocaine gels in patients with acute toothaches: Efficacy, tolerability and compliance with label dose administration directions For adults, following the directions on the package and not reapplying excessively keeps the risk extremely low.
Clove Oil and Eugenol
Clove oil is the home remedy with the strongest scientific backing. Its active ingredient, eugenol, has been used in dentistry for decades and works through multiple mechanisms: it blocks prostaglandins (inflammatory chemicals that amplify pain), interferes with nerve signal transmission, and acts as a mild local anesthetic.5PubMed Central. Analgesic effect of the aqueous and ethanolic extracts of clove In animal studies, eugenol’s anesthetic effect has been compared to that of surgical anesthetics, and it also appears to block several types of pain receptors, including ones involved in nerve pain.6Natural Product Communications. Eugenol: A Natural Compound with Versatile Pharmacological Actions
To use it, soak a small cotton ball or cotton swab in clove oil and hold it against the painful tooth and surrounding gum for a few minutes. The taste is strong and not pleasant, but the numbing effect is real. Avoid swallowing large amounts, and if you have pure eugenol rather than diluted clove oil, use it sparingly since concentrated eugenol can irritate soft tissue. Over-the-counter toothache kits often contain eugenol as their primary ingredient, sometimes labeled as “clove oil” on the front and “eugenol” in the ingredients list.
Salt Water Rinses
Rinsing with warm salt water is the oldest dental home remedy, and it still holds up. A small randomized trial found that patients who used salt water rinses after oral surgery showed better wound healing and no adverse effects compared to a placebo group.7La Clinica Terapeutica. Effects of sea salt rinses on subjects undergone to oral surgery: a single blinded randomized controlled trial Salt water creates a mildly hypertonic environment that draws fluid out of swollen tissue, which can reduce pressure on nerve endings and flush debris from around an exposed cavity or inflamed gum.
Mix about half a teaspoon of table salt into a cup of warm (not hot) water, swish gently for 30 seconds, and spit. You can repeat this every few hours. It will not cure anything, but it can help manage swelling and keep the area clean between brushings, which matters when pain makes you hesitant to brush near the affected tooth.
Hydrogen Peroxide Rinses
Diluted hydrogen peroxide is another rinse option. Research has shown that hydrogen peroxide mouthwashes reduce gum inflammation and plaque buildup when used regularly.8PubMed. The effects of hydrogen peroxide mouthwashes on the prevention of plaque and gingival inflammation: a systematic review A six-month randomized trial found that a hydrogen peroxide-based rinse significantly reduced gingival inflammation compared to a control.9PubMed. Efficacy of a fluoridated hydrogen peroxide-based mouthrinse for the treatment of gingivitis: a randomized clinical trial For a toothache specifically, the antimicrobial effect can help if your pain is partly driven by bacterial activity around an infected tooth or inflamed gum tissue.10PubMed. Hydrogen peroxide: a review of its use in dentistry
Use a 1.5 to 3 percent solution (standard drugstore hydrogen peroxide is 3 percent) diluted with equal parts water. Swish for 30 to 60 seconds and spit thoroughly. Do not swallow it. If your toothache is from a deep cavity or cracked tooth rather than a gum issue, this will help less than the salt water rinse, since the peroxide primarily acts on surface bacteria and gum tissue.
A Cold Compress on the Outside
Holding a cold pack or a bag of ice wrapped in a cloth against your cheek, on the side of the painful tooth, can provide meaningful short-term relief. Cold application causes blood vessels to constrict, reduces swelling, and dampens pain perception in the area.11PubMed. Therapeutic efficacy of cold therapy after intraoral surgical procedures: a literature review Apply for about 15 to 20 minutes at a time, then take a break for at least 10 minutes before reapplying. Continuous icing without breaks can damage skin. This approach works best when swelling is part of the picture, as it often is with an abscessed tooth or post-procedure pain.
Avoiding the Triggers That Make It Worse
If your toothache flares with every sip of cold water or bite of hot food, there is a mechanical reason for that. When a tooth has exposed dentin (from a crack, a deep cavity, or worn enamel), temperature changes cause tiny fluid movements inside microscopic tubes that run through the tooth. Cold stimulation pulls fluid outward, which triggers nerve fibers quickly and sharply. Hot stimulation pushes fluid inward more slowly, so the pain tends to arrive with a delay and feels more like a deep ache.12PLoS ONE. Fluid Mechanics in Dentinal Microtubules Provides Mechanistic Insights into the Difference between Hot and Cold Dental Pain
The practical takeaway: while you are managing a toothache at home, eat and drink at lukewarm temperatures. Avoid ice-cold beverages, very hot soup, and sugary or acidic foods that can irritate an exposed nerve. Chewing on the opposite side of your mouth reduces mechanical pressure on the sensitive tooth. If you can identify a specific trigger that makes the pain spike, avoiding it is free and immediate relief.
What Not to Put on a Toothache
The internet is full of suggestions that sound reasonable but can actually cause harm. Two of the worst offenders are aspirin and raw garlic applied directly to the gum tissue.
Placing an aspirin tablet or powder against the gum next to a sore tooth is a widespread folk remedy. The problem is that aspirin is acidic, with a pH between 3.5 and 5.0. Left in contact with soft tissue, it causes chemical burns through protein coagulation, leading to tissue death, ulceration, and painful white sloughing of the gum.13Saudi Endodontic Journal. Chemical burn from direct application of aspirin onto a painful tooth Dental literature describes this as one of the most common self-inflicted chemical burns seen in emergency dental clinics.14SRM Journal of Research in Dental Sciences. Chemical burns of gingiva and its management Aspirin works for pain only when swallowed, so it can enter the bloodstream. Pressing it against gum tissue does nothing for the toothache and adds a burn injury on top of whatever you already had.
Raw garlic is another popular recommendation. A case report documented a patient who placed crushed garlic cloves against the gum to relieve a toothache and left them there overnight. The result was a garlic burn: sloughing tissue and ulceration across the area.15PubMed Central. Garlic burn as self-inflicted mucosal injury–a case report and review of the literature Garlic contains allicin, a sulfur compound that is caustic enough to damage mucous membranes with prolonged contact. Eating garlic in food is fine. Holding crushed garlic against your gum tissue for hours is not.
The general rule: if you would not put something on an open wound on your skin, do not hold it against your gums. Whiskey, baking soda paste, and essential oils other than clove oil have limited or no evidence for toothache relief and carry various risks of tissue irritation. Stick to what has been studied.
Peppermint Tea Bags and Peppermint Oil
Peppermint shows up in many home-remedy lists, and there is at least some pharmacological basis for it. Menthol, the primary active compound in peppermint, has documented analgesic and anti-inflammatory properties, and peppermint has been noted for potential benefits in dental health broadly.16Critical Reviews in Food Science and Nutrition. Peppermint and menthol: a review on their biochemistry, pharmacological activities, clinical applications, and safety considerations A warm, damp peppermint tea bag held against the affected area may provide a mild numbing and soothing sensation. The evidence for this specific use is thin compared to clove oil or ibuprofen, but it is unlikely to cause harm and can be a reasonable addition to your comfort measures rather than a standalone treatment.
Managing a Toothache in Children
For kids, the drug choices narrow. A clinical practice guideline from the American Dental Association recommends ibuprofen or naproxen, alone or combined with acetaminophen, as first-line treatment for acute dental pain in children. The same guideline makes clear that codeine and tramadol are contraindicated in children for managing acute pain.17The Journal of the American Dental Association. Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in children Doses need to be weight-based, so check the packaging or call your pediatrician for guidance rather than guessing.
Benzocaine gels should not be used in children under two, as noted earlier. For older children, the same home strategies that work for adults (salt water rinses, cold compress, avoiding trigger foods) are safe. Clove oil can be used in older children in very small amounts on a cotton swab, but it has a strong taste that many kids will refuse.
Pregnancy and Toothache
Toothaches during pregnancy are common because hormonal changes increase the risk of gum inflammation. Managing them at home is trickier because some drugs carry risks. Acetaminophen has long been considered the safest over-the-counter pain reliever during pregnancy. Ibuprofen is generally avoided in the third trimester because it can affect fetal circulation, though it may be used earlier in pregnancy under medical guidance. Salt water rinses and cold compresses are safe throughout pregnancy. If you are pregnant and dealing with a toothache, calling your obstetrician or midwife before reaching for anything beyond acetaminophen is a reasonable precaution.
When Home Remedies Are Not Enough
Everything above is a bridge to professional treatment, not a substitute for it. A toothache that persists beyond a day or two, worsens despite medication, or comes with swelling in the face or jaw needs a dentist. Certain warning signs mean you should seek care urgently rather than waiting for a routine appointment:
- Facial swelling: Puffiness or hardness in the cheek, under the jaw, or around the eye on the affected side can indicate a spreading infection.
- Fever: A temperature over 101°F (38.3°C) alongside dental pain suggests the infection may be entering the bloodstream.
- Difficulty swallowing: If pharyngeal swelling becomes severe enough that you cannot swallow liquids or control your saliva, that signals a possible airway issue and is a medical emergency.18Emergency Medicine Clinics of North America. THE SWOLLEN FACE: Severe Odontogenic Infections
- Trouble breathing or sleeping flat: Difficulty lying down because of throat tightness is another indicator that swelling may be approaching the airway.
- Pain unresponsive to medication: If a full dose of ibuprofen plus acetaminophen barely touches the pain, the inflammation is likely beyond what home management can reach.
Dental infections can become dangerous faster than most people expect. An untreated abscess can spread into the deep tissue spaces of the neck within days, and once that happens, treatment shifts from a dentist’s chair to a hospital operating room. Do not let a fear of dental costs or a dislike of dental visits lead you to rely on home remedies longer than necessary.
Why Toothaches Hurt So Much
Teeth contain living tissue, and the nerve-rich pulp at the center of each tooth sits inside a rigid shell that cannot expand when inflammation occurs. Two distinct types of pain arise from the dental pulp: sensitivity, which is a quick sharp reaction to things like cold or touch, and inflammatory pain, which is the deeper, throbbing ache that tends to linger or wake you up at night. These two types of pain are carried by different nerve fibers with different characteristics, which is why a toothache can sometimes feel like two separate problems.19Australian Endodontic Journal. Pulp microenvironment and mechanisms of pain arising from the dental pulp: From an endodontic perspective The confined space means even mild swelling inside the tooth creates significant pressure on the nerve, which is why toothache pain is often described as among the most intense everyday pains people experience.
Understanding the dual nature of the pain also explains why a combination approach works better than any single remedy. Ibuprofen tackles the inflammatory component. Acetaminophen dampens the central pain signaling. A topical numbing agent like eugenol or benzocaine addresses the sensitivity component at the nerve endings. Cold reduces swelling-related pressure. No single intervention hits all of these pathways at once, which is why layering several safe measures tends to provide the best relief while you wait for professional care.
Traditional Plant Remedies Around the World
The impulse to treat a toothache with whatever is available goes back centuries and crosses every culture. In parts of Mexico, where dental caries affect close to 97 percent of the population over age 40, traditional practices include chewing tree bark to reduce inflammation, packing plant-based fillings into cavities, and using root extracts from plants like chicalote (a type of prickly poppy) as a local anesthetic.20Pharmaceutical Biology. Use of traditional herbal medicine as an alternative in dental treatment in Mexican dentistry: a review Many of these plants contain alkaloids or phenolic compounds that have genuine pharmacological activity, which is how clove oil became a standard dental material in the first place. The gap between folk remedy and evidence-based treatment is not always as wide as it seems; sometimes it is mainly a question of dosing, standardization, and knowing which part of the plant actually works. But plenty of traditional remedies have no effect at all, or carry real risks, which is why the field keeps trying to sort the useful ones from the rest.