Severe Toothache Pain Relief

WARNING: BEFORE USING ANY MEDICATIONS YOU SHOULD CHECK WITH YOUR MEDICAL GP IF YOU ARE ABLE TO USE THEM. ALWAYS READ THE LABEL AND NEVER EXCEED THE MAXIMUM DAILY DOSE OF EACH MEDICATION. THE FOLLOWING REGIMEN IS SUITABLE FOR ADULTS ONLY AND SHOULD NOT BE USED FOR CHILDREN.

A severe toothache can be debilitating. It can interrupt your sleep and prevent you from doing your day to day activities. In most cases severe toothaches are caused by inflammation which leads to a build-up of pressure within the tooth or surrounding tissues. It is important to understand that pain medications do not remove the source of the pain but only block the pain sensation for a short period.

The most predictable method to relieve a severe toothache is to see your dentist who will directly treat the offending tooth and in most cases provide instant relief. If you are unable to see a dentist immediately, there are some powerful over-the-counter medications you can use obtain relief for a short period. In this blog we will discuss an evidence based combination of paracetamol (Panadol) and Ibuprofen (Nurofen) which has been shown to be superior to even some prescription medications in alleviating the symptoms of a severe toothache (1,2,3).

Can I take Panadol and Nurofen?

Before taking any medications it is important that you check with your medical GP if you are able to use them. Most people are able to use paracetamol as there are generally few side effects. Nurofen is also generally well tolerated however some medical conditions (eg asthma, peptic ulcer disease) and pregnancy may mean you need to avoid this medication. Also some medications can interact with Panadol and Nurofen and as such you will need to avoid these pain medications.

Combining Panadol and Nurofen:

It is recommended that both Panadol and Nurofen be taken every 4-6 hours up to the maximum doses. However, taking these medications every 4-6 hours will often mean that the pain relief will wear off towards the end of the 4 hour period. A more effective pain management strategy is to alternate between 200mg of Nurofen and 1000mg of Panadol every 2 hours up to the maximum daily dose for each medication. This provides continual pain relief, an example of this strategy is shown on the diagram below:

Pain management diagram

Correct alternating use of these medications will often provide effective relief from the symptoms of a toothache until you are able to see your dentist.

Dr Michael Russo (BCom BDent)

1. Oral and Dental Expert Group. Therapeutic guidelines: oral and dental. Version 2. Melbourne: Therapeutic Guidelines Limited; 2012.

2. Hargreaves K, Abbott PV. Drugs for pain management in dentistry. Aust Dent J 2005;50(4 Suppl 2):S14-22

3. Hargreaves KM, Keiser K. Development of new pain management strategies. J Dent Educ 2002;66(1):113-21.