Over-the-counter (OTC) pain medications for tooth pain 

 Key takeaways:

• Ibuprofen, Aspirin, Naproxen, Acetaminophen, and Benzocaine are common over-the-counter (OTC) pain medications used to treat tooth pain. 
• Although easily accessible, you shouldn’t use OTC pain medicines without consulting a qualified medical professional first. 
• Prolonged use or abuse of pain relief medications can lead to serious consequences like kidney problems, liver damage, heart attack, and stroke. 
• You can manage tooth pain at home with a cold compress, a salt water rinse, garlic, and other home remedies. 

A toothache (tooth pain) is pain felt in or around the tooth. It can cause extreme discomfort that can interfere with your daily life. 

Toothaches can be caused by: 

• Tooth decay 
• A cracked tooth
• Impacted wisdom teeth  
• An infection 
• Gum diseases

Sometimes, medical conditions such as heart and lung diseases can cause toothache. This is known as referred pain, i.e., pain felt in an area of the body that is not where the problem is. 

Here are common over-the-counter (OTC) medications you can use to manage tooth pain. 

 1. Ibuprofen

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that is commonly used in the treatment of tooth pain.

Ibuprofen blocks the action of cyclooxygenase enzymes (COX-1 and COX-2), which are needed to produce prostaglandins — a group of chemicals that cause pain, inflammation, and fever. 

 Ibuprofen drug interactions

While ibuprofen is helpful for relieving different forms of pain in the body, they are not without risks and can cause possible drug interactions. Ibuprofen may interact with certain drugs by increasing or decreasing their effectiveness. These drugs include:

• Blood thinning medications 
• Diabetes medicines 
• High blood pressure medications 
• Antibiotics like Ciprofloxacin 
• Antidepressants 

 Side effects of ibuprofen

Side effects associated with using ibuprofen include:

• Nausea and vomiting 
• Abdominal pain 
• Dizziness 
• Headache 
• Constipation 
• Gastrointestinal bleeding 

 2. Aspirin

Like ibuprofen, aspirin is a non-steroidal anti-inflammatory drug. It reduces pain and inflammation by inhibiting the production of prostaglandins. 

Results from research show that aspirin may help treat dental and sore throat pain.

 Aspirin drug interactions

Aspirin has the same drug interactions as ibuprofen. It can also interact with other NSAIDs like ibuprofen and Naproxen, as well as phenytoin, a drug used to treat epilepsy.

 Side effects of aspirin

It's important to take aspirin as recommended by a healthcare professional to reduce the risk of side effects. Taking aspirin can cause the following side effects: 

• Stomach upset 
• Indigestion 
• Heartburn 
• Drowsiness 
• Bloating 
• Headache
• Loss of appetite
• Yellow eyes and skin 
• Seizures 
• Difficulty breathing  

 3. Naproxen

Naproxen is also a non-steroidal anti-inflammatory drug that works by blocking the synthesis of prostaglandins. 

The drug comes in two forms — regular naproxen and naproxen sodium. Both are the same; the only difference is that the body absorbs naproxen sodium more quickly. 

 Naproxen drug interactions

The drug interactions of Naproxen are similar to those of Ibuprofen. The main difference is that it has a more significant interaction with a drug used in treating autoimmune disorders known as methotrexate.

 Side effects of naproxen

Common side effects of naproxen are:

• Confusion
• Headache
• Ringing in the ears
• Fatigue 
• Depression 
• Excessive thirst 
• Blisters 

 4. Acetaminophen

Acetaminophen, also known as paracetamol, belongs to a class of drugs called analgesics and antipyretics — drugs that reduce pain and fever. 

The exact mechanism of action of acetaminophen is unclear. Experts believe it reduces pain and fever by inhibiting the synthesis of prostaglandins, but in a different way from NSAIDs.

Acetaminophen use tends to cause fewer stomach problems compared to NSAIDs. However, unlike NSAIDs, it doesn’t treat inflammation.

 Acetaminophen drug interactions

No serious adverse drug interactions with the proper therapeutic doses of paracetamol have been observed in humans.

However, considerable controversy exists regarding its potential to increase the anticoagulant effects of warfarin, a blood-thinning medication. Also, because acetaminophen is readily available and affordable, people tend to abuse, self-medicate, and misuse it, but this is wrong. Healthcare professionals have long warned against the overuse of acetaminophen as it can cause severe side effects, including liver damage and even death.

 Acetaminophen side effects

Some common possible side effects of acetaminophen include:

• Diarrhea 
• Insomnia 
• Agitation 
• Rash
• Itching 
• Difficulty breathing or swallowing 

 5. Benzocaine

Benzocaine is a local anesthetic used to relieve mild tooth pain. It usually comes as a cream or gel that numbs the painful area. 

The United States Food and Drug Administration (FDA) advises against the use of benzocaine in children younger than two years because it can cause a rare but potentially fatal condition called methemoglobinemia.

 Benzocaine drug interactions

Benzocaine can cause methemoglobinemia (a disorder that reduces the oxygen-carrying capacity of the blood) when used simultaneously with lidocaine. 

 Side effects of benzocaine

Benzocaine may cause the following:

• Chest pain 
• Lightheadedness
• Allergic reactions, such as rashes
• Methemoglobinemia
• Fast or irregular heartbeat 

 Which is the best over-the-counter drug for tooth pain?

There is no “best” over-the-counter drug for tooth pain. It’s important to consult a dentist or a general practitioner before using any pain medication for toothache. 

A healthcare professional will help you make the right choice after considering the following: 

• The cause of your toothache 
• Any medical condition you may have 
• If you’re currently taking any medication 
• Your lifestyle habits — if you smoke or heavily use alcohol

 Side effects of taking too much pain relief medications

Pain relief medications can have severe adverse effects, especially if you take too much or use them for a prolonged period. 

These side effects include: 

• Liver damage: Pain relief medications like acetaminophen can damage your liver if you exceed the recommended daily dose or use it for long.
• Peptic ulcer disease: Chronic use of NSAIDs can lead to the development of sores (ulcers) in the stomach or duodenum (the first part of the small intestine).
• Heart attack and stroke: According to the FDA, non-aspirin NSAIDs can increase the risk of a heart attack or stroke.
• Kidney problems: Long-term use of NSAIDs can damage your kidneys or lead to acute kidney injury if you take them when you are dehydrated or when your blood pressure is low.

 Home remedies for tooth pain

Before consulting a doctor about tooth pain, you can try some home remedies. These home treatments can also be used as a temporary solution while you wait for a doctor’s appointment. 

Common home remedies for tooth pain include: 

• Cold compress: Cold compress is part of the R.I.C.E. therapy for treating some mild health issues at home. Wrap an ice pack with a towel or cloth and apply it to the painful area for no more than 20 minutes. You can repeat the process after a few hours. Ice decreases blood flow to the site, which can help reduce pain and inflammation. 
• Salt water rinse: Add ½ teaspoon of salt to a cup of warm water and use it to rinse your mouth. Salt water can reduce swelling and boost wound healing.
• Garlic: Grind a fresh clove of garlic and apply it to the affected tooth. Fresh garlic contains a compound called allicin, which has strong antibacterial properties.
• Thyme essential oil: Add a few drops to a cotton ball and press it against the painful tooth. You can also add a drop of the oil to a glass of water to make a mouthwash. Thyme exerts powerful antioxidant and antibacterial effects.
• Clove oil: You can use clove oil like thyme essential oil. Clove oil helps reduce pain and inflammation.
• Aloe vera: The gel from the plant’s leaves can be applied to the painful area of the mouth to soothe toothache. Research has shown that aloe vera can destroy germs responsible for tooth decay and gum disease.
• Peppermint tea bag or oil: Peppermint is a well-known antibacterial and antioxidant. Place a used, warm tea bag against the affected area for several minutes. Alternatively, apply peppermint oil to a cotton ball and hold it against the aching tooth.  

 Can you buy antibiotics over-the-counter for tooth infections?

Antibiotics are medicines used to treat bacterial infections, e.g., amoxicillin. In countries like the United States, you cannot purchase oral antibiotics without a prescription. However, in some other countries, it is possible. Whether it is possible to buy antibiotics over the counter in your country or not, understand that it is wrong to use them if they are not prescribed by a healthcare professional.

If you suspect you have an infected tooth, book an appointment with a dentist. An infection doesn’t go away on its own and requires immediate treatment to prevent it from spreading. 

Signs of a tooth infection are: 

• Fever
• Change in tooth color
• Difficulty opening your mouth
• Swelling of the face, jaw, or gums 
• Sensitivity to hot and cold food or drinks
• A leaking sore on the gums near a tooth 
• Bad breath or a sour taste in your mouth 
• Tooth pain that spreads to your jawbone, neck, or ear 

 When to speak to a dentist about tooth pain

You should speak to your dentist if:

• You’re experiencing a severe toothache 
• Your tooth pain lasts more than two days
• You notice any signs of an infection 

Early treatment of dental problems is key to preventing serious problems and complications that can be life-threatening.