There is no pain like tooth pain. Since oral pain can be so severe, patients often ask if over the counter remedies can offer relief. Ibuprofen can help in many cases, but it is important to know how it can offer the best relief and when to see a dentist for further treatment. 

Why Dentists Recommend Ibuprofen for Oral Pain

Ibuprofen is often a dentist’s first choice for over the counter relief. It is a non-steroid anti-inflammatory drug (NSAID), so it helps by reducing the inflammation that presses on nerves. And Ibuprofen does not have the adverse effects that opioids do, such as dizziness, drowsiness, nausea, and addiction. In most mild to moderate cases of oral pain, ibuprofen offers sufficient relief.

For severe pain, ibuprofen alone may not be enough. According to a 2018 study in the Journal of the American Dental Association, acetaminophen by itself does not alleviate oral pain since it is not an NSAID, but combining acetaminophen with ibuprofen can offer stronger relief than prescription opioids. For patients in the study who were being treated for postoperative oral pain, taking 600 mg of ibuprofen was the most effective solution for up to 6 hours of relief. The next best treatment was alternating 400 mg of ibuprofen with 1,000 mg of acetaminophen. Dental experts agree that to keep inflammation suppressed and stay on top of pain, it’s best to alternate ibuprofen with acetaminophen every four hours.

While some dentists do prescribe opioids for tooth pain, many have become educated about the safer effectiveness of non-opioid alternatives. This is why in a vast majority of cases, ibuprofen or an ibuprofen combination is recommended. 

The Most Common Causes of Tooth Pain

Besides residual pain from oral surgery, patients can experience toothaches for a variety of reasons. The most common are:

Cavities

After bacteria eats away at a tooth’s enamel, it gets into the soft layer underneath called dentin. Dentin is close to nerves, so patients are likely to feel:

• Sensitivity while chewing or drinking cold liquids 
• Pain while chewing

Ibuprofen can usually offer temporary relief for cavity pain, but it’s important to have cavities filled before an abscess forms. 

Abscessed Tooth

If cavities go untreated, bacteria can make it all the way into the tooth’s pulp. An infection called pulpitis can settle in, leading to bacterial fluid (pus) in the gums called an abscess. Symptoms include:

• Severe throbbing, pounding, or burning pain that can sometimes radiate to the jaw
• Swelling in the gums or face
• Nausea and fever

Abscess pain can be so severe that ibuprofen does not help. A dentist may recommend a prescription painkiller until treatment can take place, and an antibiotic to prevent the infection from spreading.

Gum Disease 

Periodontitis, also known as gum disease, is usually the result of poor dental hygiene. It does not cause a lot of oral pain in the early stages, but as it progresses patients may experience:

• Redness, swelling, and bleeding of the gums
• Recession, in which gums start to pull away from the teeth
• Infection in the gums where food has settled in

Pain and tenderness in the gums will vary based on the severity of disease. Over the counter pain relievers may help in minor cases, but are not as effective in advanced cases.

Wisdom Teeth Crowning or Overcrowding

In patients in their late teens and early 20s, oral pain can occur towards the back of the mouth as wisdom teeth erupt. Sometimes, small white specks will emerge from the gums to reveal that new teeth are coming in. Other symptoms include:

• Redness, swelling, and irritation in the gums behind the second molars
• A dull ache near the back of the jaw that feels like pressure
• Pain that radiates around the ears and jaw  

Because of the swelling that can occur when wisdom teeth erupt, Advil or Motrin is a good option for reducing gum inflammation. But once a dentist has discovered that wisdom teeth are the cause for oral pain, he or she should discuss whether surgery should be scheduled to remove the teeth. 

Pain After a Filling

When numbness wears off after getting a filling, it is normal to feel some sensitivity. But if pain persists, the tooth could be in worse condition than originally expected or another issue could be present. 

• Pain and sensitivity next to the tooth could indicate there is another cavity nearby 
• A zinging pain could mean the cavity extends deeper than the filling and may require a root canal or extraction.
• Intense pain near the filling, although rare, could mean a nearby tooth was cracked during the procedure. 

If patients feel pain after a filling, they can try taking Ibuprofen for relief. However, it is extremely important to contact the dentist so the problem can be fixed.

Why Some Patients Should Avoid Ibuprofen

Patients who are taking medications for other health conditions should not take Ibuprofen for oral pain. Non-steroidal anti-inflammatory drugs, aspirin and naproxen can thin the blood, so it’s important to speak to a doctor about alternative relief if:

• Taking a prescription blood-thinner like Warfarin
• Taking a prescription diuretic
• At high risk for stomach bleeding or gastrointestinal problems  
• Diagnosed with high blood pressure, cirrhosis of the liver, or kidney disease 

A doctor may recommend acetaminophen to dull the pain, in combination with an oral analgesic to numb it. 

When to See a Dentist for Tooth Pain

Even though Ibuprofen can offer effective relief, it is meant to be a temporary solution. Unless the pain goes away on its own after a day or two, a dentist needs to perform an exam to evaluate what is causing the pain. Prompt treatment can prevent the pain from getting much worse and treat an infection before it spreads to other teeth. 

While waiting to be seen by a dentist, patients can try natural remedies to ease the pain, such as:. 

• Placing a cold compress at the swollen site every 20 minutes for several hours
• Swishing with warm salt water to clean the inflamed area and loosen debris
• Sleeping with the head elevated to reduce blood pooling and inflammation

If you have any dental concerns and you don’t already have a regular dentist, use Dental Health Society’s convenient online locator tool to find a dentist near you.