Toothache can occur due to many reasons. Gum diseases, cracks developed in teeth or an abscess can cause pain. It is not a safe practice to take over the counter (OTC) pills without understanding the cause of a toothache. As toothache medications may cause side effects, you need to take OTC pills that are safe to take. It becomes essential to know the drug interactions with medications that may be already taking.

The most logical thing to do if you have a toothache is to seek medical advice from a dentist. Your dentist may first assess the cause behind the toothache. If it is due to an abscess (formation of pus) triggered by an injury or infection, your dentist may either administer antibiotics or drain the abscess. Antibiotics are prescribed only when the infection is acute and is also spreading fast. Usually, antibiotics belonging to a class of medications called penicillin are administered. For some specific infections, azole class of medications (for example – metronidazole) are prescribed.

However, you may at times need to take medications till you get to meet a dentist. In such instances, you may need to treat the toothache with over the counter (OTC) pills. Swift intake to OTC pills for toothache may arrest further spread of microbes (if your condition is due to a bacterial attack). The most widely used OTC pills for toothache are acetaminophen and ibuprofen.


This OTC pill for toothache belongs to a class of medications called pain relieving drugs. Apart from toothache, it is also used for a variety of medical conditions. These include pain in joints, headache, backache, etc. This drug is also taken to reduce fever. An excessive dose of acetaminophen though can impair the function of liver. For adolescents and adults – weighing at least 112 pounds, the daily dose of acetaminophen cannot exceed 4000 milligrams. None of the single doses can be more than 1000 milligrams. For children, doses of acetaminophen are restricted by weight and age of your child. For children aged between 2 and 12 years, its dose is in the range of 12.5 milligram per kg of body weight. In no instance can children be administered doses more than what is generally considered as safe – i.e., a maximum of 3750 milligrams per day – or as prescribed on this drug’s label.

Common side effects of consuming acetaminophen are drowsiness, swelling of skin, difficulties in focusing on things, drop in one’s ability to stay concentrated, rashes on skin, etc. Some very rare adverse effects include low count of platelet and drop in the count of other blood cells (i.e., white and red blood cells). If you sense any of these signs, you are advised to take needful advice from a qualified medical practitioner.

It is not safe to administer this medicine to children aged less than 2 years. For children aged between 2 and 12 years, co-administration of acetaminophen with cold and cough medications needs to be done with utmost care. It is always recommended to take proper medical help if children are to be administered with such combinatorial treatment.

If you develop rashes on your skin or if you feel nauseated, you need to talk to a dentist or a qualified medical professional. Acetaminophen is not administered to women who are pregnant. Also, the drug runs the risk of getting passed through breast milk. You are hence advised to talk to your doctor if you are breastfeeding a baby.

If you have a medical history of liver or hepatic disorders such as cirrhosis (a condition triggered by excessive intake of alcohol), you are advised not to take this drug. Also, if you drink sizable amount of alcohol every day (say, more than 2 or 3 drinks per day), it is not safe to take this drug. Also, keep your pharmacist or the treating doctor informed if you are taking blood thinning drugs (also called as anticoagulants) such as warfarin. Let your pharmacist know if you are consuming anticonvulsants (like phenobarbital, carbamazepine, etc.), dapsone (topical variant), drugs administered onto women in their pre-menopause stage (like flibanserin, etc.). It is extremely important to keep the drug out of reach of children. There are no risks of substance abuse associated with this drug. But, if you suspect a likely overdose of acetaminophen, contact a poison control center or a local hospital setting without any delay.


This is a popular OTC pill taken to decrease pain caused by toothache, abdominal cramps (especially during menstrual cycles), headache and muscular cramps. It belongs to a class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). Its main function is to reduce pain and inflammation. It is also used for the treatment of fever. It works by controlling and stopping the substances that may cause inflammation in the body.

While using this drug as an over the counter (OTC) medication, you are advised to read all the instructions with needful caution. The right dose is often a factor of your body’s response system as well as your medical condition. If taken in excessive doses, it can significantly increase the risks of internal bleeding. Hence, you are advised to take this drug at an optimal dosage level and for a lesser span of time. For children, this drug is given based on their body weight. Hence, you are advised to take needful inputs from your pharmacist while taking it through the OTC route.

Common side effects of ibuprofen are inability to pass stools, headache, drowsiness, vomiting, etc. Ibuprofen may increase your blood pressure. Hence you need to check for any spikes in blood pressure or other symptoms associated with hypertension. You need to inform your pharmacist or a medical professional, if you develop serious side effects such as blurring of eyesight, mood swings, weariness, signs of cardiac dysfunction (gain of body weight, swelling of feet or ankles) as well as symptoms of renal disorders (such as an altered output of urine, etc.).

As a very remote occurrence, this drug may at times cause serious liver / hepatic disorders. So, if you spot signs such as a drop in appetite, yellowing of skin or eyes, dizziness, vomiting, dark colored urine, etc., you are advised to inform a doctor without any delay. Also, if you have any known allergies or hypersensitivity to NSAIDs like celecoxib, naproxen, etc. or drugs like aspirin, you need to inform your pharmacist.

You also need to tell your pharmacist if you have prior medical conditions such as hypertension, liver related health problems, gastrointestinal problems like ulcers, etc. You are advised to drink a lot of fluids or water while using this OTC pill. It is essential because dehydration can trigger renal problems as well as cardiac ailments. Though this drug may pass through mother’s milk, it is widely known to cause no serious problems to the baby. However, you are advised to take needful inputs from your pharmacist or a qualified medical practitioner if you are nursing a baby.

In general, decay of tooth is widely considered as a leading cause for toothache. It is the decay of teeth – once left untreated – that soon becomes a cavity. Once a cavity is formed, it means bacteria had gained access through your tooth’s enamel and have reached the inner parts of your tooth. When the nerves associated with your tooth are attacked, you may start experiencing pain in the tooth.

Infections in the sinus are also capable of causing toothache. Other reasons for a toothache are food getting stuck in between your gums or teeth, eruption of your wisdom tooth, loss of a tooth filling, etc. You may notice toothache often shows up at night times in very acute levels. This is because of your sleeping posture; more blood may reach your head when you are resting. It is this additional supply of blood that adds to the pressure and worsens your toothache. There is also a psychological reason for suffering from toothache during night times; you may have very minimal things to do or focus upon while you are trying to sleep i.e., your bedtime. So, with nothing much to do and with a pain gnawing your tooth, the toothache only gets acute or more severe.

You are advised to take a few other precautions before you get to see your dentist. Some of the good practices are (1) saying no to excessively cold or hot foods, (2) rinsing your mouth with salt solution (salt added to warm water), (3) opting to use a softer brush to clean your teeth and (4) chewing foods with teeth on the other side (i.e., without disturbing the painful tooth or teeth).

Most of the home remedies and pain management approaches listed above may yield temporary relief. You are advised to consult your dentist immediately if are experiencing toothache in the nights. If you experience symptoms of infections along with toothache, you may need to take antibiotics to arrest microbial attacks. But if the toothache is mainly due to an abscessed or broken tooth, your dentist can get a permanent cure for such pains. You are advised not to leave a toothache to remain untreated for long. In most cases, ignoring a toothache can lead to acute medical conditions such as a severe gum related disease, loss of tooth and other such complications.


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