General Information

Toothache is a common dental complaint. Pain may be felt in the affected tooth; however, in some people, the pain may feel like it is coming from your head, sinuses, jaw or ear. Most people describe the pain as throbbing and continuous. Sometimes pain and swelling in the jaw can be a sign of a tooth infection or abscess.

Toothache is usually caused by dental decay, which is in turn caused by acid-producing bacteria in your mouth. These acids break down sugars and attack tooth enamel. The corrosion of tooth enamel can mean exposure of the nerve endings in your teeth, which is why you feel pain. Toothache can also occur because of broken teeth, a lost filling, a recently restored tooth, or due to sinusitis (inflammation of the sinus cavities behind the face).

Typically, you feel toothache when chewing and your teeth may be sensitive to hot or cold food. Depending on the severity, people may also develop bleeding around the tooth or gums. If pain improves, the nerve ending may have died. However, tooth decay does not go away and your tooth will continue decaying unless a dentist treats it. If pain intensifies or there is swelling, the tissues surrounding your tooth could be infected and require treatment.

Although good oral hygiene is important in preventing tooth decay, other reasons, such as hereditary factors and lack of saliva, can also cause it. Saliva helps prevent tooth decay because it neutralises acids and helps clear acids and bacteria from your mouth.

Regular dental check-ups can prevent dental decay and major dental surgery, such as root canal treatments.

See Your Pharmacist or Medical Professional

  • if you have inflammation (redness), abscess or fever
  • if you feel generally unwell
  • if you have a swollen jaw or face
  • if you have an injury caused by trauma, such as a blow to the mouth
  • if you have other symptoms, such as dry eyes and dry mouth
  • if the person with tooth pain is elderly, or a child
  • if you take other medicines that cause a dry mouth
  • if you are pregnant or breastfeeding, as some medicines may not be suitable

Treatment Tips

Tips for healthy teeth and gums:

  • brush your teeth twice daily and gently brush your gums and tongue
  • fluoride in toothpaste and water can help prevent tooth decay
  • dental floss and interdental brushes help reduce tooth decay by removing food and plaque from between your teeth
  • mouthwashes containing antiseptics temporarily lower the number of bacteria in your saliva
  • people with sensitive teeth often have different reactions to toothpastes designed for sensitive teeth, and may have to try a number of products before they find one that suits them
  • use a soft toothbrush to prevent damaging your gums
  • chewing sugar-free gum stimulates saliva production
  • saliva substitute products can help manage dry mouth (Biotene, Hamilton Aquae); check with your pharmacist
  • limit sugary foods and drinks
  • do not smoke
  • visit a dentist regularly (every 6 months)

Treatment Options

  • use temporary pain relief until you visit a dentist
  • do not use aspirin for tooth pain as this can increase the risk of bleeding when your dentist treats you
  • always tell your dentist which pain reliever you have taken before they treat you
  • some pain relievers are not suitable for everyone; check with your pharmacist
  • apply a cold compress against the cheek to reduce swelling
  • avoid very hot or cold foods

Oral pain relievers (analgesics)

[GENERAL SALE]

e.g. paracetamol [smaller packs] (Panadol Tablets/ Mini Caps, Panadol Optizorb Caplets/ Tablets, Panadol Rapid Caplets/ Soluble Tablets, Herron Gold Tablets); paracetamol for children (Panadol Children 7+ Years Soluble Tablets)

[PHARMACY ONLY]
e.g. paracetamol [larger pack sizes] (Panadol, Panamax, Panadol Optizorb Caplets/ Tablets, Panadol Rapid Caplets); paracetamol for children (Panadol Children 3+ Years Chewable Tablets); paracetamol liquid preparations (Dymadon for Babies 1 Month-2 Years, Dymadon for Kids Suspension 2-12 Years, Panadol Children 1 Month-1 Year Baby Drops, Panadol Children 1-5 Years Suspension, Panadol 5-12 Years Suspension, Panamax Elixir)

  • paracetamol is a safe choice for most people but it is important not to take more than recommended
  • paracetamol is an ingredient in many cold and flu remedies, so be careful not to double dose
  • the maximum daily dose for an adult is 4 g (4000 mg), and no more than 1 g (1000 mg) every four hours
  • see manufacturer’s directions for children’s doses (dose by weight for children)

Non-steroidal anti-inflammatory drugs (NSAIDs)

[GENERAL SALE]
e.g. ibuprofen [smaller packs] (Nurofen Tablets/ Caplets/ Liquid Capsules, Nurofen Zavance, Advil Tablets/ Liquid Capsules, Herron Blue Tablets); ibuprofen for children (Nurofen for Children 7+ Years Chewable Capsules)

[PHARMACY ONLY]
e.g. ibuprofen [larger pack sizes] (Advil Liquid Capsules, Nurofen Tablets/ Caplets/ Liquid Capsules, Nurofen Zavance, Rafen); ibuprofen suspension (Advil Pain & Fever Infant Drops, Advil Pain & Fever Relief Oral Suspension, Dimetapp Children’s Pain & Fever Relief Ibuprofen Oral Suspension, Nurofen for Children Baby Drops 3+ Months, Nurofen for Children 3 Months-5 Years, Nurofen for Children 5-12 Years); diclofenac (Voltaren Rapid 12.5); naproxen (Naprogesic)

[PHARMACIST ONLY]
e.g. ibuprofen [higher strength] (Nurofen Zavance 400 Double Strength Tablets, Advil 400 Double Strength Caplets, Advil 12 Hour Extended Release Tablets); diclofenac 25 mg (Voltaren Rapid 25)

[PRESCRIPTION MEDICINE]
e.g. diclofenac, higher strength (Voltaren Rapid 50 mg); celecoxib (Celebrex); ibuprofen, larger pack size (Brufen) and others

  • NSAIDs relieve pain and reduce inflammation (redness)
  • ibuprofen has been recommended for dental pain
  • paracetamol and NSAIDs can be used together as they work differently. They are usually given at different times; see your pharmacist for dosing advice
  • do not use aspirin for tooth pain as it can increase the risk of bleeding when your dentist treats you
  • NSAIDs are not suitable for everyone. Check with your pharmacist before taking NSAIDs if you:
    • have a history of stomach problems, such as ulcers or indigestion
    • have asthma; some people with asthma find their condition is made worse by these types of medicines
    • have kidney problems or a heart condition
    • take other medications (e.g. for blood pressure, arthritis or sports injuries; lithium or warfarin)
    • have an allergy to aspirin or NSAIDs
    • are pregnant or breastfeeding
    • are dehydrated

Sometimes NSAIDs can cause side effects. It is important to take these products with a glass of water and food to minimise heartburn. If you develop indigestion, or unusual or increased bleeding or bruising, stop taking them and talk to your pharmacist.

Combination analgesics

Paracetamol + caffeine

[GENERAL SALE]
e.g. paracetamol and caffeine [smaller packs] (Panadol Extra Caplets, Panadol Extra Optizorb Caplets)

[PHARMACY ONLY]
e.g. paracetamol and caffeine [larger pack sizes] (Panadol Extra Caplets, Panadol Extra Optizorb Caplets)

  • caffeine acts on paracetamol to increase its effectiveness
  • if you have caffeine-containing drinks while taking this medicine, you may experience caffeine-related side effects, including sleeplessness

Paracetamol + ibuprofen

[PHARMACY ONLY]
e.g. paracetamol and ibuprofen [smaller packs] (Nuromol, Combigesic, Ibupane, Maxigesic and Mersynofen)

[PHARMACIST ONLY]
e.g. paracetamol and ibuprofen [larger pack sizes] (Nuromol, Combigesic, Ibupane, Fenmol, Maxigesic and Mersynofen)

  • these products contain two ingredients that relieve pain in different ways
  • try single-ingredient products first, and if these do not give adequate pain relief, then consider trying combination products
  • see the warnings above relating to individual ingredients, particularly for ibuprofen – see  NSAID warnings above
  • be careful with combined paracetamol and ibuprofen products as different brands have different doses, dosing instructions and maximum daily doses, check with your pharmacist
  • don’t take combination analgesics with other single ingredient analgesic products, in case you double up and increase your risk of side effects
  • always follow the directions on the packet and do not take more than the recommended dose

Ibuprofen + codeine

[PRESCRIPTION ONLY]
e.g. packets of 24 or fewer (Nurofen Plus, Panafen Plus)

Paracetamol + codeine

[PRESCRIPTION ONLY]
e.g. packets of 24 or fewer (Codapane Forte, Panadeine);  larger pack sizes (Codalgin Forte, Mersyndol Day Strength, Panadeine Extra, Panamax Co)

Analgesic+ Sedating Antihistamine

[PRESCRIPTION ONLY]
e.g. Mersyndol

  • these medicines are used for moderate pain and contain two or more ingredients that relieve pain in different ways
  • see the warnings above relating to individual ingredients, particularly for ibuprofen
  • codeine reduces perception of your pain by blocking pain signals from nerves in your body
  • products containing codeine may cause constipation
  • products containing a sedating antihistamine can make you drowsy; do not drive when taking them, and avoid alcohol. They may not be appropriate for people with certain medical conditions or taking certain medications
  • always follow the directions on the packet and do not take more than the recommended dose

Topical pain relief

[PHARMACY ONLY]
e.g. local anaesthetic benzocaine (Nyal Toothache Drops); benzocaine + clove oil (Oral-eze Dental Emergency Toothache Medication)

  • apply drops to the affected tooth with a cotton wool swab
  • clove oil is irritating and may damage gum tissue and teeth
  • keep clove oil out of reach of children as it is harmful if swallowed
  • not to be used for longer than 48 hours

More Information

Availability of medicines

  • GENERAL SALE available through pharmacies and possibly other retail outlets.
  • PHARMACY ONLY available for sale through pharmacies only.
  • PHARMACIST ONLY may only be sold by a pharmacist.
  • PRESCRIPTION ONLY available only with a prescription from your doctor or other health professional.

Search myDr for Consumer Medicine Information

Last Reviewed: 14/02/2020

myDr



References

1. NPS Medicinewise. Dose confusion with paracetamol/ibuprofen combinations. 2017; https://www.nps.org.au/news/dose-confusion-with-paracetamol-ibuprofen-combinations. Accessed 10/02/2020.
2. Pharmaceutical Society of Australia. Self Care Fact Card: Dry Mouth V4.0. Accessed 12/02/2020.
3. Therapeutic Guidelines Ltd. eTG - Dry Mouth. 2019. Accessed 12/02/2020.
4. NPS Medicinewise. Consumer Medicine Information: Panadol Extra. 2017; https://www.nps.org.au/medicine-finder/panadol-extra-optizorb-formulation-caplets. Accessed 10/02/2020.
5. Australian Medicines Handbook. Ibuprofen. 2020. Accessed 10/02/2020.
6. Therapeutic Goods Administration. ARTG Search - Toothache. 2020; http://tga-search.clients.funnelback.com/s/search.html?query=&collection=tga-artg. Accessed 12/02/2020.

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