Painkillers aren't working for my toothache

Toothache can be debilitating condition. Especially if painkillers don't work.

Painkillers aren't working for my toothache
Viktor Simunović, Viktor Simunović
19 March 2024.

There are several reasons why a painkiller might not work for a toothache.

Firstly, the severity of the toothache may be too great. If you have a severe infection or abscess, over-the-counter painkillers may not be strong enough to numb the pain. In these cases, visiting a dentist as soon as possible is vital to avoid further complications.

Secondly, painkillers might not influence the source of the toothache. Painkillers block the signals in your nerves that tell your brain you're in pain. However, if the source of the pain is still present, such as an exposed nerve or a cracked tooth, the pain will persist until the issue is addressed.

Finally, individual responses to painkillers can vary. Some people may find that certain painkillers are less effective for them due to their particular body chemistry, metabolism, tolerance levels, or even allergies.

Remember, painkillers should be viewed as a temporary solution to manage pain. To truly resolve the issue, a professional dentist needs to treat the root cause of the toothache.

Conditions that cause painkillers not to work for toothache


Pulpitis, an inflammation of the dental pulp, can often render common painkillers ineffective due to the severity and nature of the toothache it causes. This dental pain can be acute or chronic, usually stemming from an exposed nerve, and may require immediate attention from a dentist.

Pulpitis can occur when tooth decay reaches the innermost layer of the tooth, where the pulp and nerve are located. The inflamed pulp can increase pressure within the tooth, leading to intense pain.

Cracked tooth

Experiencing persistent toothache even after taking painkillers could indicate a cracked tooth, which typically results in more complex pain dynamics than simple tooth decay. When a tooth cracks, the sharp pain you feel is the tooth's response to the pressure of biting down. This pressure disturbs the tooth's pulp, where the nerves and blood vessels are located. As a result, painkillers might not effectively alleviate tooth pain from a cracked tooth.

Dental abscess

A dental abscess, another common cause of severe toothache, can also render painkillers ineffective due to the nature of its underlying infection. This infection, originating in the tooth's pulp, causes a buildup of pus and bacteria, leading to severe pain and discomfort.

Over-the-counter painkillers often cannot penetrate the abscess and alleviate the pain, resulting in persistent toothache.


Caries, commonly known as tooth decay, can significantly contribute to persistent toothaches that seem unresponsive to over-the-counter painkillers. This dental condition occurs when bacteria in your mouth produce acids that erode the tooth's enamel, leading to cavities. The deeper the decay penetrates the tooth's layers, the more severe the pain can be.

Over-the-counter remedies may not alleviate this pain if the decay has reached the dental pulp, the innermost part of the tooth. In such cases, a root canal may be necessary to remove the infected pulp and seal the tooth.


Despite diligent use of over-the-counter painkillers, one might still experience persistent toothache due to a condition known as Pericoronitis. This dental disorder, often associated with the partial eruption or breakthrough of wisdom teeth, triggers an inflammation of the gum tissue, causing unbearable pain.

Pain medications, such as ibuprofen, are typically used as a first-line pain reliever. However, the effectiveness of such painkillers can be limited. This is because Pericoronitis often involves an infection, necessitating antibiotic intervention alongside pain management.


Another common reason for persistent toothache, even after using over-the-counter painkillers, is severe gum disease known as Periodontitis. This condition affects the structures supporting the tooth, causing inflammation, which, if left untreated, could lead to tooth loss.

Since painkillers are not intended to address the root cause of toothaches, they may not be effective if you have Periodontitis. Home remedies, such as rinsing with warm salt water or gently massaging the gum, can help reduce swelling and discomfort. However, these remedies are temporary and do not replace professional dental care.

Referred pain

Referred pain signifies a vital phenomenon in which the pain is felt in an area different from its actual source. This could potentially explain why your toothache persists despite taking painkillers.

For instance, a problem in your jaw or gums could be causing the pain in your tooth. Painkillers may not be effective if they do not target the correct area.

How to relieve tooth pain?

Take OTC oral painkillers

OTC oral painkillers, such as ibuprofen or acetaminophen, can be a first line of defense in managing the discomfort associated with a toothache. These medications work by reducing inflammation and blocking pain signals to the brain. The recommended dosage often provides temporary relief. However, stay within the suggested dose, as overuse can lead to health complications like liver damage or gastrointestinal bleeding.

Rinse with warm salt water

Utilizing the soothing properties of warm salt water, rinsing your mouth can be an effective, easily accessible method for temporary toothache relief. This natural remedy can alleviate discomfort by reducing inflammation and washing away irritants lodged between teeth. The warmth of the water aids in improving circulation, which can expedite the healing process, while the salt serves as a natural antiseptic to prevent infection.

To employ this remedy, dissolve half a teaspoon of salt in one cup of warm water. Rinse your mouth thoroughly for about 30 seconds before spitting it out. Repeat this process every few hours as needed.

Use cold compress

In addition to rinsing with warm salt water, applying a cold compress to the affected area is another effective method for mitigating the discomfort associated with a toothache. The cold temperature can help numb the area, reducing pain and inflammation. This method works by constricting the blood vessels, which slows blood flow to the area, thereby lessening the severity of the pain.

To make a cold compress, wrap a handful of ice cubes in a thin cloth or towel and apply it to the cheek adjacent to the painful tooth. Hold it in place for 15 minutes, then remove it for 15 minutes. Repeat this process as needed. Remember, direct application of ice to the tooth can exacerbate the pain, so make sure it's sufficiently wrapped.

Avoid sudden temperature changes

While applying a cold compress provides temporary relief, maintaining a steady oral temperature is equally important to avoid aggravating your toothache. Sudden temperature changes, either hot or cold, can stimulate the nerves in the affected tooth, leading to sharp, severe pain. This sensitivity is often the result of damaged tooth enamel exposing the tooth's inner layers. Therefore, it is advisable to avoid foods and beverages at extreme temperatures.

Maintain oral hygiene

Maintaining ideal oral hygiene is essential in alleviating toothache pain and preventing further dental complications. Regular brushing using fluoride toothpaste and flossing to remove trapped food debris are fundamental practices. They eradicate plaque buildup, which can lead to cavities, a common cause of toothache.

Furthermore, using an antimicrobial mouthwash can reduce bacteria in the mouth, potentially easing toothaches. Regular dental check-ups also play a key role in maintaining oral health. Dental professionals can detect early signs of tooth decay or other oral health issues that might lead to toothaches.

Clove oil

Beyond routine oral hygiene practices, the use of natural remedies like clove oil can also provide relief from toothache pain. Clove oil contains eugenol, a compound with potent analgesic and antiseptic properties. It numbs the area and reduces inflammation, thereby mitigating tooth pain.

To use clove oil, dab a small amount on a cotton ball and apply it to the affected area. Repeat this process as needed, but stay within the recommended dosage as it may lead to adverse effects.

Manage stress

Managing stress efficiently can greatly alleviate tooth pain, as high stress levels contribute to dental issues such as teeth grinding and gum disease. Stress triggers our body's fight-or-flight response, often resulting in tightened jaw muscles and clenched teeth. Over time, this can lead to toothaches, sensitivity, and even physical damage.

To combat stress, it's essential to incorporate stress management techniques, such as deep breathing exercises, yoga, and meditation, into your daily routine. Maintaining a healthy work-life balance and ensuring enough sleep can also minimize stress levels. If you're struggling with stress management, consider seeking professional help from a psychologist or counselor.

3-3-3 method for tooth pain

The 3-3-3 method for pain is a technique often used in mindfulness and meditation to help manage and reduce the experience of pain. It involves three steps, each lasting three minutes:

  1. For the first three minutes, focus on your pain. Try to identify exactly where it is, how it feels, and any other details that come to mind. Don't judge or try to change the pain. Just observe it.
  2. For the next three minutes, focus on your breath. Feel the sensation of each inhale and exhale, and try to breathe deeply and calmly.
  3. Let your mind wander to pleasant thoughts or memories for the final three minutes. Imagine a place or situation that makes you feel happy and relaxed.

This method can help distract from the pain, reduce its intensity, or even change the way your brain perceives it. It's a form of mindfulness that can be helpful for chronic pain sufferers. However, this is just a coping technique, not a medical treatment substitute. Always consult with a healthcare provider for appropriate pain management strategies.

When to see a dentist?

So, how do you discern the right time to consult a dentist for your toothache? The decision to seek important dental care should not be delayed if your toothache persists for more than two days, is severe, or is accompanied by other symptoms such as fever, earache, or pain upon opening your mouth.

Additionally, if over-the-counter painkillers are ineffective, it's a clear indication that you need a dental intervention. Ignoring these warning signs could lead to worsening conditions, including abscesses or tooth loss.

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