What to Do for a Toothache: Immediate Relief and When to See a Dentist

A toothache can range from a dull ache to severe, throbbing pain that makes it hard to eat, sleep, or concentrate. While home remedies can provide temporary relief, a toothache is your body's signal that something is wrong inside or around the tooth. The most important step is to see a dentist or endodontist to identify the cause and get proper treatment. In the meantime, here is what you can do right now to manage the pain.

7 min readMedically reviewed contentLast updated March 20, 2026

Key Takeaways

  • Over-the-counter ibuprofen (Advil, Motrin) is the most effective non-prescription pain reliever for toothache because it reduces both pain and inflammation.
  • A cold compress applied to the outside of the cheek (20 minutes on, 20 minutes off) helps numb the area and reduce swelling.
  • A warm salt water rinse (half a teaspoon of salt in 8 ounces of warm water) helps clean the area and can temporarily reduce discomfort.
  • Clove oil contains eugenol, a natural anesthetic. A small amount applied with a cotton ball can temporarily numb a sore tooth.
  • A toothache that is severe, lasts more than 1 to 2 days, or comes with fever or swelling needs professional care. These may be signs of an infection that requires treatment.
  • Common causes of toothache include cavities, cracked teeth, infected pulp (needing a root canal), gum disease, and abscesses.

Immediate Toothache Relief at Home

These remedies can help manage toothache pain temporarily while you wait to see a dentist. They treat the symptom, not the underlying cause. Professional evaluation is still necessary.

Over-the-Counter Pain Medication

Ibuprofen (Advil, Motrin) is the most effective over-the-counter option for toothache pain. It works as both a pain reliever and an anti-inflammatory, which helps because most toothaches involve inflammation in or around the tooth. A typical adult dose is 200 to 400 mg every 4 to 6 hours as needed. Do not exceed 1,200 mg in 24 hours without medical guidance.

Acetaminophen (Tylenol) is an alternative if you cannot take ibuprofen due to stomach issues, allergies, or other medical reasons. Acetaminophen reduces pain but does not reduce inflammation. For more severe pain, some dentists recommend alternating ibuprofen and acetaminophen every 3 hours (for example, ibuprofen at noon, acetaminophen at 3 PM, ibuprofen at 6 PM). Ask your dentist or pharmacist if this approach is appropriate for you.

Avoid placing aspirin directly on the gum tissue near the aching tooth. This is a common home remedy that can actually burn the gum tissue and cause more damage.

Cold Compress

Wrap an ice pack or a bag of frozen vegetables in a thin towel and hold it against the outside of your cheek near the painful tooth. Apply for 20 minutes, then remove for 20 minutes. Repeat as needed.

Cold constricts blood vessels in the area, which reduces swelling and numbs the nerve endings. This is especially helpful if the toothache involves visible swelling of the face or jaw.

Warm Salt Water Rinse

Dissolve half a teaspoon of table salt in 8 ounces of warm (not hot) water. Gently swish the solution around the painful area for 30 seconds, then spit it out. You can repeat this several times a day.

Salt water helps clean the area around the tooth, reduces bacteria, and can draw out some fluid from inflamed gum tissue. It is a simple, safe remedy that provides mild relief for many types of toothache.

Clove Oil (Eugenol)

Clove oil contains eugenol, a compound with natural anesthetic and antibacterial properties. Dentists have used eugenol-based products for decades. To use clove oil at home, place a small amount on a cotton ball or cotton swab and apply it directly to the painful tooth and surrounding gum. Hold it in place for a few minutes.

The numbing effect is temporary, usually lasting 30 to 60 minutes. Clove oil has a strong taste that some people find unpleasant. Use only a small amount, as too much can irritate the gum tissue. Clove oil is available at most pharmacies.

Other Home Remedies

Peppermint tea bags, placed against the tooth after cooling slightly, may provide mild numbing relief. Hydrogen peroxide rinse (3% diluted with equal parts water) can help reduce bacteria and temporarily ease pain from gum-related toothaches. Spit it out completely; do not swallow.

Elevating your head with an extra pillow when lying down can also help. When you lie flat, blood pools in the head, which can increase throbbing pain. Keeping your head elevated reduces this effect, especially at night.

What to Avoid When You Have a Toothache

Some common instincts can actually make a toothache worse. Avoid these mistakes while managing your pain.

  • Very hot or very cold foods and drinks: Temperature extremes can trigger sharp pain in a tooth with exposed dentin or inflamed pulp.
  • Chewing on the painful side: Biting pressure can aggravate a cracked tooth or inflamed nerve. Chew on the opposite side until you see a dentist.
  • Sugary foods and drinks: Sugar feeds bacteria and can worsen decay-related toothaches.
  • Placing aspirin on the gum: Aspirin is acidic and can cause a chemical burn on soft tissue. Take it orally instead.
  • Ignoring the pain: A toothache that goes away on its own is not necessarily a good sign. The nerve may have died, which means the infection is still present but no longer sending pain signals. This can lead to an abscess.

Common Causes of Toothache

Understanding what might be causing your toothache helps you know how urgent the situation is and which type of dentist to see.

Cavities (Tooth Decay)

Cavities are the most common cause of toothache. When decay eats through the outer enamel and reaches the softer dentin layer underneath, the tooth becomes sensitive to temperature, sweets, and pressure. If the cavity reaches the pulp (the nerve inside the tooth), the pain becomes more intense and constant. A small cavity can be treated with a filling. A deep cavity that has reached the pulp typically requires root canal treatment.

Cracked or Fractured Tooth

A crack in a tooth can cause sharp, intermittent pain when biting or chewing. The pain often comes and goes because the crack opens slightly under pressure and then closes. Cracks can be difficult to see on X-rays. An endodontist can evaluate the tooth with magnification and special tests to determine the extent of the crack and whether the tooth can be saved.

Infected or Inflamed Pulp (Pulpitis)

When the pulp tissue inside a tooth becomes infected or severely inflamed, it causes a deep, throbbing toothache that may keep you awake at night. This type of pain often comes on spontaneously (without any trigger) and may radiate to the ear, temple, or jaw. Pulpitis requires treatment by an endodontist, usually root canal treatment to remove the infected tissue and save the tooth.

Dental Abscess

An abscess is a pocket of pus caused by a bacterial infection. It can form at the tip of the tooth root (periapical abscess) or in the gum tissue alongside the tooth (periodontal abscess). Symptoms include severe, constant pain, swelling, fever, a bad taste in the mouth, and sometimes a visible bump on the gum. A dental abscess requires professional treatment. Antibiotics alone will not resolve it; the source of the infection must be treated.

Gum Disease

Advanced gum disease (periodontitis) can cause aching, soreness, or throbbing in the gums and teeth. As the gum tissue pulls away from the teeth and bone is lost, teeth may become loose and sensitive. A periodontist specializes in treating gum disease and can help stabilize the teeth and tissue.

When a Toothache Means You Need a Root Canal

Not every toothache requires a root canal, but certain symptoms strongly suggest the pulp inside the tooth is damaged or infected. If you experience any of the following, schedule an appointment with an endodontist.

  • Severe, throbbing pain that does not respond to over-the-counter pain medication
  • Pain that wakes you up at night or comes on without any trigger
  • Prolonged sensitivity to hot or cold that lingers for more than 30 seconds after the stimulus is removed
  • Pain when biting or pressing on the tooth
  • Swelling in the gum near the tooth, especially if the swelling is spreading
  • A darkened or discolored tooth compared to the teeth around it
  • A small bump (fistula) on the gum that may ooze pus

When to Go to the Emergency Room

Most toothaches are treated by a dentist or endodontist, not an emergency room. However, go to the ER if you have swelling that is spreading to the eye, throat, or floor of the mouth; difficulty breathing or swallowing; a fever above 101 degrees Fahrenheit (38.3 degrees Celsius) with facial swelling; or uncontrollable bleeding.

These symptoms can indicate a serious infection that needs immediate medical attention. The ER can provide antibiotics and pain management, but you will still need to follow up with a dentist or endodontist for definitive treatment of the tooth.

Find an Endodontist Near You

Every endodontist on My Specialty Dentist has verified specialty credentials. If your toothache suggests a root canal or infected tooth, search by location to find an endodontist who can diagnose the problem and relieve your pain.

Search Endodontists in Your Area

Frequently Asked Questions

What is the fastest way to stop a toothache?

The fastest home remedy is taking 400 mg of ibuprofen and applying a cold compress to the outside of your cheek for 20 minutes. Ibuprofen reduces both pain and inflammation. For topical relief, apply a small amount of clove oil to the tooth with a cotton ball. These are temporary measures. See a dentist as soon as possible for lasting relief.

Why does my toothache get worse at night?

Toothaches often feel worse at night because lying down increases blood flow to the head, which raises pressure on the inflamed tooth. At night there are also fewer distractions, making you more aware of the pain. Sleeping with your head elevated on an extra pillow and taking ibuprofen before bed can help.

Can a toothache go away on its own?

A toothache may seem to go away, but this does not always mean the problem is resolved. If the nerve inside the tooth dies, the pain may stop even though the infection remains. This can lead to an abscess, which is a more serious infection. If you have had a toothache that suddenly stopped, see a dentist to make sure the underlying cause has been addressed.

How do I know if my toothache is serious?

Signs of a serious toothache include pain that lasts more than 1 to 2 days, swelling in the face or gums, fever, difficulty opening your mouth, or a bad taste from pus draining from the area. Severe, throbbing pain that wakes you at night or does not respond to over-the-counter pain medication also warrants prompt professional care.

Should I go to the ER for a toothache?

Go to the ER if you have facial swelling that is spreading toward your eye or throat, difficulty breathing or swallowing, a high fever with facial swelling, or uncontrolled bleeding. For most toothaches, a dentist or endodontist is the appropriate provider. Many endodontists offer same-day or next-day emergency appointments.

Does a toothache always mean I need a root canal?

No. A toothache can be caused by a cavity, gum disease, a cracked tooth, or even sinus pressure. However, certain symptoms suggest the nerve inside the tooth is damaged: severe throbbing pain, prolonged sensitivity to hot or cold, and pain that comes on spontaneously. An endodontist can determine whether a root canal is needed through diagnostic testing.

Sources

  1. 1.American Dental Association. "Toothache and Dental Emergencies." 2023.
  2. 2.American Association of Endodontists. "Tooth Pain." 2023.
  3. 3.Becker DE. "Pain management: Part 1: Managing acute and postoperative dental pain." Anesth Prog. 2010;57(2):67-79.
  4. 4.Alqareer A, et al. "The effect of clove and benzocaine versus placebo as topical anesthetics." J Dent. 2006;34(10):747-50.
  5. 5.National Institute of Dental and Craniofacial Research. "Tooth Decay." 2023.

Related Articles