What To Do If Painkillers Aren’t Helping Your Toothache

Written, Edited, and Reviewed by Dr David Chen.

If painkillers aren’t working for your toothache, it means the condition is too severe to be treated at home and you need to see a dentist. If even the OTC pain relievers aren’t helping, you should skip the home remedies because those are even less effective.

acetaminophen and ibuprofen

You really gotta see a dentist and we’ll explain why. However, we’ll still give you a couple of tips on what to do in the meantime while you wait for your appointment.

Why painkillers aren’t working for my toothache

Mild tooth pain can be managed at home with OTC painkillers and other home remedies but severe toothaches are not DIY manageable.

If you’re having excruciating tooth pain, the chances of pain relievers working will be close to nil. We’re sorry but that is the cold hard truth and you need to hear it. Sometimes it can be so bad that you can’t even sleep.

The fact that taking pain medication isn’t working for your tooth pain is affirmation that what you have is a severe toothache, not a mild one. There are 3 common dental conditions which can cause enough pain to render painkillers ineffective.

Pulpitis that is irreversible is when the inflamed pulp can no longer recover back to a healthy state. The most notable symptom is severe tooth nerve pain that can even prevent you from getting a wink of sleep.

Since the tooth nerve can no longer revert back to a normal state, it requires permanent treatment. That involves a root canal which removes the unhealthy nerve from the tooth permanently.

Taking painkillers will do little to relieve the pain because the pulp is already beyond a state of repair. It requires permanent treatment and throwing temporary pain relief at it does nothing for it.

A fractured tooth can cause unbearable pain and this includes external and internal fractures.

  • External fractures: These are very obvious and visible even to the untrained eye. What you may see is a large part of the tooth may be broken off. The worst fractures are the ones where the tooth is broken down to the gum line.
  • Internal fractures: Unfortunately a crack inside of the tooth will be undetectable to the naked eye. These fractures originate from within the tooth. They will even give your dentist a tough time in figuring out that the tooth is cracked. This condition is referred to as the cracked tooth syndrome.

As you can imagine, if your tooth is cracked in half it would be no surprise that it causes excruciating pain. It also will not be repairable at home.

A dental abscess that results in significant facial swelling will be untreatable with OTC painkillers. For an infection of this degree, it will at the minimum require a dental abscess incision and drainage along with antibiotics.

Without those two treatments, you will never get pain relief nor get the swelling to reduce. Did you really think taking some pills will get rid of this condition? Think again.

In summary, these three conditions are nearly immune to pain relievers. If you’ve any one of them, you may be out of luck with trying to manage the pain at home.

It’s time to seek professional help.

See a dentist for permanent pain relief

Toothaches that cannot be relieved with painkillers will need professional treatment by a dentist. If you pay close attention, you’ll notice a commonality among all of these dental procedures which get you out of pain. These treatments are very physical in nature.

  • Root canal. The unhealthy nerve will get physically removed from the tooth. Once its gone, the tooth will no longer be able to feel any pain.
  • Tooth extraction. The entire tooth gets physically removed from the jaw bone. This will eliminate not only the tooth but the nerve inside of it as well.
  • Incision and drainage. An incision will be made into the swollen abscess and then the swelling will get manually drained by your dentist.

The difference between these procedures and taking pain relievers is that they treat the source of your pain. It will permanently get rid of the tooth nerve or infection. The medications on the other hand only attempt to block pain signals but do nothing to treat the source.

Tips on how to relieve a toothache at home

The best thing to do to relieve your toothache is to schedule an appointment with your dentist. Only after you’ve done that you can give our tips a try on how to reduce the tooth pain while you wait for your scheduled appointment.

You may just learn a thing or two that you never knew about. Our pain management strategy here is similar to our how to manage an unbearable toothache protocol.

  1. Take advil dual action. Systemically alleviate the pain by taking this painkiller which combines ibuprofen WITH acetaminophen. When taken together, they work synergistically and provide greater pain relief. It’s the best OTC option.
  2. Use a topical analgesic. Topically alleviate the pain by using a numbing gel like Orajel or Anbesol. This treats the tooth from the surface which is different from a systemic medication that treats it via the bloodstream.
  3. Apply a cold compress. The ice can numb the face and also help reduce swelling.
  4. Rinse with salt water. Keeping the mouth clean is imperative to minimize discomfort. Excessive food and plaque in your mouth typically worsens the pain.
  5. Eliminate irritants. If certain foods or actions that you do make the pain worse, you should strive to avoid doing them.
  6. Elevate your head while sleeping. Sleeping with an extra pillow underneath your head can offer relief. Sometimes when you lie flat, the blood will rush to your head and make the discomfort even worse.
advil dual action - 3 pills
Advil dual action – ibuprofen with acetaminophen

The above are what we would recommend that you do. There are other home remedies that you can use such as essential oils (clove oil, oregano oil, tea tree oil) and etc. However, they’re not as effective as the ones we’ve listed above.


Before we go, we just wish to reiterate that all of these pain alleviating tips are NOT a replacement for treatment by a dentist. These tips only help reduce the discomfort temporarily but do nothing to address the source of your misery.

In other words, go to your dentist appointment!


1311 Jackson Ave
Long Island City, NY 11101

Email Us


Dental Services

If you're in NYC and in need of a dentist, please schedule an appointment with our clinical dental practice, 1311 Jackson Ave Dental.

Our purpose at afterva, is to encourage you to seek in person care with a doctor. It's not meant to be a substitute for medical advice. Each situation is unique and that makes it impossible to diagnose and treat without a clinical exam.

sitemap | privacy policy