Medically reviewed guide · Last updated: 23 June 2026 · Reading time: approx. 9 min

Toothache: quick relief, the right painkiller and when it is an emergency

Quick relief at a glance

  • Cool the cheek from outside with a cold pack in a cloth, in intervals. Never apply heat, as heat worsens an inflammation.
  • If needed, an anti-inflammatory painkiller: for toothache ibuprofen is usually the better choice than paracetamol.
  • Rinse with lukewarm salt water, keep brushing carefully and remove trapped food.
  • Keep your upper body raised, do not lie flat. Avoid alcohol, nicotine and very hot, cold or sweet foods.
  • Important: painkillers only bridge the time. The cause must be treated by a dentist, so make an appointment promptly.

Toothache often comes suddenly and at the most awkward moment, and it can make it hard to think about anything else. The most important message first: you do not have to endure the pain, and there is effective quick relief. Just as important, though, is that painkillers and home remedies only bridge the time until the dentist. The actual cause, whether a cavity, an inflammation or an abscess, remains and needs to be treated. This guide shows you what helps now, which painkiller makes sense, what the type of pain reveals and when toothache becomes an emergency.

Quick relief: what you can do now

The following measures are well supported and noticeably ease acute toothache until you get dental help.

  • Cool, do not heat: Place a cold pack wrapped in a cloth on the cheek from outside, about 15 minutes, then a break. The cold reduces the blood flow in the inflamed tissue and eases pain and swelling. Heat, on the other hand, would worsen an inflammation and promote its spread.
  • Rinse with salt water: Dissolve half a teaspoon of salt in a glass of lukewarm water and rinse gently. This cleans and can reduce bacteria. Many also find rinses with sage or chamomile soothing.
  • Keep it clean carefully: Keep brushing the painful area too, but gently with a soft brush. Trapped food, for example between tooth and gum, can itself cause strong pain and can be removed with floss.
  • Raise the upper body: Do not lie flat, but prop your head up. When lying down, the pressure in the inflamed tissue rises, which intensifies the pain, especially at night.
  • Avoid irritants: Avoid alcohol and cigarettes as well as very hot, very cold or sweet foods and drinks. Strong physical exertion also drives up blood pressure and with it the pain.
  • Home remedies in moderation: Chewing a clove or a little clove oil on the painful spot has a mild numbing effect and is a well-known home remedy. But it does not replace treatment.
  • Numbing dental gel: Pharmacies offer gels with a local anaesthetic that you can apply specifically to the painful gum. They ease the pain in the short term, especially with localised pain, until you can get to the practice.

Keep track of your painkillers

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Painkillers: ibuprofen before paracetamol

For toothache it pays to look closely at the right remedy, because not every one works equally well. Toothache almost always arises from an inflammation, for example of the tooth nerve or the gum. That is why a remedy makes sense that not only dampens the pain but also the inflammation.

Remedy When it makes sense What to watch
Ibuprofen (anti-inflammatory, NSAID) Usually the first choice for toothache, as it dampens pain and inflammation and often works within 20 to 30 minutes Not on an empty stomach; caution with stomach, kidney or heart problems, asthma and in late pregnancy
Paracetamol Alternative when ibuprofen is not suitable, for example with a sensitive stomach or in pregnancy Not anti-inflammatory and usually weaker; respect the daily maximum dose as it can strain the liver
Acetylsalicylic acid (aspirin) Better avoided for toothache Inhibits blood clotting and can lead to stronger bleeding during treatment; never place it on the tooth or gum

In short: for toothache ibuprofen is usually the better choice than paracetamol, because it also treats the inflammation. Paracetamol is the alternative when anti-inflammatories are not an option. A combination of both substances can work more strongly but should only be used after medical or dental advice. Important in any case: use painkillers at a low dose and only for a short time, follow the package leaflet and do not combine substances on your own. Read more on effect and caution on our page about ibuprofen.

Home remedies put to the test

Many home remedies circulate around toothache. Some actually help, others are ineffective or even harmful. Sensible options are cooling the cheek from outside, a rinse with lukewarm salt water and mild rinses with sage or chamomile. A clove or a little clove oil on the painful spot also has a mild numbing effect. Keep away, however, from the old myth of placing an aspirin tablet on the tooth, because the acid burns the gum. Heat, hot compresses or strong alcohol on the tooth also do more harm than good, because they fuel the inflammation or irritate the tissue. All home remedies have one thing in common: they ease the pain at most temporarily and do not replace dental treatment.

Pain character: what the pain reveals

The type of toothache often gives first clues about the cause. This does not replace a diagnosis, but it helps you classify what is happening and judge the urgency better.

Pain character Possible cause Typical clue
Brief and sharp with cold, sweet or sour Cavity or exposed, sensitive tooth necks Disappears once the stimulus is gone
Throbbing and persistent, worse at night and with heat Inflammation of the tooth nerve (pulpitis) Comes on its own too, can radiate
Pressure and pain on biting, often with swelling Pus at the root tip or an abscess Tooth feels longer, tapping hurts
Dull, with bleeding gums Gum inflammation or periodontitis Often with bad breath, teeth can become loose
Pain far back with a stiff jaw Erupting or inflamed wisdom tooth Opening the mouth is difficult, swelling possible
Pressure in the upper back teeth, worse when bending Inflammation of the maxillary sinus, not real toothache Often several upper teeth at once, with a cold

Common causes are therefore cavities, an inflammation of the tooth nerve, an abscess, a gum inflammation or periodontitis, exposed tooth necks, wisdom teeth, cracks or defective fillings and nighttime grinding. Read more about gum disease in our article on periodontitis. If the pain radiates into the head or comes from tension, our article on headaches can help.

The most common causes in detail

If you want to know more precisely, here are the main triggers briefly explained.

  • Cavities: Bacteria dissolve the enamel and advance into the softer dentin. At first there is only a sensitivity to cold or sweet. Once the cavity reaches the nerve, the pain becomes stronger and persistent. Treatment is usually a filling, with a deep cavity a root canal treatment.
  • Inflammation of the tooth nerve (pulpitis): If the pulp is irritated or inflamed, a throbbing, often spontaneous pain arises that worsens at night and with heat. A mild irritation can settle, a strong inflammation usually requires a root canal treatment.
  • Abscess and root tip infection: If bacteria and pus collect at the root tip, a pressure and biting pain arises, often with swelling and sometimes fever. This needs prompt treatment, and swelling is always a warning sign.
  • Gum and tooth bed: A gum inflammation or periodontitis shows up through bleeding gums, dull pain and, over time, loose teeth.
  • Wisdom teeth: If they break through or become inflamed, it hurts far back in the jaw, often with swelling and difficulty opening the mouth.
  • Grinding (bruxism): Nighttime clenching and grinding leads to morning pressure or biting pain and a tense jaw. A bite splint often helps here.

Emergency: when to act immediately

Act immediately if

the cheek swells heavily or the swelling spreads toward the eye, the floor of the mouth or the throat, if difficulty swallowing or breathing occurs, with high fever and swelling or after a dental accident with a knocked-out or broken tooth. A spreading dental infection can become dangerous. With shortness of breath or trouble swallowing, call emergency services. Outside opening hours the dental emergency service helps. Do not clean a knocked-out tooth, but store it in a tooth-rescue box or in cold milk and bring it to the dentist immediately.

These emergencies are rare but important. Most toothache can be bridged well with quick relief and treated at the root in a dental practice. The key is not to wait too long, because untreated, a small problem often becomes a bigger one.

What happens at the dentist

The treatment depends on the cause. For a cavity a filling is often enough, for a deep cavity or an inflammation of the tooth nerve a root canal treatment is needed. An abscess is opened and relieved, sometimes complemented by an antibiotic. With periodontitis the thorough cleaning of the tooth bed is the focus, and with inflamed wisdom teeth removal is an option depending on their position. Against nighttime grinding a bite splint helps. In almost all cases: the earlier the cause is treated, the simpler, gentler and cheaper it is.

Even without a clear emergency sign, you should see a dental practice if the pain lasts longer than one to two days, keeps coming back, or comes with a lasting sensitivity or bleeding gums. Even if the painkiller eases the symptoms temporarily, the cause does not disappear on its own. A prompt appointment often saves you a more involved treatment later. Outside regular opening hours, for example at the weekend, the dental emergency service helps, whose number you can find through a search for your region or the dental association.

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Your painkillers, safely in view

So that you do not lose track of dose and intervals during acute pain: brite helps you manage your remedies, get reminders to take them and check interactions.

  • Digital medication plan, always up to date
  • Reminder to take and on intervals between doses
  • Interaction check, for example for ibuprofen with other remedies
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Toothache in pregnancy and in children

In pregnancy a different order applies to the choice of painkiller: here paracetamol is the remedy of choice, while ibuprofen should only be used to a limited extent and especially not in the last third of pregnancy. When in doubt, talking to a doctor, dentist or pharmacy helps. Important: dental treatment is well possible during pregnancy, including local anaesthesia, and should not be postponed if needed, as untreated inflammations can also harm the expectant mother.

For children, ibuprofen or paracetamol syrups are suitable, strictly according to the dose given for age and weight. Aspirin is off limits for children. In addition, gentle cooling from outside and careful oral care help. Even if the pain eases, the child should be seen promptly at a dental or paediatric dental practice to find the cause and avoid follow-on damage to the permanent teeth.

How to prevent toothache

Most toothache can be avoided through good prevention. Brush your teeth twice a day with fluoride toothpaste and clean between the teeth once a day with floss or interdental brushes. A diet low in sugar and acid protects the enamel. Regular check-ups and a professional cleaning detect problems early, before they become painful. Anyone who grinds at night should talk about a bite splint. These small habits are the best and cheapest protection against the next toothache. Anyone who applies them consistently saves not only pain in the long run, but often also involved and expensive treatments.

The bottom line: with toothache, the right quick relief brings fast easing, above all cooling from outside and the right painkiller, where ibuprofen is usually the better choice. But dampening the pain is only the first step. The second, treating the cause, is done by the dental practice, and the earlier the better. Anyone who also pays attention to good oral care and regular check-ups has a good chance that the next toothache will be a long time coming.

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Frequently asked questions about toothache

Cool the cheek from outside with a cold pack wrapped in a cloth, take an anti-inflammatory painkiller such as ibuprofen if needed, rinse with lukewarm salt water and keep your upper body raised rather than lying flat. These measures bridge the time until the dentist but do not fix the cause. So see a dental practice promptly.
For toothache ibuprofen is usually the better choice, because it not only relieves the pain but also dampens the underlying inflammation. Paracetamol is not anti-inflammatory and is rather an alternative when ibuprofen is not tolerated, for example with a sensitive stomach or in pregnancy. Follow the package leaflet and do not combine substances without medical advice.
Brief, sharp pain with cold or sweet points to a cavity or exposed tooth necks. Throbbing, persistent pain that worsens at night and with heat suggests inflammation of the tooth nerve. Pain on biting with swelling can indicate an abscess. Bleeding gums and dull pain fit a gum inflammation.
When lying down, the blood flow in the head area increases, which raises the pressure on inflamed tissue in the tooth. In addition, nothing distracts from the pain at night. It helps to keep the upper body raised and to cool the cheek from outside until the painkiller works or you can get to a dental practice.
With toothache, cold helps, not heat. A cold pack placed on the cheek from outside reduces the blood flow in the inflamed tissue and eases pain and swelling. Heat, on the other hand, can worsen an inflammation and promote its spread, especially with a swollen cheek. So avoid warm compresses and very hot food or drinks.
No. Placing a tablet, especially aspirin, directly on the tooth or gum is a common mistake. The acetylsalicylic acid can burn and damage the gum and leads to stronger bleeding during a later treatment. Painkillers only work if you take them as a tablet.
Get help immediately with a heavily swelling cheek or swelling toward the eye or throat, with difficulty swallowing or breathing, high fever with swelling, or after a dental accident with a knocked-out tooth. A spreading dental infection can become dangerous. Outside opening hours the dental emergency service helps, and with breathing trouble the emergency services.
Yes. An inflammation of the maxillary sinus can cause a pressing pain in the upper back teeth that worsens when bending and is easily misread as toothache. A gum inflammation or periodontitis can also cause pain, often with bleeding gums. The dental practice can assign the cause.
Cool the cheek in intervals, take a suitable painkiller if needed, rinse with salt water and continue brushing carefully to remove trapped food. Avoid alcohol, nicotine and very hot, cold or sweet foods and avoid strong physical exertion. Do not lie flat, but keep your head raised.

Related topics

Sources

  • Deutsche Apotheker Zeitung: Painkillers for toothache, ibuprofen as the first choice. Accessed 2026.
  • gesund.bund.de and Gesundheitsinformation.de (IQWiG): Toothache and periodontitis. Accessed 2026.
  • Patient information from dental practices and professional societies on first aid and emergencies in toothache. Accessed 2026.

This article is for general information and does not replace dental advice, diagnosis or treatment. Information on painkillers is kept general. With strong, persistent toothache or toothache accompanied by swelling and fever, and after an accident, please contact a dental practice, the dental emergency service or, with breathing trouble, the emergency services.