How to Treat Severe Toothache

Severe toothache can make it difficult to eat, concentrate or get a decent night’s sleep. The pain might start as a dull ache before developing into an intense, throbbing sensation. Sometimes it comes on suddenly, without any obvious warning.

When your tooth is hurting badly, the first thing you want to know is how to stop it. Painkillers and simple home remedies can provide temporary relief, but persistent or severe toothache often indicates a dental problem that needs professional treatment.

In this guide, we’ll explain what you can safely take for severe toothache, how much ibuprofen is recommended for adults in the UK, what you can do at home and when it’s important to seek urgent dental care.

How to Stop Severe Toothache

If you’re experiencing severe toothache, there are several things you can try while arranging an appointment with your dentist. These measures may make the pain more manageable, but they won’t necessarily resolve the underlying problem.

1. Take Appropriate Pain Relief

Over-the-counter painkillers such as paracetamol and ibuprofen can help relieve dental pain. Ibuprofen also reduces inflammation, which can be useful when pain is associated with inflamed tissues around a tooth.

Not everyone can take ibuprofen safely, so always check the instructions and speak to a pharmacist if you’re unsure. We’ll explain the usual adult doses and precautions further below.

2. Rinse Your Mouth With Warm Salt Water

A warm salt water rinse is a simple way to keep the mouth clean and may soothe irritated gum tissue.

To prepare a rinse:

• Dissolve half a teaspoon of salt in a glass of warm water.
• Gently rinse your mouth with the solution.
• Spit it out rather than swallowing it.
• Repeat when needed.

Make sure the water is comfortably warm rather than hot. Salt water will not cure an infected tooth or dental abscess, but it may help with temporary discomfort. Young children should not use salt water rinses because they may swallow the solution.

3. Use a Cold Compress

If your cheek feels sore or slightly swollen, try placing a cold compress against the outside of your face. Wrap an ice pack or a bag of frozen peas in a clean towel and apply it for around 10 to 15 minutes at a time, taking breaks between applications.

Never place ice directly against your skin. Avoid using heat on a swollen face, as this may make inflammation worse. Facial swelling should also be assessed promptly by a dentist, particularly if it is increasing.

4. Avoid Foods and Drinks That Trigger Pain

When a tooth is inflamed or damaged, everyday things like drinking tea, eating ice cream or biting into something crunchy can suddenly become painful.

Until you can see a dentist, try to:

• Eat soft foods such as scrambled eggs, yoghurt or mashed potatoes.
• Chew on the opposite side of your mouth.
• Avoid very hot or cold drinks if they trigger sensitivity.
• Limit sugary foods and drinks.
• Avoid hard or crunchy foods that put pressure on the affected tooth.

5. Keep Your Mouth Clean

It’s tempting to avoid brushing altogether when a tooth hurts, but keeping your mouth clean remains important.

Use a soft toothbrush and clean gently around the affected area. If a tooth is particularly painful, avoid aggressive brushing or flossing that makes the discomfort worse.

If something is trapped between your teeth, gentle cleaning may help. Don’t use sharp objects to try to remove it.

6. Try Sleeping With Your Head Slightly Raised

Some people find that toothache becomes more noticeable when they lie down. If this happens, sleeping with an extra pillow to keep your head slightly elevated may help reduce the throbbing sensation.

However, if toothache is keeping you awake, particularly when painkillers aren’t helping, you should seek an urgent dental appointment rather than simply trying to sleep through the pain.

What to Take for Severe Toothache

For most adults, the two main over-the-counter painkillers used for toothache in the UK are paracetamol and ibuprofen.

Both can relieve pain, but they work differently and have different precautions. Choosing the right option depends on your medical history, other medicines you’re taking and whether you have any conditions that make a particular painkiller unsuitable.

Paracetamol for Severe Toothache

Paracetamol can help reduce dental pain and is often suitable for people who cannot take anti-inflammatory medicines such as ibuprofen.

For most adults aged 18 or over, the usual dose is:

• 500mg to 1,000mg per dose.
• At least four hours between doses.
• No more than four 1,000mg doses, or 4,000mg in total, within 24 hours.

These are standard adult doses, not necessarily the right doses for everyone. People weighing under 50kg may need a lower dose, and additional precautions apply to people with liver or kidney problems or certain other medical conditions.

It’s also important to check other medicines you’re taking. Some cold and flu remedies and combination painkillers already contain paracetamol. Taking multiple products containing it can lead to an accidental overdose and serious liver damage.

Ibuprofen for Severe Toothache

Ibuprofen belongs to a group of medicines called non-steroidal anti-inflammatory drugs, or NSAIDs.

Unlike paracetamol, ibuprofen reduces both pain and inflammation. This makes it useful for many types of dental pain, including pain caused by inflammation inside a tooth or in the surrounding tissues.

However, ibuprofen isn’t suitable for everybody. If you have a history of stomach ulcers, certain medical conditions, or take medicines that interact with ibuprofen, you may need a different painkiller.

Can You Take Paracetamol and Ibuprofen Together for Toothache?

Yes. Adults can generally take paracetamol and ibuprofen together when necessary, provided both medicines are suitable for them.

Because they work in different ways, the combination may provide better pain relief than either medicine alone. However, NHS advice is to try them individually first to see whether one is sufficient.

If you use both medicines, follow the instructions for each one separately. You must still respect the minimum interval between doses and the maximum daily amount of each medicine.

Taking more than the recommended dose will not safely solve severe toothache. If pain remains difficult to control, arrange urgent dental care.

How Much Ibuprofen for Severe Toothache?

For most adults aged 18 or over who can safely take ibuprofen, the usual over-the-counter dose for toothache is 200mg to 400mg, up to three times in 24 hours.

According to NHS guidance:

• 200mg tablets: Take one or two tablets per dose, up to three times a day.
• 400mg tablets: Take one tablet per dose, up to three times a day.
• Minimum interval: Leave at least four hours between doses.
• Maximum non-prescription dose: Do not exceed 1,200mg within 24 hours.

Ibuprofen is best taken with or after food to reduce the risk of stomach irritation. Use the lowest effective dose for the shortest possible time, and always follow the instructions on your particular medicine, as some formulations have different dosing directions.

Higher doses may sometimes be prescribed by a clinician for specific circumstances, but you should never increase the dose yourself because your toothache is severe.

Who Should Avoid Ibuprofen?

Ibuprofen may not be suitable if you:

• Have or have previously had a stomach ulcer.
• Have kidney, liver or heart problems.
• Have asthma that is affected by aspirin or other anti-inflammatory medicines.
• Have had an allergic reaction to ibuprofen, aspirin or another NSAID.
• Take blood-thinning medicines such as warfarin.
• Take certain other medicines, including some steroids, antidepressants or blood pressure medicines.
• Are pregnant or trying to become pregnant.

If you’re pregnant, paracetamol is generally the preferred painkiller, but you should seek advice from a pharmacist or healthcare professional. Ibuprofen should normally be avoided during pregnancy unless specifically advised by a clinician.

Do not combine ibuprofen with other NSAIDs such as naproxen or aspirin for pain relief. This can increase the risk of side effects, including stomach bleeding.

Important: The doses above are for adults. Children need age-appropriate medicines and doses. Never give aspirin to anyone under 16 unless a doctor has specifically prescribed it.

What If Ibuprofen or Paracetamol Doesn’t Help Your Toothache?

If you’ve taken an appropriate dose of pain relief and the tooth is still intensely painful, the answer isn’t to keep increasing the amount you’re taking.

Severe dental pain can occur when the nerve inside the tooth is badly inflamed, when an infection develops around the root or when a tooth is cracked. In these situations, over-the-counter medicines may not provide enough relief.

If your toothache is affecting sleep, eating or normal daily activities despite painkillers, seek an emergency dental appointment.

A dentist may be able to relieve the pain by treating the affected tooth, removing damaged or infected tissue, or addressing the cause of the pressure and inflammation.

Will Toothache Ever Go Away on Its Own?

Sometimes toothache settles without treatment, but that doesn’t always mean the tooth is healthy again.

Temporary sensitivity caused by minor irritation may improve once the trigger is removed. However, persistent or severe toothache caused by deep decay, a crack or an infection is unlikely to be permanently resolved without dental treatment.

Why Does Toothache Sometimes Suddenly Stop?

One particularly misleading situation occurs when a tooth has been extremely painful for several days and then suddenly stops hurting.

In some cases, this happens because the nerve tissue inside the tooth has died. Once the nerve is no longer functioning, the original pain may disappear, even though bacteria remain inside the tooth.

The infection can then develop around the tip of the root, sometimes causing an abscess, swelling or pain when biting.

This is why a tooth that stops hurting isn’t necessarily a tooth that has healed.

If the nerve is irreversibly damaged or infected, root canal treatment may be recommended to preserve the natural tooth.

If you’re concerned about the procedure, our article Are Root Canals Bad for You? explains how modern root canal treatment works and addresses some common misconceptions.

How Long Should You Wait Before Seeing a Dentist?

The NHS recommends seeing a dentist if toothache lasts longer than two days. You should seek help sooner if the pain is severe, persistent, interfering with sleep or accompanied by other worrying symptoms.

Don’t wait several days if you’re struggling to manage the pain. Early assessment may also improve the chances of saving a damaged tooth.

Why Is Severe Toothache Worse at Night?

If your tooth seems relatively manageable during the day but starts throbbing as soon as you go to bed, you’re not imagining it.

Toothache can feel worse at night for several reasons. Lying flat can make pressure sensations in an inflamed area more noticeable. There are also fewer distractions when you’re trying to sleep, so it becomes harder to ignore the pain.

Some people experience a dull, persistent ache, while others describe a throbbing sensation that seems to spread towards the ear, temple or jaw.

Night-time toothache doesn’t automatically mean you have an abscess, but severe spontaneous pain can indicate significant inflammation inside the tooth.

If you’re regularly waking up with toothache, arrange a dental examination rather than relying on painkillers every night.

What Causes Severe Throbbing Toothache?

There are several possible causes of severe dental pain. The location, duration and type of pain may offer clues, but a proper diagnosis usually requires a dental examination and sometimes X-rays.

Deep Tooth Decay

Tooth decay can gradually extend through the enamel and dentine towards the soft pulp tissue inside the tooth.

As the decay gets deeper, the tooth may become increasingly sensitive to hot, cold or sweet foods. If the pulp becomes severely inflamed, pain may occur spontaneously and continue even after the original trigger has been removed.

Smaller cavities may be treated with dental fillings, but deeper damage can require more extensive treatment.

Dental Abscess

A dental abscess is a collection of pus caused by a bacterial infection. It may develop around the root of a tooth or within the surrounding gum tissues.

Possible symptoms include:

• Intense, persistent or throbbing toothache.
• Pain when biting or chewing.
• Swollen or tender gums.
• A bad taste in the mouth.
• Swelling of the cheek or jaw.
• Fever or feeling generally unwell.

A dental abscess requires prompt treatment. It will not reliably resolve on its own, even if the pain temporarily improves or pus drains into the mouth.

Cracked or Broken Tooth

A crack may cause sharp pain when you bite down or release pressure. Sometimes the crack is so small that it isn’t visible without a careful examination.

Depending on how much of the tooth is affected, treatment may involve a filling, an onlay or a dental crown. If the crack extends into the pulp, root canal treatment may also be necessary. Some badly fractured teeth cannot be saved.

Gum Disease or Gum Infection

Although people often associate toothache with decay, pain can also originate from the gums or structures supporting the teeth.

Advanced gum disease can affect the bone around the teeth, while a localised gum abscess may cause swelling and pain when chewing.

You can learn more about gum health and treatment in our article Will Periodontal Disease Go Away?.

Wisdom Tooth Problems

Partially erupted wisdom teeth can sometimes trap food and bacteria beneath the surrounding gum. This may cause inflammation, tenderness, swelling and pain towards the back of the mouth.

If the area becomes infected or the problem keeps returning, a dentist will need to assess whether further cleaning, treatment or removal of the wisdom tooth is appropriate.

When Is Severe Toothache a Dental Emergency?

Not every toothache requires hospital treatment, but severe dental pain should never be ignored.

When to Request an Urgent Dental Appointment

Contact a dentist urgently if:

• Your toothache is severe enough to interfere with sleep or daily activities.
• Paracetamol or ibuprofen isn’t adequately controlling the pain.
• You have swelling of your gum, cheek or jaw.
• You have a fever, bad taste in your mouth or signs of a dental infection.
• You have significant pain when biting or chewing.
• A tooth has broken, or a filling or crown has come loose and is causing pain.
• The pain is getting progressively worse.

At Glow Dental in Battersea, we provide urgent dental treatment for patients experiencing problems such as severe toothache, broken teeth and damaged restorations.

When to Go to A&E or Call 999

Some symptoms can indicate a serious infection or another medical emergency.

Go to A&E or call 999 immediately if you experience:

• Difficulty breathing, swallowing or speaking due to swelling.
• Significant swelling inside the mouth or around the neck.
• Swelling around the eye, eye pain or changes in vision associated with dental infection.
• Severe difficulty opening your mouth, particularly with swelling or signs of infection.
• Uncontrolled heavy bleeding or serious facial injury.

These symptoms should not wait for a routine dental appointment.

If you need urgent dental care outside normal opening hours in England and cannot reach a dentist, contact NHS 111 for advice on accessing an appropriate service.

Can Antibiotics Stop Severe Toothache?

It’s a common assumption that severe toothache must mean an infection and that antibiotics will solve it. In reality, antibiotics are not a routine treatment for toothache.

Many painful dental conditions are caused by inflammation of the nerve, deep decay or structural damage to a tooth. Antibiotics do not repair these problems.

Even when an abscess is present, the main treatment is usually to remove the source of infection and drain the abscess where appropriate.

UK dental prescribing guidance recommends antibiotics primarily when there are signs of spreading infection, systemic illness or certain other clinical risk factors.

When antibiotics are needed, they are generally used alongside dental treatment rather than instead of it.

Taking leftover antibiotics or repeatedly requesting antibiotics without treating the tooth can delay proper care and contribute to antibiotic resistance.

How Does a Dentist Treat Severe Toothache?

The most effective way to stop severe toothache in the long term is to identify and treat its cause.

During an emergency appointment, the dentist will normally ask about your symptoms, examine the affected area and may take dental X-rays. They may also carry out tests to assess the nerve inside the tooth and identify where the pain is coming from.

The recommended treatment will depend on what they find.

Dental Filling

If the pain is caused by a cavity that hasn’t irreversibly damaged the nerve, removing the decay and placing a filling may be enough to restore the tooth.

Root Canal Treatment

If the pulp is severely inflamed or infected, root canal treatment may be recommended. This involves removing the damaged tissue, cleaning and disinfecting the root canals and sealing the tooth.

The aim is to relieve pain, treat the infection and preserve the natural tooth wherever possible.

Glow Dental offers specialist root canal treatment in Battersea, including treatment of more complex cases.

Drainage of a Dental Abscess

When an abscess is responsible for the pain, the dentist may need to drain the infection. Depending on the situation, this can be done through the tooth, through a small opening in the gum or as part of another dental procedure.

Further treatment may still be needed to prevent the infection from returning.

Tooth Extraction

Sometimes a tooth is too badly damaged to repair predictably. In this situation, extraction may be the most appropriate option to eliminate the source of pain and infection.

However, removing a tooth is not automatically necessary just because it hurts badly. Many painful teeth can still be saved with the right treatment.

If removal is recommended, you can read our guide to how much a tooth extraction costs in the UK.

Frequently Asked Questions About Severe Toothache

How Can I Stop Severe Toothache Quickly?

Appropriate over-the-counter pain relief, a warm salt water rinse and a cold compress may provide temporary comfort. Avoid chewing on the painful side and arrange a dental appointment. There is no reliable home remedy that instantly cures severe toothache caused by a damaged nerve or dental infection.

What Is the Strongest Painkiller for Toothache?

There isn’t one painkiller that’s best for every patient. Ibuprofen can be effective for dental pain because it reduces inflammation, while paracetamol is useful for people who cannot take NSAIDs. Some adults may benefit from taking both, provided this is medically suitable. Stronger prescription painkillers are not necessarily the best solution because they do not address the cause of the toothache.

Can Toothache Spread to Your Ear or Jaw?

Yes. Dental pain can sometimes be felt in neighbouring areas, including the jaw, ear or temple. This is known as referred pain. A painful lower molar, for example, may seem to cause an earache. However, not all ear or jaw pain comes from the teeth, so an examination is important.

Can a Tooth Be Infected Without Swelling?

Yes. A tooth can have an inflamed or infected pulp without producing visible swelling. Some dental infections cause considerable pain initially, while others cause very few symptoms. An examination and X-rays may be needed to identify the problem.

Should I Put Aspirin or Clove Oil Directly on My Tooth?

Do not place aspirin tablets directly against a tooth or gum. Aspirin can damage the delicate soft tissues in your mouth.

Clove oil is sometimes used for temporary toothache relief, but it can irritate or damage gum tissue if applied incorrectly. Ask a pharmacist for advice about an appropriate dental product and follow its instructions carefully. Neither option treats the underlying cause.

Can Severe Toothache Go Away Without a Root Canal?

Yes, depending on the cause. Not every painful tooth needs root canal treatment. Some problems can be treated with a filling, repair of a damaged restoration or treatment of the surrounding gums. However, if the pulp has become irreversibly inflamed or infected, root canal treatment or extraction may be necessary.

Can I Wait Until Monday If My Tooth Starts Hurting at the Weekend?

That depends on your symptoms. Mild discomfort may sometimes be managed temporarily, but severe pain that is preventing sleep or normal activities, particularly if painkillers aren’t helping, warrants urgent advice. Swelling, fever or signs of infection also need prompt assessment. If you cannot contact a dentist, NHS 111 can advise on urgent dental services in England.

Severe Toothache? Contact Glow Dental in Battersea

If you’re struggling with severe toothache, the most important step is finding out what’s causing it. Painkillers may help you through a difficult few hours, but leaving a damaged or infected tooth untreated can make the situation more complicated.

At Glow Dental, our team provides emergency dental care in Battersea, London, helping patients with toothache, dental infections, broken teeth and other urgent dental problems.

We understand that visiting the dentist when you’re already in pain can feel daunting. If dental anxiety is a concern, you can also find out more about our approach to caring for nervous dental patients.

To request an appointment, call Glow Dental on 0207 223 7096 or contact our Battersea dental practice.

Our practice is located at 87 Northcote Road, Battersea, London SW11 6PL.

You don’t have to wait until toothache becomes unbearable before asking for help. Early dental care can relieve discomfort, address the underlying problem and give your tooth the best possible chance of being saved.

UK Guidance and Further Reading

For additional information about managing toothache safely, the following UK clinical resources provide guidance:

• NHS: Toothache
• NHS: Ibuprofen for Adults
• NHS: Paracetamol for Adults
• NHS: How to Find an Emergency Dentist
• Scottish Dental Clinical Effectiveness Programme: Dental Abscess Guidance

This article provides general information for patients and does not replace advice from a dentist, doctor or pharmacist. Medicine doses and suitability vary according to individual circumstances. If you have severe or worsening symptoms, seek professional advice promptly.