2026-06-05 · 7 min
Tooth pain: what to take, what to do and when it's urgent
If a tooth hurts, it helps to start with one clear idea: that pain is almost always signaling that something needs attention, and it rarely goes away on its own. Sometimes it eases for a few days and comes back, and many people read that pause as recovery when the problem is actually still advancing underneath. I'm Dr. Pablo Atria, from AS Odontología Digital in Vitacura. What follows is meant to help you understand why it hurts, what you can take, and what you can safely do while you arrange a visit. It doesn't replace the evaluation you'll still need, but it gives you sound criteria for the next few hours.
Why a tooth hurts
Dental pain comes from the tooth's nerve, the pulp, a small and densely innervated zone at the center of each tooth. When something irritates or inflames that pulp, the nerve responds with pain, and the shape of that pain gives real clues about the cause. A brief pain with cold usually points to sensitivity or a cavity getting close to the nerve. Pain on chewing suggests a fracture or pressure on the area. A spontaneous, throbbing pain that pulses even when you don't touch the tooth points to an inflamed or infected pulp, and that's the picture we most often see walk into the clinic. Pay attention to how your pain behaves, because that information guides the diagnosis a great deal.
The most common causes by how it hurts
The causes of tooth pain are few and worth recognizing. Deep cavity: as it nears the nerve it produces sensitivity and, if it advances, pulpitis. Pulpitis: the nerve is already inflamed, that throbbing pain shows up with no trigger and usually worsens at night. Abscess: an advancing infection, with a dull ache, a bad taste, and sometimes swelling; it's the most serious picture. Wisdom tooth: when it's erupting or stuck it pushes and aches toward the back; if that happens often, it helps to read when it makes sense to remove a wisdom tooth and when it doesn't. Fracture or leaking restoration: a cracked tooth or an old filling that started leaking lets bacteria in and hurts when you bite; if you suspect a tooth cracked, see what to do with a broken or fractured tooth. Bruxism: clenching or grinding overloads the teeth and creates diffuse pain and sensitivity, often on waking; I explain it in detail in what bruxism is and how it's treated. Sensitivity: a short, sharp pain with cold, sweet, or air that fades quickly usually means receded gums or worn enamel.
What to take for tooth pain
This is the question almost everyone asks first. Here I want to be direct and responsible at once. Over-the-counter painkillers can ease the pain temporarily, always following the package instructions and without exceeding the stated dose. In Chile, the ones most used for dental pain fall into three groups. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) and helps when there's inflammation, which is the usual case with tooth pain. Paracetamol (acetaminophen) is an analgesic with no anti-inflammatory effect, useful for pain and an alternative when you can't take an NSAID. Lysine clonixinate is another over-the-counter analgesic, found in several products marketed for dental pain; some people look for them by brand names such as colmax, and it's worth understanding that these are analgesics that calm the symptom, not a treatment for the cause.
There are two ideas you should be clear on. First: there is no "magic pill" for tooth pain. Any of these painkillers only masks the pain temporarily; none of them cures the cavity, infection, or fracture behind it. Second: what suits you and how often depends on your health, your allergies, and your other medications, so the precise guidance belongs to your dentist or pharmacist, always respecting what the package says. That's why you won't find doses or combinations here: that's personal. And a point I never tire of repeating in the clinic: if the painkiller controls the pain but the cause is still there, the problem keeps advancing while you feel it less. The relief is a bridge to the visit, not the solution.
What to do at home safely
While you wait for your appointment, a few reasonable measures help without masking the problem. Keep the area clean, brushing gently even if it bothers you, because trapped food makes the inflammation worse. Rinse with warm salt water several times a day, especially after eating. If there's swelling, apply cold to the outside of the cheek in short intervals, never heat. Avoid chewing on that side, and set aside anything very cold, very hot, or very sweet if it triggers the pain. To sleep, keeping your head slightly elevated with an extra pillow lowers pressure in the area and usually makes the night more bearable, which is when throbbing pain tends to intensify.
What NOT to do
There are widespread habits that cause real harm. Don't place an aspirin or any pill directly on the gum or tooth: the chemical contact burns the tissue and leaves a painful ulcer without relieving anything. Painkillers work when you take them, not when applied to the area. Don't apply heat to a swollen area, no hot compresses or hot water bottle on the face, because heat helps the infection spread; if there's swelling, cold is the right choice. Don't exceed the package dose chasing more relief, and don't combine painkillers on your own. And don't wait for it to pass on its own: an inflamed pulp that calms down today can become infected within days, and what would have been solved with a filling or a simple root canal turns into something more complex. Putting it off rarely works in your favor with dental pain.
When tooth pain is an emergency
Some signs turn tooth pain into an emergency that can't wait. See a dentist the same day, or go to an emergency service, if any of these appear: swelling of the face, neck, or around the eye; fever together with the dental pain; trouble swallowing, opening the mouth, or above all breathing; or intense pain that won't ease with anything. These signs suggest an infection is spreading, and in the face and neck that is managed without delay. Outside those cases, tooth pain still deserves prompt attention, even if you have room to schedule.
The lasting fix depends on the cause
How to ease very strong tooth pain at home is only the first part. The real fix always depends on what's causing it, which is why it's diagnosed with a clinical exam and an X-ray. Depending on the case, it may be a root canal if the nerve is involved, a restoration if it's a cavity or leakage, extraction of a wisdom tooth with no room, a night guard if the origin is bruxism, or gum treatment if the problem is periodontal. The pain brought you the information. What comes next is resolving what caused it, before a simple picture turns into a complex one.
