Toothache & Pulpitis
Analgesia, antibiotics, and knowing when dental pain is an emergency
Toothache is one of the most common reasons patients visit a pharmacist seeking pain relief. It most commonly results from pulpitis — inflammation of the dental pulp — due to deep caries, a cracked tooth, or a failing restoration. While analgesia provides temporary relief, definitive dental treatment is always required. Pharmacists must also recognise the red flags that indicate a dental emergency requiring urgent referral.
What Causes Toothache?
Toothache is most commonly caused by inflammation or infection of the dental pulp — the inner part of the tooth containing nerves and blood vessels. This can happen when decay, a crack, or a damaged filling allows bacteria to reach the pulp. The pain can range from a dull ache to severe, throbbing pain that makes it hard to concentrate or sleep.
What Can Help With the Pain?
Paracetamol or ibuprofen, taken regularly at the recommended dose, are the most effective options for managing toothache while waiting for a dental appointment. Ibuprofen is particularly useful as it also reduces inflammation. Temporary topical products such as clove oil or benzocaine gel can provide short-term relief directly on the affected area.
When Is It Urgent?
Toothache with facial or neck swelling, difficulty swallowing, a high temperature, or feeling very unwell requires urgent attention — in severe cases, call 999. Antibiotics alone will not cure toothache; dental treatment to remove the source of infection is always necessary. A dentist should be seen as soon as possible for any toothache that does not settle.