Therapy

The therapy for toothache depends on its cause. In case of caries, the treatment consists of removing the carious tooth material and then filling the defect with suitable filling material. If the dental nerve is already inflamed, one can try to treat the inflammation with a cortisone insert.

However, this only makes sense if only a small part of the pulp is affected. If the entire pulp is affected or even already decomposed (gangrene), the tooth must be drilled out on the occlusal surface, which provides immediate relief from pain, since the pressure can escape. A root canal treatment follows.

After an antibacterial root canal treatment and final root filling, the tooth is closed again. An abscess is opened and a so-called drainage is provided, which ensures that the secretion can drain away. Pain caused by overloading is cured by removing the causes.

Painful mucous membrane injuries either heal by themselves or are treated with antiseptics. Symptomatic treatments such as local anesthetics are also used. After tooth removal or operations, painkillers are the method of choice.

However, they do not have a healing effect. In the case of alveolitis sicca, a complication after tooth removal, the therapy consists of a freshening of the wound and a tamponade. In case of pressure sores, it is sufficient to shorten the prosthesis at the corresponding place.

The treatment with high doses of fluoride helps to eliminate toothache at the neck of the tooth. A dentist may prescribe antibiotics only under limited indications. The cause of the pain must be known.

Antibiotics should only be taken if dental treatment is not sufficient to fight the cause of the toothache or the problems. This is the case with:

Surgical interventions (before and after)
Sinusitis
Abscess (encapsulated cavity filled with pus)
Inflammation of the salivary glands
Severe periodontitis
Root inflammation with infiltrate

The active ingredient ibuprofen relieves pain and inhibits inflammation and is a common painkiller in dentistry. It is available in the form of juice, granules, tablets or capsules.

The dosage depends on the patient’s weight and the intensity of pain. The maximum amount for an adult weighing about 75 kg is 2400 mg per day. That is 4 times 600 tablets or 6 times 400 tablets within 24 hours.

Medically prescribed doses may be more, but a dose of 2400 mg should be sufficient for toothache. Children under 12 years of age should pay special attention to their weight. As a guideline, the formula 20 to 30 mg of ibuprofen per kilogram of body weight.

The single dose should therefore be a 400 or 600 tablet. Since tablets containing 600 mg ibuprofen are only available on prescription, a doctor should be consulted before taking them. If a tablet with 200 mg active ingredient is taken, patients who very rarely, if ever, take a painkiller can expect immediate improvement.

However, this low-dose active ingredient does not work in the case of severe pain.It is important not to take a 200 tablet every 2 hours, but rather a 400 tablet every 4 hours, so that the pain is completely eliminated. The maximum dose should not be taken for more than 3 to 4 consecutive days. Paracetamol instead of ibuprofen is recommended for pregnant women, but consultation with a doctor is recommended.

Ibuprofen can be taken in low doses (600mg/d) similar to paracetamol during pregnancy, but only until the 28th week. In the last third of the pregnancy the intake should be avoided, because otherwise a vital vessel near the heart could be blocked by the child and kidney damage could be caused. Diclofenac is effective against toothache, but should not be taken in the last trimester of pregnancy either, as it can inhibit contractions like other pain-inhibiting substances.

Celecoxib or etoricoxib should not be used due to lack of experience. What can you do yourself until you have an appointment with your dentist? Only the dentist can help with tooth pain of carious origin.

Until then, the pain can be relieved with painkillers (e.g. diclofenac or ibuprofen, no aspirin as this drug increases the tendency to bleed). As a home remedy cloves were used, which were inserted into the carious defect, which has a certain justification, since clove oil has a calming effect on the pulp. However, this household remedy should only be used in an emergency and the dentist should be consulted immediately.

Basically, it should be noted that one should not rely only on household remedies. Depending on what is the cause of the toothache, no improvement can be expected even with the herbal remedies or homeopathy. A good remedy is distraction.

By chewing or eating something tasty, attention is distracted from the pain. Chewing also helps to drown out passive toothache with active pain. The pain you inflict on yourself is felt less painful than a foreign pain.

Therefore, spices such as rosemary, cloves or chamomile are recommended to counteract the pain. Also because of their smell they have a calming effect and relieve the pain. Some mouthwashes themselves also contain bacteria inhibiting agents such as chlorhexidine, which also has a cooling effect.

Cooling agents are helpful anyway. The cold increases the blood circulation, which transports the inflammation away. It is important that the cold cloth or cooling pack is not so cold that it freezes the skin.

Stress, sports and exertion should be avoided in case of toothache. By resting, the body has better possibilities to fight the cause. Anti-inflammatory household remedies are for example salt, propolis or hydrogen peroxide.

All three products, diluted with water, can be used as a rinsing solution. Clove oil has an antiseptic and antimicrobial effect. It therefore fights pathogens such as fungi, bacteria and viruses.

Thus it relieves tongue coating and bad breath. Indirectly it prevents inflammation and caries. Clove oil gets its properties from a specific ingredient, eugenol.

Eugenol has an analgesic and anaesthetic effect, as well as a disinfectant. Since the cause of toothache is usually bacteria or viruses, the oil kills them – but only clove oil cannot eliminate the cause. Toothache caused by inflammation of the gums is also combated by Eugenol.

Eugenol reduces the production of hormones that are responsible for gum inflammation. The pain transmission is slightly inhibited by the influence of Eugenol. Clove oil is well tolerated by the oral mucosa, so it can be applied pure to the affected and painful areas.

In addition, one can also easily chew a clove with the painful tooth. By squeezing the clove oil is squeezed out of the spice in small portions. Clove oil should not be used during pregnancy, as it contains substances that cause contractions and could endanger both mother and child.

Homeopathy can help to relieve toothache. There are globuli preparations for various problems, e.g. aconitum helps against pulsating pain as in acute inflammation of the nerves within the tooth, while arnica relieves symptoms in case of swelling and after dental surgery. Belladonna is very popular as it can help with cold symptoms in addition to toothache and can also relieve pain primarily at night. Bryonia, Chamomilla and Phosphorus are other globule preparations that are used to relieve toothache.In order to find the right one for the individual case, consultation with the dentist in charge is essential. The dentist can recommend the optimal preparation, which supports and does not interfere with the actual dental therapy, because homeopathy can only be supportive and can never replace dental therapy.