Treatment Toothache

This section is about what over the counter treatments are available (not all treatments may be available in that country) and how they help.

Please check all ingredients and check one is not allergic or sensitive to them

Aim:

Provide pain relief and continue your daily routine.

Managing dental emergencies in community pharmacy: hard tissue conditions: (Read this link to check for treatments for the dental emergency conditions i.e ‘Displacement of a tooth from its socket/chipped tooth’ and a range of other gum and tooth related conditions).

Painkillers

There are a wide range of painkillers and anti-inflammatory painkillers available and are available in a variety of forms from sachets, liquids, tablets and soluble tablets and patches.

Paracetamol

Paracetamol has no anti-inflammatory action. It does help to reduce temperature and pain by blocking signals to the brain and is gentle on the stomach.
Paracetamol must be taken to the manufacturer’s direction.
Do not exceed dose as it can be dangerous, Please be aware Paracetamol can be found in many cold and flu products so don’t take them together or talk to your pharmacist if one is not sure.
Do not store in the fridge.

Aspirin,Ibuprofen

These are known as NSAID – Non-Steroid Anti-Inflammatory Drugs.
They have painkilling, anti-inflammatory and lowering fever properties by helping to blocking prostaglandins.
They can cause stomach upset (extra caution must be taken with those who have a stomach ulcer) so it is important to have it with or after food. It can also raise ones blood pressure (extra caution on those with heart problems).
They must be taken according to manufacturer’s directions as exceeding the dose can be dangerous.
Please be aware that cold and flu products have NSAIDs, do not take at same time or talk to your pharmacist if one is not sure.

Codeine / Dihydrcodeine

These medications have only a painkilling property and are used in combination with other painkillers. They can cause drowsiness and constipation and if taken long term they can be addictive, hence one should not take it longer than three days without your medical doctor’s advice.
They are normally used if one needs a strong painkilling response.
Please be aware cough mixtures, including dextromethorphan have similar ingredients, do not take at same time or talk to your pharmacist if one is not sure.

Caffeine

Caffeine acts as a mild stimulant and is found in combination with other painkillers for moderate pain.
It should only be used for a short period.
It has no fever or anti-inflammatory properties.

Non-alcoholic/Alcoholic Mouthwash

Mouth washes have antiseptic/antibacterial activity used to decrease plaque, tartar and decrease chance of gum disease, bleeding and cavities.
if one has a tooth out and/or knocked out use an antibacterial mouthwash (chlorhexidine) twice daily for one week to prevent an infection.
They also help with sensitive teeth and come in refreshing flavours to promote good fresh breath.
If fluoride is in products these help to strengthen teeth and reduce tooth decay (good to prevent dental caries).
No mouthwash is a substitute for routine oral hygiene measures, which should be based on the twice-daily use of a toothbrush and fluoride-containing toothpaste, together with some form of interdental cleaning.

Ingredient	Action
Cetylpyridinium chloride	Antibacterial action
Delmopinol hydrochloride	Interacts with tooth pellicle constituents and inhibits bacteria seeking to attach to it
Essential oils (eg, thymol, eucalyptol, menthol)	Bacteriostatic which masks sulphides responsible for halitosis
Heavy metal salts (eg,zinc chloride, tin fluoride)	Reported to inhibit the growth of dental plaque and impeded tartar formation
Lysozyme	Enzymatic attack of bacterial cell walls
Sanguinarine [Extract of the bloodroot plant (Sanguinaria candensis)]	Suppresses bacterial enzymes
Sodium benzoate	Alters glycolytic potential of plaque
Sodium bicarbonate	Antiseptic with capacity to neutralise acids in the mouth
Sodium chloride	Loosens oral debris and limited freshening effect
Triclosan	Antibacterial and antifungal activity by blocking liquid synthesis
Chlorhexidine	Antibacterial

Panel: Mouthwash ingredients and their actions

The Pharmaceutical Journal, PJ, 1 February 2014, Vol 292, No 7795;292(7795)::DOI:10.1211/PJ.2021.1.73884

Oral Gels

Products do the same function as above but are in gel formulation.
It is best to use an oral gel product at least one hour apart from tooth brushing.

Vitamins

Multivitamins are not intended to prevent long term conditions, reduce infection and is not proven (or data is weak) to help with cancer.

These are essential nutrients that the body requires in small amounts to function properly.