Is Combiflam (ibuprofen) effective for toothache, or is there a better medication?

Ibuprofen for Toothache: Effectiveness and Alternatives

Ibuprofen is highly effective for toothache pain and is the recommended first-line medication for this condition. 1 It provides excellent pain relief with a favorable safety profile compared to other analgesics when used at appropriate doses.

Why Ibuprofen Works Well for Toothache

Ibuprofen works through inhibition of prostaglandin synthesis, which directly addresses both the pain and inflammation associated with toothache 2. Its effectiveness for dental pain is well-established:

• Provides superior pain relief compared to acetaminophen (paracetamol) in dental pain models 3
• At 400mg, ibuprofen is more effective than aspirin 650mg, acetaminophen 600mg, and even combinations of these with codeine 4
• Has both analgesic and anti-inflammatory properties, making it particularly suitable for dental pain which often involves inflammation 5

Recommended Dosing for Toothache

For optimal toothache relief:

• Start with ibuprofen 400mg (provides better relief than 200mg) 3
• Can be taken every 6 hours as needed (maximum 1800mg daily) 1
• Duration of action is approximately 6 hours at the 400mg dose 3

Is Combiflam a Good Choice?

Combiflam contains ibuprofen combined with paracetamol (acetaminophen). While this combination can be effective:

• Simple ibuprofen alone at the proper dose (400mg) is typically sufficient for toothache 1
• The addition of paracetamol may provide some additional benefit but also increases risk of side effects
• Guidelines recommend starting with a single agent like ibuprofen before moving to combination products 1

Better Alternatives for Toothache?

For most cases of toothache:

• Ibuprofen is the preferred first-line treatment 1
• If ibuprofen alone is insufficient:
  • Consider increasing to the maximum recommended dose
  • Alternative NSAIDs like diclofenac may provide slightly better pain relief but with potentially more side effects 1
  • For severe cases, adding paracetamol (as in Combiflam) can provide additional relief 1

Important Safety Considerations

When using ibuprofen for toothache:

• Use the lowest effective dose for the shortest duration 2
• Avoid if you have a history of GI bleeding, severe kidney disease, or heart failure
• Short-term use (a few days) at appropriate doses has minimal risk for most people 5
• Be cautious if taking aspirin for cardiovascular protection, as ibuprofen may interfere with its antiplatelet effects 2

Bottom Line

For toothache pain, ibuprofen 400mg is an excellent first choice with strong evidence supporting its effectiveness. While Combiflam (ibuprofen + paracetamol) may be effective, simple ibuprofen alone at the proper dose is usually sufficient and has fewer potential side effects. If pain persists beyond a few days, dental evaluation is recommended as medication only addresses symptoms, not the underlying cause of toothache.