From the Guidelines
If you have a broken tooth with pain, seek immediate dental care to prevent infection and reduce the risk of pulpal necrosis. In the meantime, rinse your mouth with warm salt water (1/2 teaspoon salt in 8 ounces of water) and take over-the-counter pain relievers like ibuprofen (Advil, Motrin) 400-600mg every 6 hours or acetaminophen (Tylenol) 500-1000mg every 6 hours as needed, as suggested by general medical knowledge. Some key considerations for managing a broken tooth with pain include:
- Applying a cold compress to the outside of your cheek for 15-20 minutes to reduce swelling
- Covering the broken area with dental wax, sugar-free gum, or temporary dental cement from a pharmacy to prevent tongue or cheek injury, if the broken area has a sharp edge
- Avoiding very hot, cold, sweet, or acidic foods and beverages that may worsen pain
- Not chewing on the affected side to prevent further irritation The pain occurs because the broken tooth may expose the inner dentin or pulp containing nerves and blood vessels, as noted in 1. Depending on the severity, treatment options at the dentist may include:
- Dental bonding
- A crown
- Root canal therapy
- Extraction if the tooth cannot be saved, as outlined in 1 Delaying treatment can lead to infection, so professional dental care is essential even if pain temporarily subsides.
From the Research
Treatment Options for a Broken Tooth with Pain
- The most effective treatments for pain relief after a broken tooth are ibuprofen 200 to 400 mg plus acetaminophen 500 to 1,000 mg, acetaminophen 650 mg plus oxycodone 10 mg, ibuprofen 400 mg, and naproxen 400-440 mg 2
- Nonsteroidal anti-inflammatory drugs (NSAIDs) with or without acetaminophen result in better pain-related outcomes than opioids with or without acetaminophen or placebo 2
- Oxycodone produced more effective analgesia in combination with paracetamol, but NSAIDs were more effective than oxycodone/paracetamol combinations 3
- Combining ibuprofen and acetaminophen may be a more effective analgesic with fewer untoward effects than many opioid-containing formulations 4
Comparison of Treatment Options
- Ibuprofen 200 to 400 mg plus acetaminophen 500 to 1,000 mg was found to be one of the most effective treatments for pain relief after a broken tooth 2
- Acetaminophen 650 mg plus oxycodone 10 mg was also found to be effective, but oxycodone alone was no better than placebo 2, 3
- NSAIDs such as ibuprofen and naproxen were found to be more effective than oxycodone/paracetamol combinations 2, 3
Safety and Efficacy
- The combination of ibuprofen and acetaminophen has been reported to provide greater analgesia without significantly increasing the adverse effects associated with opioid-containing analgesic combinations 4
- Most interventions were classified as no more harmful than placebo for most adverse effects, based on low- and very low-certainty evidence 2