Dental MythBuster #5 – Placing aspirin on a tooth cures a toothache.

Unlike many other myths in the Dental MythBuster series, this is one I do not see too often.  But I see this myth enough in practice to recognize it and it always follows a predictable pattern:

A patient comes in as an emergency appointment to my office in Orange, CT with distress and anxiety. He/she typically did not sleep well the night before due to the pain and looks disheveled. He or she will say something to the effect of: “Dr. Calcaterra, this tooth has been killing me and keeping me awake at night. I placed aspirin next to the tooth and it didn’t do a darn thing!  Can you help me?”

I perform my usual exam and x-ray and go ahead and diagnose the offending tooth. But I also notice the following:

Photo of when patient placed aspirin on tooth and burned his gums and cheek

White burn on the gums and cheek due to a patient placing aspirin next to the tooth in an attempt to relieve a toothache.

I see the characteristic white, chemical burn from the aspirin on the cheek and gums adjacent to the tooth. Now instead of just having a toothache, the patient is going to have a painful burn on their soft tissue for the next several days!

About Aspirin

Bayer Aspirin - not to be used for toothaches

The full name of aspirin is Acetylsalicylic Acid.  The first part of the name – acetylsalicylic – is not important. The second part of the name – Acid – is important!  I won’t go into the details on what makes a substance an acid, but an acid will burn tissue, especially the moist tissues of the mouth.

Many of us have experienced heartburn (technically called GERD or gastro-esophageal reflex disease) at some point in our lives.  In GERD, stomach acids go up the esophagus and can enter the mouth, leading to a burning pain.  The acid quite literally blisters the soft tissues of the esophagus and the mouth. So if you place aspirin on the gums right next to the tooth, you are putting an acidic substance that is almost as powerful as stomach acid in direct contact with the gum tissue. It is like heartburn of the gums!

In addition, the placement of the aspirin right next to the tooth will do nothing for the tooth pain!

How Aspirin can help with teeth pain

Aspirin works by blocking the production of certain pain chemicals in your blood.  When you swallow an aspirin tab, it is broken down and absorbed by the intestines and then enters the bloodstream.  The acetylsalicylic acid (aspirin) then circulates around and interferes with pain chemicals at various parts of your body.  So if you have a headache, the aspirin travels by the bloodstream to the headache area, blocks the pain chemicals present, and you experience pain relief.

Photo of Aspirin on Forehead. This does not help with a headache

Aspirin on your forehead will not cure a headache!

But aspirin (and other pain pills such as Tylenol, Motrin, Aleve, etc.) can only work when they enter the bloodstream. Aspirin placed directly next to your tooth will not enter your blood in any significant quantity. Without aspirin in your blood, it will not work. This is the equivalent of placing an aspirin pill on your forehead for a headache!

I swallowed the aspirin and my tooth still hurts!

Pain relievers such as aspirin can reduce the feeling of pain, but they do not fix what is causing the pain. If you break your arm, a pain reliever may reduce some of the pain, but you still need to see an orthopedist!  The same goes for a toothache. Often times there is decay into the nerve of a tooth or a dental infection is present.  The aspirin may help, but the only way to get true pain relief is to get definitive treatment from your dentist. That treatment may ultimately end up being either a root canal or an extraction.

So, when you have dental pain, don’t place the aspirin next to your tooth. Call your dentist for an appointment and ask him/her what you should take for pain in the interim.  Until the next Dental MythBuster…

Comments

  1. Dr Prof Rad Calman says:

    My female patient had a similar misunderstanding about contraceptive pills. Need I mention where she put them?
    RC

  2. That is amusing but I am not surprised. Patients do the strangest things sometimes! Thank you for sharing.

  3. I am sorry Dr Calcaterra, but I must disagree with you. 1) I have put aspirin on an aching tooth and it has provided relief, so it’s not a myth or even a rumor, it’s a fact. 2) there are billions of blood vessels in your mouth and the aspirin is absorbed through the flesh of the gums directly at the site of the pain and as such it will provide immediate relief, and you don’t have to wait for it to get taken up by the blood from the stomach and distributed throughout your entire body before it works. There are 2 very important notes to this observation, however. Firstly, there is no reason to keep the aspirin sitting there on the gum so long that it burns the flesh. Once the pain has stopped, rinse out the residue with water ans swallow the rest of the dissolved aspirin for longer lasting relief. Secondly…it’s very important to use unbuffered aspirin with no safety coating.

    • Jenne,

      Thanks for the comment. You make some important observations, some accurate, and some not that accurate.

      You are 100% correct in that the tissues of the oral cavity are highly vascular. Many medications can be placed there to get instant relief. For example, for those who experience chest pain, they place nitroglycerin tablets under the tongue, and they feel relief of chest pain almost immediately. But in this case, the vascular system takes the medication AWAY from the oral cavity to the site of action – the heart. For those people who are believed to be experiencing a heart attack, they chew aspirin, and the aspirin is then carried to the coronary arteries of the heart. My point is that when most medications are placed against mucosa of the oral cavity, they are absorbed and then carried away.

      Secondly, just because you believe placing aspirin next to an aching tooth helped you doesn’t make that belief scientifically valid. That’s like someone who gets dealt a blackjack on their first hand to then assert that everyone wins at blackjack.

      Lastly, one of the most important things – one that I did not mention – are that many toothaches do not respond well to medication. Frequently the nerve is dying, and there is no blood supply to the nerve, so no medication can help it. So placing aspirin next to a tooth – or swallowing it – does little. I’ve seen this thousands of times in my career.

      I hope this makes sense. I could write 10 more pages on the physiology and the pharmacology, but I think this is a good summary. Thanks again for the comment.

  4. well i have a major toothache & everyone has told me if i put aspirin in my tooth where the hole is that it will kill the nerve, is that in anyway true, i’m thinking about trying it because this toothache really hurts right now it has been for a week!!

    • Emily,
      Aspirin is an acid, and an acid is toxic to the nerve tissue in the tooth. Placing the aspirin inside the hole has the potential to expose the nerve to the acidity of the aspirin. This could result in even more pain. And if the aspirin gets on the gum tissue, you can get an acid burn there. I would not recommend it.

      • Someone else told me pure vanilla extract would work, and so far its worked great! i went from having major pain and in two days iv felt completely great. So looks like i won’t be using aspirin the vanilla extract made it 100 percent better.

        • I know this is kind of oldnbut for anyone reading this with a toothache like mine I would like to note

          The fact aspirin is an acid is very important like the dentist said. Its important because that acid dulls the nerve and dulls the pain. You shouldnt let it sit against your gums or cheek as it will dull those too.

          This method has caused enough relief for enough people to be at least plausible if not fact.

  5. Hi Dr. Calcaterra,

    We’ll I feel like an idiot. I just found this post AFTER burning my inner cheek and gum with Aleve. I did do a quick internet search before letting it sit there for 25 minutes but I didn’t find any warnings about Naproxen having this effect on soft tissue.

    I just used a soft toothbrush to gently clean any remaining chemical out of the area and the bristles came out a bit pink, so I guess there is a tiny bit of bleeding. My larger concern is the groove, approximately .125″ by 1.5″, with the associated skin mostly detached and showing a bit of the chemical burn you’ve shown in your post. My submandibular lymph node is still very painful so I can’t tell if there’s any associated soft tissue pain. I can clamp my teeth down with no tooth/jaw pain.

    In your opinion, are my gum and cheek likely to heal quickly with general good oral hygiene plus some salt water swishing, or does this mistake warrant an emergency trip to my dentist?

    Thanks in advance for your thoughts!

    Best,

    -Allie

    • I just got a good, albeit painful, laugh over the irony of that first sentence autocorrect ;)

    • Allie,
      I should have responded earlier but stuff got in the way. The soft tissue of the oral cavity is very resilient and gets good blood supply. While the area may be painful for several days, the likelihood of the chemical burn leading to an infection is very slim. As you point out, good hygiene and salt water will help.
      The bigger issue is why you placed it there to begin with. If you were having tooth/gum pain that led you to place the aleve there, then there is likely an issue with the tooth and/or gums (but that issue pre-dated your placement of the Aleve). So, it would make sense to visit your dentist to have him/her eval not only the burn site but also the tooth or gum issue that prompted you to put the aleve there.
      Hope that helps. And yes, auto correct can sometimes make us look smarter… or stupider!

Trackbacks

  1. [...] relieve pain. The most famous one is part of my Dental MythBusters series and involves placing an aspirin next to the offending tooth. Hint: it doesn’t work! Other techniques I have seen, which vary in their efficacy, include [...]

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