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:
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!
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.
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 enter your bloodstream very slowly, if at all (the rate at which it enters is dependent on a number of factors – all beyond the scope of this post). 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…