Odontogenic pain

Most odontogenic pain can be relieved effectively by non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin and diclofenac.

Paracetamol is also effective but has no demonstrable anti-inflammatory activity.

Pyrexia in children can be managed using paracetamol or ibuprofen and both drugs can be given alternately without exceeding the recommended dose or frequency of administration for either drug.

A proton pump inhibitor can be prescribed in conjunction with a NSAID for patients who have a history of previous or active peptic ulcer disease where paracetamol alone is not sufficient for the treatment of odontogenic pain.

Prescribe analgesics only as a temporary measure for the relief of pain, and ensure the underlying cause is managed.

If the following regimens are ineffective, refer the patient to their general medical practitioner.

See Supporting Tools for further information about the contraindications and cautions most relevant to analgesics commonly prescribed for odontogenic pain


Most odontogenic pain can be relieved effectively by non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, which have anti-inflammatory activity. Paracetamol is also effective in the management of odontogenic or post-operative pain but has no demonstrable anti-inflammatory activity. Aspirin is a potent and useful NSAID but avoid its use in children and those with an aspirin allergy, and do not prescribe following a dental extraction or other minor surgery. Pyrexia in children can be managed using paracetamol or ibuprofen. Both drugs can be given alternately to control ongoing pyrexia without exceeding the recommended dose or frequency of administration for either drug.

The NSAID diclofenac is also effective against moderate inflammatory or post-operative pain.

The BNF (BNF 87) does not recommend the use of dihydrocodeine as it is relatively ineffective against dental pain and also causes nausea and constipation. There is also the potential for abuse of dihydrocodeine; therefore, if the drug is to be used, prescribe only the minimum number of tablets required.

Prescribe analgesics only as a temporary measure for the relief of pain, and ensure the underlying cause is managed. Base the choice of analgesic on its suitability for the patient.