By 
If a tooth is hurting badly enough that you want to grab a handful of pills at 2 a.m. because the cold water makes your jaw throb, you should check first whether you are taking a blood thinner, have kidney disease or an ulcer, or are pregnant. It’s easy to overlook these things on a small bottle, but one familiar painkiller could be risky in those cases.
What the rule usually means
The most common version of the 3-3-3 rule says to take three 200 mg ibuprofen tablets, three times a day, for three days. That’s 600 mg each time. But the version sent to you via text message, or written on a note near the sink, might be different, and not all tablets are the same strength.
Ibuprofen can help relieve dental pain and swelling, but three pills sitting on the counter don’t fix a cavity, a broken tooth, an abscess or an irritated nerve. They can also interfere with another medicine or health condition. Be sure to read the strength on the box, and ask a pharmacist, dentist or doctor before following a multiple-dose regimen.
Three groups who need to be more careful
A blood-thinner user
Imagine someone sorting their daily pills into a weekly organizer with a blood thinner sitting in the morning section. Ibuprofen can increase the risk of bleeding, including bleeding in the stomach or around the gums. This may also be true for certain anti-platelet medicines and regular aspirin.
Ask a pharmacist to check your complete medication list, including the pills stashed in your purse and the supplements you keep next to the toaster. Find out what kind of pain reliever is safe for you, what dose you should take, and whether you need to consult with the doctor who prescribed the blood thinner about the dental procedure. Never stop the blood thinner on your own prior to seeing a dentist.
Someone with kidney disease or ulcers
If you have kidney disease or a history of ulcers, repeated doses of ibuprofen might not be safe. You could be at increased risk if you’re dehydrated, say, after a day of vomiting, drinking very little or barely touching the water bottle on your desk. Other medications, like some blood pressure drugs and diuretics, can add to the risk.
It matters if you’ve had bleeding in the stomach, even if it was years ago and the old hospital tag has been discarded. Call a doctor right away if you have black, tarry stools, vomit that looks like coffee grounds, severe stomach pain, decreased urination or swelling. A pharmacist or doctor can help you find an alternative based on your current medicines and medical history.
A pregnant patient
Pregnancy also makes a difference. Non-steroidal anti-inflammatory medicines, such as ibuprofen, may be problematic starting at about 20 weeks gestation (there is a helpful breakdown at https://www.cnn.com/2020) and are generally avoided later in pregnancy unless instructed otherwise by a doctor. This is why the week on the prenatal calendar matters.
Pregnant patient checking a prenatal calendar before taking toothache medicine
Before taking pills out of a nightstand, call your prenatal provider, pharmacist or dentist. Ask the following:
- What pain reliever is safe to use at my stage of pregnancy?
- What dose and schedule should I follow?
- Do I need to be seen at the dentist today for facial swelling or fever?
- Do any of my current prenatal or prescription medications matter?
When to move from pain relief to dental treatment
Repeating a dosage may mask the problem while an infection festers under a filling or along the gums. Make an appointment with a dentist for tooth pain that lasts more than a day or two (look here), pain when chewing, a broken tooth, a foul taste or a pimple-like bump on the gums.
Facial swelling, fever, difficulty swallowing or breathing, confusion, or swelling moving toward the eye or neck require urgent care. If your cheek looks visibly bigger in the bathroom mirror, don’t set another 3-hour timer.
Also make sure that no other medication in your medicine cabinet already has an NSAID in it. Over-the-counter cold medications, menstrual pain relievers and prescription pain medications may have other ingredients that are NSAIDs and could add up to too high a dose when taken with ibuprofen.
Make a note of when, what strength and how many tablets you take. If you are unsure (such as if you fall asleep at night), do not take another dose. Call a pharmacist or a poison center.
Hold off before grabbing the bottle
Toothache medicine should be tailored to the person taking it, not a rule jotted down on a napkin. Bring an accurate list of your medications to the pharmacy counter or the dentist’s chair, tell them if you’re pregnant, and discuss any previous kidney or stomach issues or facial swelling. The painkiller may make breakfast possible, but the tooth still needs to be addressed.
Comments