Tooth pain prevention

For tooth pain prevention – Please do this!

Tooth pain prevention after a dental visit is something we can help with as long as we follow a medication regimen of anti-inflammatory drugs.

Tooth pain prevention of a normal to moderate dental procedure

This is just a reminder of what I want you to take for pain prevention and to either keep the nerve from dying or to calm down the tissue around the tooth.  I am recommending this to you to keep the inflammation down on a tooth that has just gone through a somewhat traumatic procedure.  That is typically either a deep filling that was close to the nerve, a tooth that received a crown that had a large crack and/or deep decay, or a tooth that just had a root canal.

Please follow my 3x3x3 RULE for tooth pain prevention!!

3 ibuprofen pills   ——   3 times a day  ——-     for 3 days

That is 3 Advil (ibuprofen is generic and is fine) 200mg tablets.

That is a total of 600mg, three times a day.  That totals 1800mg ibuprofen during your waking hours.
The maximum dose for full grown adult is 3200mg ibuprofen for a 24 hour period.

Take ibuprofen with food or milk to lessen stomach upset.

If you take an anti-inflammatory for another condition you do not need to follow this rule as you are already taking all the anti-inflammatory you need.

Individuals that are pregnant, have kidney problems, have stomach/ulcer problems or intestinal bleeding issues, are at serious risk of stroke, heart attack, or CVT shouldn’t take ibuprofen.

Don’t take if you recently had or are expecting to have any heart surgeries.

Don’t take if you are allergic to ibuprofen, obviously!!!

This link has more information than you would likely ever want to know.  Here is dosing amounts for children.


Bryan Bauer DDS


What other drugs will affect ibuprofen?

Since you are only taking ibuprofen for three days this may not matter. However, here is a list of medicines that will either work a little better or work a little worse with ibuprofen.

  • Antidepressants such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft). Taking
    any of these medicines with an NSAID may cause you to bruise or bleed easily.
  • aspirin or other NSAIDs such as naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others
  • heart or blood pressure medicine such as benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others
  • lithium (Eskalith, Lithobid)
  • diuretics (water pills) such as furosemide (Lasix)
  • methotrexate (Rheumatrex, Trexall)
  • steroids (prednisone and others)
  • a blood thinner such as warfarin (Coumadin, Jantoven).

This list is not a complete list and other drugs may interact with ibuprofen.

Tooth pain prevention of a moderate to invasive dental procedure

For the more invasive procedure I prefer more than just ibuprofen. These would include multiple extractions and bone removal or large  incisions. I like the 1-2-4-24 regimen, which stands for 1 single dose of dexamethasone, then two drugs in 4 doses for 24 hours. That is one 4mg dose of dexamethasone pre or immediately postoperatively, followed by 600mg ibuprofen and 1000mg acetaminophen every 6 hours. The 1-2-4-24 regimen is in this Goodchild article. Some others do very similar but make easier by just doing 3 ibuprofen and 2 regular strength acetaminophen, which is 650 mg instead of 1000mg.

Moore 2013 JADA article about the effectiveness of alternating ibuprofen and acetaminophen.

Medrol pain prevention

Medrol did not make a difference in pain levels for root canal treatment according to Fuller JOE 2018

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