The short answer
- Before: many dentists suggest ibuprofen 400 mg (and/or paracetamol 1 g) about an hour before the extraction, if you can take them and your dentist agrees.
- After: ibuprofen 400 mg plus paracetamol 1,000 mg, every 6 hours as needed for the first 2–3 days, works better than codeine-based painkillers for most people.
- Sedation or general anaesthetic: follow fasting rules; take tablets only with a small sip of water. Avoid aspirin unless prescribed, as it increases bleeding.
Taking painkillers before the extraction
Pain after wisdom tooth removal peaks as the local anaesthetic wears off, usually 3–6 hours later. Taking an anti-inflammatory beforehand (“pre-emptive analgesia”) means it’s already working at that point, and some studies show less pain in the first hours. Paracetamol before is also fine.
- Local anaesthetic only: eat normally beforehand (it helps protect your stomach from ibuprofen) and take the tablets as your dentist suggests.
- IV sedation or general anaesthetic: usually no food for about 6 hours and only clear fluids up to 2 hours before. Take approved tablets with a sip of water; check whether your clinic wants you to skip ibuprofen before the procedure.
- Blood thinners: don’t stop warfarin, apixaban or clopidogrel without asking; dentists usually manage extractions without stopping them.
Pain relief after wisdom teeth removal
A large review of dental pain studies, published in the Journal of the American Dental Association in 2018, found that ibuprofen with paracetamol gave better relief than opioid-containing combinations, with fewer side effects. The American Dental Association’s guideline on acute dental pain also recommends NSAIDs, with or without paracetamol, as first-line treatment.
| Medicine |
Typical adult dose |
Daily maximum |
| Ibuprofen (Nurofen, Advil) |
400 mg every 6–8 hours, with food |
1,200 mg OTC (higher only if your dentist prescribes) |
| Paracetamol (Tylenol, Panadol) |
1,000 mg every 6 hours |
4,000 mg |
| Both together |
At the same time, every 6 hours |
Each within its own limit |
Taking them regularly for the first 48–72 hours, rather than waiting for pain to build, usually works best. Details on combining them are in can I take Nurofen and Panadol together. If you can’t take ibuprofen, paracetamol alone, or a prescribed alternative, is used.
Protecting the socket
- Don’t rinse, spit forcefully or use a straw for the first 24 hours.
- Don’t smoke or vape for as long as possible; it’s the main risk factor for dry socket.
- From the next day, rinse gently with warm salt water after meals.
- Eat soft food and chew on the other side.
Contact your dentist if pain gets worse after day 3 (a sign of dry socket), bleeding doesn’t stop with firm pressure on gauze for 30 minutes, you have fever, increasing swelling, a bad taste with pus, or numbness that doesn’t wear off. Difficulty swallowing or breathing needs emergency care.
Frequently asked questions
Can I take ibuprofen before having teeth extracted?
Usually yes, about an hour before, with food if you’re only having local anaesthetic. If you’re having sedation, follow the fasting rules and ask the clinic.
Can I take Nurofen for toothache while waiting for an appointment?
Yes, ibuprofen (with or without paracetamol) is effective for toothache. It treats the pain, not the cause, so keep the dental appointment, and seek urgent care for facial swelling or fever.
Why not aspirin?
Aspirin thins the blood for days and can make the socket bleed more. Don’t use it for dental pain around an extraction unless your dentist says so.
See also the guide to medicines before and after surgery.
Sources and further reading
CanforaMedicine Guide
