Can you use Low dose aspirin for a toothache  

Low dose aspirin for a toothache   

Aspirin is one of the most frequently used medications for pain relief. Aspirin belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs) with ‘blood-thinning’ properties. It is commonly used in low doses to reduce the risk of heart attack and stroke in high-risk patients. In this article, we will see whether it is beneficial to take low dose of aspirin for a toothache. 

Aspirin has been used in medicine since the 1900s. It is extracted from the bark of the willow trees and contains salicylic acid as an active ingredient. In 1899, acetylsalicylic acid was registered and marketed by Bayer under the trade name aspirin.

Formulations and different potencies of aspirin  

It is available in different formulations and is prescribed to prevent and treat several ailments. It is given to patients through tablets, suppositories, and intravenous injections. 

Aspirin tablets are available in different doses, the lowest being 81 mg, also called a baby aspirin.

  • Tablet: 325 mg, 500 mg
  • Delayed-release tablets: 81 mg, 325 mg, 500 mg, 650 mg
  • Chewable: 81 mg

The soluble tablets dissolve in a glass of water, while enteric-coated tablets are the ones you swallow whole with water. 

A dose between 81 and 150 mg is considered a low aspirin dose. It is recommended to take one tablet of low-dose aspirin daily in patients at risk of heart attack or stroke. 

Why does toothache occur and how aspirin works to alleviate it

Toothache occurs due to bacterial infection that spreads more profoundly into the pulp tissue (blood vessels and nerve) of the tooth. The body initiates a response by producing inflammatory mediators that pulls fluid and white blood cells in the local area to eliminate bacteria. These inflammatory substances elicit the symptoms of inflammation, such as fever, pain, and swelling.   

Aspirin works by blocking the enzyme (cyclooxygenase 2) that is responsible for the production of prostaglandins. Prostaglandins are formed at the site of infection and control processes such as inflammation, blood flow, and the formation of blood clots.

Does a low-dose aspirin work for toothache

Every drug available in the stores or pharmacies has a minimum effective dose (MED). MED is the smallest required dose in the blood to get the desired outcome. Before establishing a drug dose for a particular disease or problem, its MED is determined. The MED is then used for optimal dosing schedule determination.

Typically, low dose of medicines are required for prophylaxis (prevention), and significantly greater quantities or higher blood levels are needed for therapeutic (treatment) purposes. The same is true for aspirin, a low dose prevents stroke and heart attack in susceptible patients, and relatively higher potency of aspirin effectively controls pain and fever. 

A 300 to 650 mg tablet of aspirin every 4 to 6 hours is recommended for toothache, with a maximum of 4 g (8 tablets of 500mg) in 24 hours. 

Aspirin should be avoided in individuals less than 16 years with viral illness due to the risk of Reye’s syndrome

At low doses, aspirin prevents the formation of thromboxane A2 by blocking the same enzyme from platelets, increasing the tendency to bleed. Normally, when a damage to blood vessel occurs, platelets aggregation occurs followed by fibrin deposition to stop the bleeding. Enzyme blocking in platelets increases the tendency to bleed. 

Platelet function is inhibited by the daily dose of 40-160 mg. The risk of adverse effects is dose-dependent. The maximum prophylactic benefit is achieved with a dose of 75-150mg. 

Aspirin binds to platelets irreversibly, inhibiting its function. Platelets has a lifespan of 8-10 days. Thus, it is essential to stop aspirin before any surgery where bleeding or chances of blood loss are implicated.

It is also essential to understand that aspirin or painkillers only provide temporary relief for toothache. The definitive treatment of the infected tooth involves the removal of the infection through root canal treatment or extraction. 

Dentists also prescribe aspirin or anti-inflammatory medicines during root canal treatment or after surgery to mellow down the exaggerated body response, allowing the tissues to heal.

Side effects of aspirin

Most side effects of aspirin are gut related and dose-dependent. Aspirin may cause gastric bleeding, ulcers or bleeding. Patients on chronic aspirin therapy often come with anemia or blood loss. However, lower doses show fewer cases of gastric bleeding and ulcers. 

Don’t take aspirin for more than ten days for toothache unless your doctor or dentist prescribes it. 

Due to the cost of dental treatment, patients often take over-the-painkillers whenever the tooth hurts, avoiding treatment. Delaying root canal treatment can destroy the tooth to the limit that it becomes unrestorable. Also, the potential for side effects increases with the duration of drug use. 

Summary

Aspirin has been used for pain and fever control for decades. It belongs to a group of non-steroidal anti-inflammatory drugs with blood thinning properties. Physicians prescribe it in low doses (75-150mg) to prevent heart disease and stroke in high-risk patients.    

A low dose of aspirin for toothache does not control pain, and higher blood levels are required to reduce the symptoms of inflammation. 

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