Are benzocaine gels like Orajel safe for tooth pain, and do they work?

Tooth pain has a way of arriving at the worst moment. It wakes you at 2 a.m. or hits right before a weekend. You reach for a tube of Orajel and start wondering about over-the-counter tooth pain relief: Will benzocaine gel for tooth pain actually help, and is it safe to use? 

A topical benzocaine gel can offer temporary numbing, but it does not fix the problem causing the pain.¹^,² Safety needs a closer look, and even adults should take the warnings seriously. Ask a dentist or doctor before using a benzocaine product.³ 

What you'll learn: 

• What benzocaine does and why relief is temporary 

• Safety precautions for adult use, including a rare but serious reaction 

• Why the Food and Drug Administration (FDA) warns against using these products on young children 

• Which symptoms mean you need a dental provider, not more gel 

Schedule a dental exam with an Aspen Dental provider to find out what is causing your tooth pain and discuss relief while it is treated. 

What benzocaine does 

Benzocaine is a numbing ingredient. It belongs to a group called local anesthetics, which temporarily numb an area.² That is the job of the gel: to offer short-term relief, not to repair the tooth. 

Relief is temporary; a fixed number of minutes isn't a promise you can rely on. The gel has not changed anything about the tooth. Decay, an infection or a crack can still need treatment even if the ache eases.³

That matters, because pain is a signal. Temporary relief should not become a reason to delay care. Think of the gel as something to discuss while arranging treatment, not a way to decide whether the tooth needs attention. 

Benzocaine versus Orajel 

Orajel is a brand. Benzocaine is an ingredient. Check the Drug Facts on the specific product you're holding rather than relying on the brand name. For example, Orajel 4X Medicated for Toothache and Gum contains 20% benzocaine along with other active ingredients.¹

The same is true of other store brands. Check the active ingredient list. If it says benzocaine, the general guidance here applies. If it lists a different ingredient, read that product's label on its own terms. 

Using benzocaine gel safely as an adult 

Follow the directions on the product label exactly. Do not apply more gel than the label specifies or use it more often than directed.¹ If it isn't helping, don't keep adding more in the hope of getting better relief. 

The Orajel 4X label includes these precautions:¹

• Use no more than the label directs. 

• If pain, redness or irritation lingers or gets worse, stop using the gel and ask a doctor. 

• If you develop swelling, a rash or a fever, stop using it and ask a doctor. 

• Store the tube where children cannot reach it. 

The label also says not to use it if you have a history of allergy to benzocaine or other local anesthetics listed in its allergy warning.¹ If you're unsure which anesthetic caused a past reaction, ask a pharmacist or your provider before using the gel. 

A serious reaction to know about: methemoglobinemia 

One warning deserves special attention: methemoglobinemia. That is a big word for a rare but serious blood problem that can be life-threatening.²^,³ 

Your red blood cells carry oxygen around your body. In this reaction, benzocaine can sharply cut the amount of oxygen your blood is able to carry.²^,³ A previous uneventful use does not rule out a reaction the next time.¹

Warning signs after using benzocaine include:¹

• Pale, gray or blue skin 

• Shortness of breath 

• A fast heartbeat 

• Headache, dizziness or lightheadedness 

• Unusual tiredness or lack of energy 

If these symptoms appear after using the gel, stop using it and get immediate medical attention.¹ Do not wait to see if they pass or treat them as another part of the toothache.

Children and teething: a clear restriction 

Do not use oral benzocaine products in children under 2 or for teething.¹ The FDA says these products do little for teething pain and can seriously injure young children.² Safer ways to soothe teething should be discussed with a pediatric provider. 

This article focuses on adult tooth pain. But if a child in your home has tooth pain, call their dental provider before reaching for any over-the-counter product. 

Other temporary options for adults 

An over-the-counter pain reliever taken by mouth may help while you wait for a dental appointment.³ Read the label and check with a pharmacist or your dental provider if you have health conditions or take other medications. Bring the product name when you ask, so the advice matches what you plan to use. 

If the toothache follows an injury, a cold compress against the outside of the cheek may help. Keep aspirin and other pain-relief pills off your gums, since they may burn the tissue.³ 

When the pain is more than a toothache 

More gel is not the answer to symptoms that need assessment. Call your dental provider right away if your toothache comes with any of these signs:³

• Swelling or red gums 

• A fever

• Pain when you bite 

• A bad-tasting fluid in your mouth 

Difficulty breathing or swallowing calls for emergency care at a hospital.³ Don't wait for a dental appointment if either happens. 

Pain lasting more than a day or two also calls for contacting your dental provider right away.³ When you call, explain when it began and what you've already tried. 

If your tooth pain is keeping you from eating, sleeping or getting through the day, reach out to your local dental provider to schedule an appointment. Getting the cause assessed is the next step toward treatment. 

Are benzocaine gels like Orajel safe for tooth pain, and do they work? FAQs 

Can I use benzocaine gel every day until I can get to the dentist? 

The label on your specific product tells you its limits. For example, Orajel 4X should not be used for longer than seven days unless a dentist or doctor directs it.¹ That is a use limit, not a reason to wait seven days before calling about a toothache. Arrange care while you're considering temporary relief. 

Is benzocaine gel safe to use if I am pregnant? 

If you are pregnant and have tooth pain, ask your dental provider, prenatal clinician or pharmacist before using an oral numbing product. Give them the exact product name and ingredient list. That lets you discuss your situation without assuming that a medicine is suitable simply because it is sold over the counter. 

What if the gel makes my mouth feel numb in a larger area than I expected? 

If the numbness feels unexpected, pause further use and ask a pharmacist or medical professional about the specific product and amount you applied. Don't try to judge absorption from the numbness alone. Difficulty swallowing or breathing needs emergency care.³ Bring the packaging so the treating team knows what you used. 

Sources 

¹ National Library of Medicine, DailyMed: “Orajel 4X Medicated for Toothache and Gum- benzalkonium chloride, benzocaine, menthol, zinc chloride gel.” https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=999851ac-925c-7d1f-e053-2a95a90a240b 

² U.S. Food and Drug Administration: “Safely Soothing Teething Pain in Infants and Children.” https://www.fda.gov/consumers/consumer-updates/safely-soothing-teething-pain-infants-and-children 

³ Mayo Clinic: “Toothache: First aid.” https://www.mayoclinic.org/first-aid/first-aid-toothache/basics/art-20056628