I wouldn't mess around with tooth pain. I agree that once you open the pain pathways it can become chronic. Tramadol does work better with Tylenol, in fact they offer it as a combination drug in SE Asia, where I took it for a knee injury last year. I also recommend taking the pain meds as prescribed, but then start tapering off as soon as you can. The issue with Tramadol is the tolerance builds when you use it for awhile (months) even a low dose. I had some difficulty myself.