Can i combine aleve and tylenol (acetaminophen) to help relieve my toothache? if not, which otc pain killer is best for my toothache?

OTC Pain Relief: Aleve can be taken 200 mg Naproxen every 8-12 hours and 400 mg initial dose for adults. Tylenol (acetaminophen) usually is 325-650 mg every 4-6 hours or 1000 mg 3-4 times/day not to exceed 4g/day. I typically tell patients to rotate the use of these drugs if they are going to do this but usually want my patients to try to use one to see the efficacy as both may not be necessary.If you have questions, ask doctor.

Ibuprofen: It is not good to combine medications. I would recommend 800 mg of ibuprofen.

Yes, but watch doses: Aleve and tylenol (acetaminophen) work in two different ways so it would be ok to take both but just do not take more than the recommended doses on each package. Both have potential short term and long term side effects including kidney and liver damage.

Yes: Yes, in fact those two in combination work quite well. When the pain progresses, often times no pain medications will "make a dent" in it. You should interpret your pain as a warning sign and be evaluated before it progresses to a dental emergency. An alternative to aleve (naproxen) is ibuprofen. Either of these are probably your best otc options.