Short answer: The most common cause of toothache in children is decay; trapped food, teething, trauma and abscesses can also cause pain. At home, examining the tooth and gently cleaning between the teeth, applying a cold compress on the outside and using an age-appropriate pain reliever as recommended by a doctor or pharmacist provide temporary relief. In case of swelling, fever, trauma or pain lasting more than a day, see a dentist.
Toothache in children is one of the complaints that worries parents most, because young children cannot always describe where the pain is or how severe it is. The pain sometimes comes from something as simple as trapped food, and sometimes from decay or an infection that needs treatment. In this article we answer the question of what to do about a child's toothache, explaining the causes, first aid at home, what to watch for when using pain relievers and when to see a dentist right away.
Causes of toothache in children
The most common cause of toothache in children is decay; this is followed by food trapped between the teeth, teething, trauma, gum inflammation and newly erupting permanent teeth.
- Decay: Because the enamel of baby teeth is thin, decay progresses quickly. A brief twinge with sweets or cold at first can, at a later stage, turn into pain that starts on its own and gets worse especially at night.
- Abscess: When decay reaches the nerve of the tooth, infection can collect at the root tip, causing a pimple-like swelling on the gum, facial swelling and fever.
- Trapped food: A meat fiber, corn skin or popcorn hull can get stuck between two teeth and press on the gum.
- Teething: In babies, the eruption of baby teeth, and at around age 6 the eruption of the first permanent molars, can make the gums tender.
- Trauma: After a fall or a knock, a tooth may fracture, become loose or change color.
- Gum inflammation and canker sores: Sores in the mouth can cause pain when chewing and be perceived as toothache.
- Sinusitis or ear infection: Pain felt in the upper back teeth can sometimes come from causes unrelated to the teeth.
First aid at home
The first thing to do at home for a child's toothache is to look at the painful area, gently clean away any trapped food and calm the child; these steps can provide relief until you reach a dentist, but they do not replace treatment.
- Examine the mouth: Under good light, look at the painful tooth and check whether there is swelling, redness or a visible hole in the gum.
- Clean between the teeth: Try to gently remove trapped food with a toothbrush and dental floss. The gum may bleed; do not force it.
- Have the child rinse: If the child can spit, have them rinse with lukewarm water, or with warm salt water if your dentist recommends it. In young children, watch out for the risk of swallowing.
- Apply cold on the outside: If there is facial swelling or trauma, you can apply a cold compress wrapped in a cloth to the outside of the cheek at short intervals.
- Keep the head slightly raised when lying down: For pain that gets worse at night, raising the pillow slightly can reduce the feeling of pressure.
- Take notes: Noting when the pain started, whether it is related to hot, cold or eating, and whether there is fever makes the dentist's job easier.
What not to do
- Do not put pain reliever tablets, aspirin, alcohol or substances such as clove oil on the tooth or gum; these can cause burns to the tissue.
- Do not apply a warm compress if there is facial swelling.
- Do not use antibiotics left over from old prescriptions without consulting a doctor.
- Do not cancel the dental appointment because the pain has stopped; in teeth where the nerve is affected, the pain can subside temporarily and later return with an abscess.
Using pain relievers
In children, a pain reliever should be used only with a medication suitable for the child's age and weight, following the package leaflet and the recommendation of a doctor or pharmacist. Syrup and suspension forms made for children should be given with a measuring spoon; non-standard measures such as kitchen spoons should not be used. Take care not to give two different medications containing the same active ingredient together.
Aspirin and products containing aspirin are generally not recommended for children because of the risk of a rare but serious side effect. A pain reliever does not remove the cause of the pain; it only helps the child feel more comfortable until you reach a dentist. If the pain continues despite the medication, or comes back quickly each time a dose wears off, the tooth needs to be assessed as soon as possible.
When should you see a dentist?
If the pain lasts more than a day, wakes the child at night, or comes with swelling, fever or trauma, the child should be taken to a dentist as soon as possible.
Situations requiring a same-day visit
- Swelling in the face, under the eye or under the jaw
- Toothache together with fever, weakness and loss of appetite
- Swelling with pus discharge on the gum
- A tooth that is broken, displaced or knocked out after a fall or a knock
- Severe pain that does not subside despite a pain reliever
If there is difficulty swallowing or breathing, or a rapidly growing swelling, go to the emergency department without delay.
Baby teeth versus permanent teeth after trauma
A baby tooth that has been completely knocked out is not put back in place because of the risk of damaging the permanent tooth developing underneath; however, the child should still be examined. With a knocked-out permanent tooth, time is critical: hold the tooth by the crown, not the root; if it is dirty, rinse it gently and briefly with milk or saline; keep it in milk or in the child's mouth and get to a dentist immediately.
Treatment options
Treatment of toothache in children is determined by the cause, and the aim is to keep the tooth in the mouth whenever possible.
- Filling: In decay that has not reached the nerve, the decay is removed and the tooth is restored with a filling.
- Root canal treatment for baby teeth: If the decay has reached the nerve, procedures can be done in which part or all of the nerve tissue is removed and the root canals are filled.
- Crown: Preformed crowns can be used to protect baby molars with extensive loss of tooth structure.
- Extraction and space maintainer: Teeth that cannot be saved are extracted; if needed, a space maintainer is made to keep room for the permanent tooth.
- Preventive treatments: Fluoride varnish and fissure sealants help prevent new decay.
Depending on the child's age and level of anxiety, procedures are done in short, understandable steps that are explained to the child in advance. Parents using calm and positive language before the visit, instead of promises like "it won't hurt", makes the child's experience easier. For other topics on children's dental health, you can see our frequently asked questions page.
Is it possible to prevent toothache?
Most toothache in children can be prevented by catching decay at an early stage. Brushing the teeth twice a day with fluoride toothpaste, having an adult do or supervise brushing until age 7–8, and limiting sugary foods and drinks to main meals rather than snacks are the basic steps. Not giving milk or fruit juice in a bottle at night and a dental check-up every six months also allow small cavities to be treated before they turn into pain.
Getting help for your child's toothache in Ankara
If your child's toothache keeps coming back, keeps them awake at night or occurs together with facial swelling, the cause of the pain needs to be seen by a dentist. At our polyclinic in Park Oran Ofis in Çankaya, examinations and treatment planning are carried out for children; for emergencies, you can also call us for an appointment.
Frequently asked questions
My child's toothache got worse at night; can I wait until morning?
If there is no swelling, fever or difficulty breathing, you can ease your child's pain with an age-appropriate pain reliever and see a dentist first thing in the morning. Pain that gets worse at night often suggests that decay has reached the nerve, so the appointment should not be postponed.
Does putting a pain reliever on the aching tooth help?
No. Placing medications such as tablets or aspirin on the tooth or gum can burn the tissue. Pain relievers should only be taken by mouth as directed by the package leaflet and a doctor's recommendation.
Should a warm compress be applied to a child with a swollen face?
A warm compress is not recommended if there is facial swelling. A cold compress wrapped in a cloth can be applied on the outside at short intervals. Toothache accompanied by swelling requires seeing a dentist the same day.
If a baby tooth is knocked out, is it put back in?
A baby tooth that has been completely knocked out is usually not put back in because of the risk of damaging the permanent tooth developing underneath. Even so, the child should be taken to a dentist and the surrounding tissues and other teeth should be checked.
