Key takeaways
- Start by rinsing with warm water and gently flossing around the sore tooth, since trapped food is a common and easy-to-fix cause.
- A cold compress on the cheek and a children's pain reliever, given exactly as the package label or your pediatrician directs, can help while you wait.
- Never put aspirin or any pain reliever directly on the gums or tooth.
- Facial swelling, fever, a pimple on the gum, or pain that wakes your child needs a same-day call. Swelling near the eye, or trouble breathing or swallowing, means go to the ER.
First steps when your child says a tooth hurts
Stay calm and take a closer look. Many toothaches have simple causes, and a few quick steps can tell you a lot.
- Ask where and when it hurts
Have your child point to the spot. Ask whether it hurts all the time, only when chewing, or after cold or sweet foods. Younger kids may just rub their cheek or refuse to eat on one side.
- Take a look
Use a flashlight to check the tooth and gums. Look for food stuck between teeth, a dark spot or hole, a chip, redness, or a bump on the gum.
- Rinse with warm water
Have your child swish warm water and spit it out to loosen food. For toddlers who can't rinse yet, gently wipe the area with a clean, damp washcloth.
- Floss gently
Slide floss along both sides of the sore tooth to remove anything trapped. Don't poke at the gums with toothpicks or other sharp objects.
- Check for swelling and fever
Look at your child's face for puffiness, and take their temperature if they seem unwell. These details help the dentist decide how soon to see your child.
- Call the dentist
Even if the pain eases, let your child's dentist know what you found.
Common causes of toothaches in kids
Tooth pain in children isn't always a cavity. These are the usual suspects.
A cavity
Decay is the most common cause. Early cavities usually don't hurt, so pain often means a cavity has grown deeper. It may begin as twinges with sweets or cold and progress to an ache that lingers or starts on its own. Our guide to cavities in children explains how decay develops and how to prevent it.
Food stuck between teeth or under the gum
A popcorn hull, a seed, or a shred of meat wedged between teeth can press on the gum and cause surprisingly sharp pain. Gentle flossing often brings quick relief.
New molars coming in
The first permanent molars usually come in around age 6, behind the last baby teeth, and more molars follow in the preteen and teen years. The gum over an erupting molar can be swollen and sore, and food can collect under the flap of gum.
Sinus pressure
The roots of the upper back teeth sit close to the sinuses. During a cold, sinus infection, or allergy flare, pressure can make several upper teeth on one side ache at once, often worse when your child bends over. Check with your pediatrician, and call the dentist if the ache lingers after the congestion clears.
Grinding or clenching
Many children grind their teeth, often during sleep, which can leave teeth or jaw muscles sore in the morning. Many kids outgrow it, but mention it at the next checkup so the dentist can look for wear.
A recent bump or fall
A tooth can hurt after an injury even if it looks fine. In the days or weeks afterward, an injured tooth may turn gray or darker, which can be a sign the nerve is affected. For chipped, loosened, or knocked-out teeth, see our first-aid guide for knocked-out and chipped teeth.
Other causes
A loose baby tooth, a canker sore, irritated gums, a worn or cracked filling, or new braces can all make the mouth feel sore. These are usually less urgent, but they're still worth mentioning to your child's dentist.
| What you notice | Possible cause |
|---|---|
| Sharp pain between two teeth right after eating | Trapped food |
| Quick twinges with cold or sweets | An early cavity or a sensitive spot |
| An ache that lingers or starts on its own, especially at night | A deeper cavity affecting the nerve |
| Several upper back teeth ache, with a stuffy nose | Sinus pressure |
| Sore, puffy gum behind the last teeth | A molar coming in |
| Sore teeth or jaw on waking | Grinding or clenching |
| A pimple on the gum, swelling, or a bad taste | Possible infection, so call the same day |
Safe home care while you wait
These steps can help your child feel more comfortable until they're seen. They ease symptoms but don't fix the cause, so follow up with the dentist even if the pain fades.
- Warm water rinses. Repeat after meals to keep the area clean.
- Gentle cleaning. Keep brushing and flossing the sore area softly. Skipping it lets plaque and food build up and can irritate the gums further.
- A cold compress. Wrap an ice pack or a bag of frozen peas in a thin towel and hold it against the outside of the cheek for short stretches. This can ease pain and swelling.
- A children's pain reliever, used carefully. Children's acetaminophen or ibuprofen can help. Give it by mouth only, choose the product made for your child's age, and follow the package label for dosing. If your child is very young, takes other medicines, or has a health condition, check with your pediatrician or pharmacist first.
- Soft, lukewarm foods. Yogurt, scrambled eggs, pasta, and smoothies are easier than crunchy, very hot, very cold, or sugary foods.
What to avoid
Don't put aspirin or any pain reliever on the gums or tooth. Pills or powders held against the gum can burn the tissue and leave a painful sore. Pain relievers are meant to be swallowed, as directed on the label.
- Don't give aspirin to children or teens unless their doctor specifically tells you to.
- Avoid benzocaine numbing gels for children under 2. The U.S. Food and Drug Administration (FDA) advises against them for this age group. For older children, ask your pediatrician or pharmacist before using any numbing product.
- Don't use leftover antibiotics or anyone else's prescription.
- Don't put heat on a swollen face, and don't try to pop a bump on the gum.
- Don't wait it out if warning signs appear, even if the pain seems to settle.
When to call the dentist
How quickly your child needs to be seen depends on the symptoms. Use this as a general guide, and call whenever you're unsure. You can reach us at (916) 770-4567.
Call to schedule a visit soon
- Pain that comes and goes, or returns after rinsing and flossing
- Sensitivity to sweet, cold, or hot foods
- A visible hole, dark spot, or rough edge on a tooth
- Food that keeps getting stuck in the same place
- Soreness around a new molar that isn't improving
Call the same day
- Swelling of the gum, cheek, or face
- Fever along with tooth pain
- A pimple-like bump on the gum, pus, or a bad taste that won't go away
- Pain that wakes your child at night or keeps them from eating
- Pain after a fall or injury, or a broken tooth
Our page on pediatric dental emergencies explains what to do for urgent problems, including injuries.
Go to the emergency room or call 911
Get emergency care right away if facial swelling spreads toward the eye or down the neck, if your child has trouble breathing, swallowing, or opening their mouth, if they seem very ill with a high fever, or if a dental injury came with a blow to the head. These can be signs of a serious infection or injury that needs immediate medical care.
What the dentist will check
The dentist will ask when the pain started, what makes it better or worse, and whether your child has had a fever, swelling, or a recent injury. They'll look at the tooth and gums, may gently tap or press on teeth to find the sore one, and often take low-dose X-rays to see inside the tooth and around its roots.
Treatment depends on the cause. Trapped food or gum irritation may need only a cleaning and some home care, and a cavity is usually repaired with a filling. If decay or injury has reached the nerve, the tooth may need pulp therapy, sometimes called a baby root canal, to remove the inflamed tissue and save the tooth. Our page on baby root canals (pulp therapy) walks through how that treatment works and how children are kept comfortable.
If an infection is spreading, the dentist may also prescribe medicine to help control it while the tooth itself is treated.
Preventing the next toothache
Most toothaches in children trace back to cavities, so everyday prevention goes a long way: brushing twice a day with fluoride toothpaste, flossing where teeth touch, saving sweets for mealtimes, and regular checkups so small problems are found before they hurt. Our brushing and flossing guide shows how to help at every age.
For active kids, a mouthguard during sports helps protect against injuries. And if your child grinds their teeth or wakes with a sore jaw, bring it up at the next visit.
Tooth pain that keeps coming back?Learn how a baby root canal can relieve pain and save the tooth.
About pulp therapyFrequently asked questions
Can a toothache go away on its own?
Sometimes. Pain from trapped food, sinus pressure, or an erupting molar often eases once the cause clears up. A cavity is different: the ache may fade for a while, but the decay remains and usually grows. If you can't find a simple explanation, have the tooth checked.
How can I tell a toothache from an ear infection?
It can be tricky, because pain from the back teeth can feel like it's coming from the ear, and the other way around. Ear infections often come with a cold, fever, or ear tugging in little ones, while tooth pain is more likely to flare with chewing or with cold and sweet foods. If you're not sure, start with your pediatrician.
Why does my child's tooth hurt more at night?
Lying down may increase pressure around an inflamed tooth, and there are fewer distractions at bedtime. Pain that regularly wakes your child is a sign the tooth should be seen soon, so call the dentist in the morning.
Is it a toothache or just a loose baby tooth?
A wiggly baby tooth can make the gum tender, especially when chewing, and that's a normal part of growing up. Gentle brushing and soft foods usually help. If the gum around it is swollen or very painful, or a tooth became loose after a fall, call the dentist.
Sources and further reading
This guide reflects recommendations from these organizations. It's general information and doesn't replace advice from your child's dentist or pediatrician.