Toothache

TOOTHACHE

Main Symptoms

  • Pain or discomfort in a tooth.
  • Not due to an injury.

Causes

  • Main Cause: tooth decay.
  • Food wedged between the teeth
  • Injured tooth.

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WHEN TO CALL YOUR DOCTOR

Call your doctor now (night or day) if:

  • Your child looks or acts very sick
  • Fever is present
  • Face is swollen
  • Severe pain and not improved 2 hours after taking pain medicine

Call your doctor within 24 hours (between 9am and 4pm) if:

  • You think your child needs to be seen.
  • Toothache present for more than 24 hours.
  • Brown cavity visible in the painful tooth.
  • Red or yellow lump present at the gumline of the painful tooth.

Call your doctor during weekday office hours if:

  • You have other questions or concerns.

Parent care at home if:

  • Mild toothache present less than 24 hours and you don't think your child needs to be seen.
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HOME CARE ADVICE

  1. Reassurance: Most toothaches are temporary and due to a sensitive tooth. If the pain becomes worse or doesn't resolve in 24 hours, it could be due to a small cavity.
  2. Floss: Floss on either side of the painful tooth to remove any wedged food.
  3. Pain Medicine: Give acetaminophen (e.g. Tylenol) or ibuprofen for pain relief.
  4. Local Cold: Apply an ice pack to the painful jaw for 20 minutes
  5. Expected Course: Most minor causes of toothache resolve in less than a day.
  6. Call Your Dentist If:
    • Toothache persists for more than 24 hours
    • The toothache becomes worse

And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.

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REFERENCES

  1. Bimstein E. Peridontal health and disease in children and adolescents. Pediatr Clin North Am. 1991;38:1183-1207.
  2. Dorfman DH, Kastner B, Vinci RJ. Dental concerns unrelated to trauma in the pediatric emergency department. Arch Pediatr Adolesc Med. 2001;155:699-703.
  3. Edelstein BL. Evidence-based dental care for children and the age 1 dental visit. Pediatr Ann. 1998;27:569-574.
  4. Marek MA, Lindsell CJ, Jauch EC, Panioli AM. Effect of education and guidelines for treatment of uncomplicated dental pain on patient and provider behavior. Ann Emerg Med. 2004;44:323-329.
  5. Mueller W. When baby teeth decay. Contemp Pediatr. 1993;10:75.
  6. Wilson S, et al. Nontraumatic dental emergencies in a pediatric emergency department. Clin Pediatr. 1997;36:333-337.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

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