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  • Pain or discomfort in a tooth
  • Not caused by an injury

Causes of a Toothache

  • Tooth Decay. If the pain persists more than a day, this is the most common cause. A yellow-brown defect in the enamel may be seen. The most common site is the surface of one of the molars. The pain is dull.
  • Dental Abscess. If the pain is severe and throbbing, the decay has become a tooth abscess. That means a pus pocket has formed within the root of the tooth. Tapping on the tooth causes increased pain. If not treated, the abscess will erode through the bone. A "gum boil" or pimple will be seen below the gum line. The patient needs to see a dentist for a root canal.
  • Cracked Enamel. Biting on a hard object by mistake can crack a tooth. The tooth becomes sensitive to hot and cold liquids. The tooth may look normal. The fracture line may be below the gum line or just hard to see.
  • Gum Disease. Gingivitis is a medical name for irritated gums. They are red and tender. If tooth brushing and flossing are ignored, the gums may even bleed. Can be very painful. Responds to getting the teeth cleaned and daily flossing.
  • Stuck Food. Hard food may become wedged between 2 teeth. Proper flossing will remove the food and stop the pain.

Tooth Abscess and Severe Pain

  • A tooth abscess can cause severe pain not controlled by normal pain medicines.
  • Root canal therapy by an endodontist is needed to cure this problem.
  • In the meantime, call your dentist's office. If you can't reach your dentist, call your doctor for advice. They can often bring the pain under control by calling in a prescription. Most often, this is for an antibiotic such as penicillin.

When To Call

Call Your Dentist or Doctor Now

  • Your child looks or acts very sick
  • Fever is present
  • Face is swollen
  • Severe pain and not better 2 hours after taking pain medicine
  • You think your child needs to be seen, and the problem is urgent

Contact Your Dentist Within 24 Hours

  • You think your child needs to be seen, but the problem is not urgent
  • Toothache lasts more than 24 hours
  • Brown or dark spot in the painful tooth
  • Red or yellow lump at the gumline of the painful tooth

Contact Your Dentist During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Mild toothache present less than 24 hours

Care Advice

What You Should Know About Toothaches:

  • Most toothaches don't last too long. They are due to a sensitive tooth.
  • If the pain becomes worse or doesn't go away in 24 hours, call your dentist. The pain could be due to a small cavity.
  • Here is some care advice that should help.


  • Floss on either side of the painful tooth to remove any wedged food.

Pain Medicine:

  • To help with the pain, give an acetaminophen product (such as Tylenol).
  • Another choice is an ibuprofen product (such as Advil).
  • Use as needed.

Cold Pack for Pain:

  • Put a cold pack or ice in a wet washcloth on the painful jaw. Do this for 20 minutes.

What to Expect:

  • Most minor causes of toothache go away in less than a day.

Call Your Dentist If:

  • Toothache lasts more than 24 hours
  • The toothache gets worse
  • You think your child needs to be seen


Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
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