Toothache (Pulpitis) in Children

What is a toothache in children?

A toothache (pulpitis) is the pain felt in or around a tooth. It occurs when the pulp inside a tooth becomes inflamed and infected. The pulp is the soft part inside the tooth that has blood vessels and nerves.

What causes a toothache in a child?

A toothache often happens after an injury to the tooth. The most common form of injury to a tooth is from a cavity. This is a hole in a tooth.

A cavity is often the result of poor dental hygiene. Sugar and starch in foods allow bacteria in the mouth to damage the teeth. The bacteria in the mouth feed on sugar and starch and make an acid that can eat through the teeth. This leads to tooth decay.

What are the symptoms of a toothache in a child?

Each child may feel symptoms a bit differently. But below are the most common symptoms of a toothache:

• Constant, throbbing pain in a tooth

• Pain in the tooth that gets worse when the tooth is touched or when hot or cold foods or fluids are consumed

• A sore, tender jaw around the tooth

• Fever

• A general feeling of tiredness or illness (malaise)

How is a toothache diagnosed in a child?

Your child’s healthcare provider can often diagnose a toothache with a complete health history and exam. They will likely refer your child to a dentist for evaluation and care.

At the dentist, your child may have X-rays done. An X-ray makes images of internal tissues, bones, and teeth. The dentist may also check for cavities using a device called a transilluminator. It uses no radiation. A transilluminator uses intense light to detect dental issues such as caries, fractures, or narrow root canal orifices.

The symptoms of a toothache may seem like other health or dental problems. Make sure your child sees their healthcare provider or dentist for a diagnosis.

How is a toothache treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. If the infection is severe, your child may be treated in a hospital. They may need antibiotics through an IV (intravenous) line.

Treatment may include:

• A filling, if needed

• Antibiotics

• Pain medicine

• Warm saltwater rinses for the mouth

• Tooth removal

• Draining a pus-filled infection (abscess) if needed

• Surgery to remove the inflamed pulp from the middle of the tooth (root canal)

How can I help prevent a toothache in my child?

Good oral habits can prevent cavities, the leading reason for toothache. Make sure your child:

• Correctly brushes their teeth twice a day. The American Dental Association (ADA) recommends people brush their teeth for 2 minutes twice a day with a soft-bristle toothbrush.

• Flosses daily

• Sees the dentist regularly. The dentist can find and treat cavities early before they cause damage to the pulp. They can also give treatments to stop cavities from happening such as fluoride treatments, particularly when you aren't getting enough fluoride through fluoridated drinking water and other sources. If paying for dental services is a problem, ask your dentist about resources.

• Eats healthy foods, limiting those high in sugar and starch

Key points about toothache in children

• A toothache is when the pulp inside a tooth becomes inflamed and infected.

• Most toothaches are caused by cavities.

• Besides pain, a toothache may cause fever and a general feeling of tiredness (malaise).

• X-rays can diagnose problems within the tooth.

• Treatment may include antibiotics, pain medicine, a filling, or removal of the tooth.

• Toothaches can be prevented with good oral care.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also, write down any new instructions your healthcare provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also, know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.