A child’s toothache can be alarming, often appearing without warning and causing immediate distress. Pain, whether a dull throb or a sharp sensation, signals a need for prompt attention to identify the cause. This guide provides parents with immediate, actionable steps to temporarily relieve a child’s pain and offers clear direction on when professional dental care is necessary.
Immediate Steps for Relief
The first step in addressing a child’s tooth pain is to thoroughly inspect the affected area to pinpoint the source of discomfort. Have the child rinse their mouth gently with warm water to flush out any debris that may be caught between teeth or lodged in the gums. This non-chemical intervention is often enough to remove food particles that are causing pressure and irritation.
Once the mouth is clear, gently use dental floss to remove any remaining food particles that might be tightly wedged. Avoid poking the area with sharp tools like toothpicks, which can cause further injury to the soft tissues.
If the child’s cheek is visibly swollen, applying a cold compress can help reduce inflammation and temporarily numb the pain receptors. The cold compress, such as an ice pack wrapped in a thin cloth, should be held against the outside of the cheek near the painful area. Apply the compress for alternating intervals, such as 15 minutes on and 15 minutes off, to prevent injury to the skin. This application of external cold diminishes localized swelling.
Safe Medication and Home Comfort Measures
Systemic pain management with over-the-counter (OTC) medication is often the most effective method for short-term relief. Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) are the recommended choices. The proper dosage is based on the child’s current weight, not their age. Consult the product’s dosing chart and never exceed the maximum recommended dose within a 24-hour period.
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that works by reducing both pain and inflammation, making it particularly effective for toothaches with accompanying swelling. Acetaminophen works primarily as a pain reliever and fever reducer. These two medications can sometimes be alternated to provide more sustained relief, but this requires careful tracking of the timing and dosage of each drug.
A strong warning must be observed regarding aspirin, which should never be given to children or teenagers because of its association with Reye’s syndrome. Furthermore, parents must never place an aspirin tablet directly on the tooth or gum tissue. This common home remedy can cause a severe chemical burn to the sensitive oral mucosa without providing significant pain relief.
For a non-medication approach, prepare a warm saltwater rinse by mixing one teaspoon of salt into eight ounces of warm water. Sodium chloride acts as a mild antiseptic and helps draw fluids out of inflamed tissues, reducing swelling and cleansing the area. The child should swish the solution around the mouth for about 30 seconds before spitting it out.
Topical anesthetics containing benzocaine should be used with caution and are not recommended for young children due to the risk of methemoglobinemia, a serious blood disorder. This risk is especially high in children under two years old.
Temporary Fixes for Common Dental Issues
When a structural issue is the cause of pain, temporary measures can be taken to protect the exposed tooth surface until a dentist can be seen. If a filling or crown has fallen out, the exposed inner layer of the tooth can be highly sensitive to temperature and air. The resulting cavity can be temporarily covered with a small piece of dental wax, or in a pinch, a piece of sugar-free gum pressed gently into the space.
The purpose of this temporary cover is to shield the sensitive dentin and prevent food debris from entering the open space, not to replace the dental restoration. If the lost restoration is an intact crown, it can sometimes be temporarily reattached using over-the-counter dental cement found at most pharmacies. The tooth and the inside of the crown must be cleaned before applying the cement and gently biting down to seat the crown.
If a tooth has been chipped or broken, retrieve any fragments found and store them carefully in milk, saline solution, or the child’s saliva. Keeping the cells moist increases the chance of reattachment by the dentist. If the remaining edge of the tooth is sharp and irritating the tongue or cheek, cover the jagged edge with a piece of dental wax.
For children experiencing pain from erupting permanent molars, which typically appear around ages six and twelve, relief measures focus on managing the pressure and inflammation. Offering soft, cold foods like yogurt, chilled fruit, or a frozen teether can provide comfort. Gently massaging the swollen gum tissue with a clean, wet gauze pad can also help alleviate localized soreness.
Recognizing Dental Emergencies
Most toothaches can wait for an urgent appointment with a pediatric dentist, but certain signs require immediate attention, possibly at an emergency room if the dental office is closed. A dental issue becomes a medical emergency when infection or trauma threatens the child’s overall health.
Seek immediate medical attention if the toothache is accompanied by significant facial swelling that extends beyond the jawline, especially if it is near the eye or throat. These symptoms indicate a rapidly spreading infection that may compromise the airway. A high fever accompanying the pain also suggests a systemic infection or abscess.
Other red flags for an immediate emergency room visit include uncontrolled bleeding that does not stop after applying pressure for 10 to 15 minutes, or pain resulting from major trauma, such as a fractured jaw or a tooth that has been completely knocked out. While an emergency room cannot perform dental repairs, they can stabilize a child, manage systemic infection, and address life-threatening injuries.