A child’s tooth pain usually responds well to over-the-counter pain relievers, cold compresses, and saltwater rinses while you arrange a dental visit. The right approach depends on your child’s age, the likely cause of the pain, and how severe the symptoms are. Here’s what to do right now and what to watch for.
Quick Pain Relief at Home
Children’s ibuprofen and children’s acetaminophen are the two most effective options for tooth pain. Ibuprofen is often the better first choice because it reduces both pain and inflammation, which matters when gums or tissues around a tooth are swollen. Give it every 6 to 8 hours as needed, up to 4 doses in 24 hours. Acetaminophen can be given every 4 to 6 hours, up to 5 doses in 24 hours. Always dose by your child’s weight, not their age, and use the measuring device that comes with the product.
If your child’s pain is stubborn, you can alternate between the two medicines. Give ibuprofen first, then acetaminophen 3 hours later, then ibuprofen 3 hours after that. This keeps pain relief overlapping without exceeding safe limits for either medication.
A cold compress held against the outside of the cheek near the sore tooth helps reduce swelling and temporarily dulls pain. Wrap ice or a cold pack in a thin cloth and apply it for 10 to 15 minutes at a time. For younger children who won’t tolerate a compress, a cold (not frozen) teething ring or a chilled wet washcloth can work.
For children old enough to swish and spit without swallowing (usually around age 6), a saltwater rinse can ease gum irritation and help clear bacteria around the painful area. Mix about one teaspoon of salt into 8 ounces of warm water. Have your child swish gently for 15 to 30 seconds and spit. This can be repeated a few times a day.
Products to Avoid
Numbing gels containing benzocaine should not be used on infants or children under 2. The FDA has warned that benzocaine can cause methemoglobinemia, a condition where oxygen levels in the blood drop dangerously low. Symptoms include pale or blue-tinged skin, lips, or nail beds, along with shortness of breath, fatigue, and a rapid heart rate. These can appear within minutes to two hours of use. Even for children over 2, the benefits of these gels for mouth pain are minimal compared to the risks.
Clove oil is another popular home remedy that is not safe for children. Swallowing clove oil can be toxic, and there is limited safety data on its use in kids. Stick with the pain relievers and cold compresses described above.
Common Causes of Tooth Pain in Children
Cavities are the most frequent reason a child complains of a toothache. Pain from a cavity can range from mild sensitivity to hot or cold foods to sharp, constant throbbing if the decay has reached the nerve inside the tooth. A cavity that’s been building for months might suddenly become painful when it breaks through deeper layers of the tooth.
Trauma is the second major cause. Falls are the leading source of dental injuries in children, followed by sports and playground collisions. A hard impact can crack a tooth, loosen it, or damage the nerve inside. If the fracture extends deep enough to expose the inner pulp of the tooth, the pain is usually intense and immediate. A tooth that looks darker than the ones around it after an injury may have nerve damage, even if it doesn’t hurt right away.
Other causes include food lodged between teeth (surprisingly painful and easy to miss), a new tooth erupting and pressing against neighboring teeth, gum irritation from aggressive brushing, or a developing abscess. An abscess forms when bacteria from a deep cavity or injury create a pocket of infection, often producing a visible bump on the gum that looks like a small pimple.
Teething Pain vs. a Toothache
In babies and toddlers, it’s not always obvious whether discomfort is from normal teething or something that needs treatment. Teething typically causes fussiness, drooling, and a desire to chew on things. It may raise your child’s temperature slightly, up to about 100.3°F, but it does not cause a true fever. If your child has a temperature above that, the pain is more likely from illness or infection than from a tooth coming in.
A toothache from decay or infection tends to produce more focused pain. Your child might point to a specific spot, refuse to eat on one side, or cry when something touches a particular tooth. Teething discomfort is more diffuse and comes and goes over days or weeks as teeth push through. Ear pulling can accompany both teething and ear infections, so if it persists or comes with a high fever, it’s worth having your pediatrician take a look.
For teething specifically, the American Academy of Pediatrics recommends gently rubbing or massaging your baby’s gums with a clean finger, or letting them chew on a firm rubber teething ring. No gels, no medications applied directly to the gums.
Signs That Need Prompt Attention
Most toothaches warrant a dental visit within a day or two, but certain symptoms call for faster action:
- Fever combined with tooth or jaw pain. This combination suggests an infection that may need treatment beyond what home care can provide.
- Facial swelling. Swelling along the jaw, cheek, or under the eye can signal an abscess. Mild puffiness right after a bump is normal, but swelling that’s warm to the touch, growing, or spreading is a red flag.
- Pus around a tooth or on the gums. Visible pus means a bacterial infection that needs drainage and likely a course of antibiotics.
- Pain so severe your child can’t eat or sleep. If over-the-counter pain relievers aren’t making a dent, the problem has likely progressed beyond what home care can manage.
- A knocked-out permanent tooth. This is a true emergency. Place the tooth in milk or saliva (not water) and get to a dentist within 30 minutes if possible. Baby teeth that get knocked out are generally not reimplanted.
Keeping Tooth Pain From Coming Back
Most childhood tooth pain traces back to cavities, and cavities are largely preventable. Brush your child’s teeth twice a day with a fluoride toothpaste. Children under 3 need just a rice-grain-sized smear; kids 3 to 6 use a pea-sized amount. Supervise brushing until your child has the coordination to do a thorough job on their own, which for most kids is around age 7 or 8.
Professional fluoride treatments, applied at dental checkups, are one of the strongest tools for preventing decay. Evidence supports starting these as early as 6 months of age for children at higher risk, with treatments repeated every 3 to 6 months. Dental sealants, thin protective coatings painted onto the chewing surfaces of back teeth, are another effective barrier against cavities in the grooves where food and bacteria tend to collect.
Frequent snacking on sugary or starchy foods feeds the bacteria that produce acid and erode tooth enamel. Juice, flavored milk, gummy snacks, and crackers are common culprits. Limiting these between meals, and encouraging water as the default drink, makes a measurable difference in cavity rates over time. Your child’s first dental visit should happen by their first birthday or when their first tooth appears, whichever comes first, so problems can be caught before they start causing pain.