Child toothache — causes, safe pain relief and when it needs same-day care

Key facts

• Tooth decay is the most common cause of child toothache
• Use children's paracetamol or ibuprofen dosed by weight, as on the pack
• Never give aspirin to children under 16 or place tablets on the gum
• Swelling, a gum boil or night pain needs same-day dental care
• Spreading facial swelling, trouble swallowing or high fever needs emergency care

Common causes of toothache in children

Tooth decay is the most frequent cause. When a cavity gets close to the nerve, a child may complain of pain with sweets or cold drinks, then pain that lingers or wakes them at night. Food such as popcorn husks or meat fibres trapped between back teeth can cause pressure and gum soreness. Erupting six-year or twelve-year molars can make the gum swollen and tender. Loose baby teeth sometimes ache as they move. A fall or knock can crack or bruise a tooth. Sinus congestion can make upper back teeth feel sore, and grinding can cause morning jaw or tooth ache.

Safe pain relief for children

Children's paracetamol or children's ibuprofen are commonly used for toothache. Use the product made for children and the dose for your child's weight or age printed on the pack, measured with the syringe or spoon provided. As a general guide, paracetamol is often given at about 15 mg per kg per dose, no more than four doses in 24 hours, and ibuprofen at about 5 to 10 mg per kg per dose every six to eight hours with food. Do not give aspirin to children under 16, do not exceed the stated dose, and ask your pharmacist or doctor if your child has asthma, kidney problems or other conditions.

What you can do at home

Gently brush the area and use floss to remove any food trapped between teeth, as this alone can relieve pain. A cold compress on the cheek for short periods may help with swelling after a knock. Offer soft, lukewarm food and avoid very hot, cold or sugary items. Do not place aspirin or crushed tablets on the gum, as this can burn the tissue. Avoid numbing gels containing benzocaine for young children unless a doctor or pharmacist advises them. Note when the pain started, what triggers it and whether it wakes your child, as this helps the dentist find the cause.

When toothache needs same-day care

Seek same-day dental care if there is swelling of the gum or face, a pimple-like bump on the gum, pain that wakes the child at night or does not settle with pain relief, a broken or knocked-out tooth, or a tooth that has become dark or very loose after injury. Go to an emergency department urgently if there is facial swelling spreading towards the eye or neck, difficulty swallowing or breathing, high fever, or a child who is drowsy or very unwell. A knocked-out adult tooth should be placed back in its socket or kept in milk and brought in immediately, while a knocked-out baby tooth should not be replanted.

How the dentist treats it

The dentist asks about the pain, examines the teeth and gums, and may take an X-ray to see how deep decay goes or whether there is infection at the root. Treatment depends on the cause: a filling for a cavity, a pulpotomy and crown when decay reaches the nerve of a baby tooth, cleaning and advice for gum soreness, smoothing or bonding a chipped tooth, or extraction of a badly infected tooth. Antibiotics are not a substitute for dental treatment and are used only when infection is spreading. Visits are paced to the child, with numbing gel and gentle local anaesthesia.

Positive early visits shape a child's attitude to dentistry for life. We keep appointments short, explain everything in child-friendly language, and focus on prevention.

Prepared by the Manhal Medical Center editorial team · Updated: 2026-10-18 · Treating specialist: Dr. Fariba Alnoory

This page is general information and does not replace a consultation. Suitability, risks and results vary between patients.