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Does this describe your child's symptoms?

  • Pain or discomfort in a tooth
  • Not due to an injury


  • Main Cause: tooth decay
  • Food wedged between the teeth
  • Injured tooth

Tooth Abscess and Severe Pain

  • A tooth abscess can cause severe pain not controlled by non-prescription pain medicines.
  • Root canal therapy by an endodontist is needed to cure this problem.
  • In the meantime, if your child's dental office is closed, your doctor or dentist can bring the pain under control within hours by calling in a prescription for penicillin or amoxicillin.

If not, see these topics

When to Call Your Doctor

Call Your Dentist or Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Fever is present
  • Face is swollen
  • Severe pain and not improved 2 hours after taking pain medicine
  • You think your child needs to be seen urgently
Call Your Dentist Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen, but not urgently
  • Toothache present over 24 hours
  • Brown cavity visible in the painful tooth
  • Red or yellow lump present at the gumline of the painful tooth
Call Your Dentist During Weekday Office Hours If
  • You have other questions or concerns
Parent Care at Home If
  • Mild toothache present less than 24 hours and you don't think your child needs to be seen

  1. Reassurance: Most toothaches are temporary and due to a sensitive tooth. If the pain becomes worse or doesn't resolve in 24 hours, it could be due to a small cavity.
  2. Floss: Floss on either side of the painful tooth to remove any wedged food.
  3. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief.
  4. Local Cold: Apply a cold pack or ice in a wet washcloth to the painful jaw for 20 minutes.
  5. Expected Course: Most minor causes of toothache resolve in less than a day.
  6. Call Your Dentist If:
    • Toothache persists over 24 hours
    • The toothache becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/15/2011

Last Revised: 8/1/2011

Content Set: Pediatric HouseCalls Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.