Medically reviewed by Dr. Joshua Kohan, DMD — kids dentist, Say Cheese Kids Dental & Orthodontics, Chino, CA
Quick Answer
Call the dentist if your child has persistent or significant pain, a fever, swelling of the face or gum, or pain that wakes them at night. Go to an emergency room instead if there is difficulty swallowing or breathing, or swelling spreading toward the eye or neck. A brief twinge from cold that settles quickly can usually wait for a routine appointment.
Call Us Today If You See Any of These
- Persistent or significant pain — particularly pain that wakes your child at night, which usually means the nerve is involved
- Fever alongside tooth pain — a sign infection may be spreading
- Swelling of the gum, cheek or face — even mild swelling should be seen the same day
- Difficulty swallowing or breathing — this is an emergency room visit, not a dental one
- Pain lasting more than a day, or that keeps returning
- A visible hole, dark spot or broken tooth alongside the pain
When It Can Probably Wait
Not every ache is urgent. These can usually be handled at a normal appointment:
- A brief twinge with something cold or sweet that settles within seconds
- Soreness around a tooth that is visibly loose and about to come out naturally
- Discomfort after a knock that eases within a few hours with no swelling
- Mild sensitivity that comes and goes without disturbing sleep or eating
If you are unsure which category you are in, call. Describing it over the phone takes two minutes and we would far rather hear about something minor.
What Causes Toothache in Children
Tooth decay
By far the most common cause. Baby tooth enamel is thin, so decay reaches the nerve faster than in adult teeth. Pain often means it is already well advanced — see why kids get cavities so easily.
Infection or abscess
When decay reaches the nerve, infection can develop at the root. This is what produces swelling and fever, and it needs treating promptly — an infected baby tooth sits directly above the developing permanent tooth.
Something stuck between teeth
Genuinely common and easily missed. A popcorn hull or piece of food wedged between two teeth can cause real pain. Gentle flossing sometimes solves it entirely.
A new tooth coming through
Erupting molars can be sore for several days. Usually manageable with a cold compress and age-appropriate pain relief.
A crack or injury
Sometimes days after a fall or a knock during sport. See emergency dental care.
What to Do Before the Appointment
- Rinse gently with warm salt water
- Floss carefully either side of the sore tooth in case something is trapped
- Cold compress on the outside of the cheek, 15 minutes at a time
- Age-appropriate children’s paracetamol or ibuprofen, following the label
- Soft foods, and avoid very hot, very cold or sugary things
- Never place aspirin or painkillers directly against the gum — it burns the tissue
Avoid numbing gels for young children unless a clinician has advised it. And note that pain settling down does not always mean the problem has resolved — a nerve that dies stops hurting while the infection continues.
Common Questions
My child’s toothache stopped. Do we still need to come in?
Yes. Pain that disappears on its own can mean the nerve has died, which does not resolve the underlying infection. It still needs assessing.
Can a toothache be an emergency?
It can. Facial swelling, fever, or difficulty swallowing or breathing all need immediate attention. Swelling spreading toward the eye or neck means an emergency room.
What pain relief can I give?
Age-appropriate children’s paracetamol or ibuprofen, following the label for your child’s weight and age. Never place tablets against the gum.
Could it just be teething?
In infants and around age six when molars arrive, often yes. But teething does not cause fever or facial swelling — those need to be seen.
Do you see toothaches the same day?
Yes, we keep room in the schedule. Call (909) 479-6030.
What if it happens at the weekend?
We are open Monday to Thursday 8 to 5 and Friday until 2. Outside those hours, pain with swelling or fever should go to an urgent care or emergency department.
Will my child need the tooth out?
Usually not. Most painful teeth can be saved with a filling, pulp treatment or a crown. Extraction is the last option, not the first.
How do I stop it happening again?
Most toothaches trace back to decay caught late. Six-monthly exams find it while it is small and painless.
Final Thoughts
The rule of thumb we give parents: pain that wakes a child, fever, or any swelling means call today. Everything else can usually wait for a normal appointment — but calling to check costs nothing.
Call (909) 479-6030 or request an appointment. We see families from Chino, Chino Hills, Ontario, Eastvale, Pomona and Montclair.
