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Toothache (Pulpitis)

What is pulpitis or toothache?

Toothaches are caused by an inflammation of the pulp inside the tooth. The pulp is part of the inside of the tooth that has tissue and nerves. A toothache usually follows injury to the tooth. The most common form of injury to the tooth is from dental caries, or a cavity. This is often a result of poor dental hygiene.

What causes a toothache?

Most toothaches are a result of a cavity. Sugar and starch in foods are the substances that allow bacteria in the mouth to cause damage to teeth. The bacteria in the mouth feed on sugar and starch and make an acid that can eat through the teeth. This leads to tooth decay. Different types of bacteria are involved in this process that can lead to an infection in the inside of the tooth.

What are the signs and symptoms of a toothache?

The following are the most common signs and symptoms of a toothache. However, each child may experience symptoms differently. Signs and symptoms may include:

  • Constant, throbbing pain in a tooth

  • A tooth is painful to touch

  • Pain in the tooth that worsens with hot or cold foods or liquids

  • A sore and tender jaw in the area of the tooth

  • Fever

  • Malaise (generally tired and feeling badly)

How is a toothache diagnosed?

The symptoms of a toothache may resemble other medical conditions or dental problems. Always talk with your child's healthcare provider or dentist for a diagnosis. A toothache is usually diagnosed based on a complete history and physical exam of your child and your child's mouth. Your child's healthcare provider will probably refer your child to a dentist for complete evaluation and treatment. At the dentist, X-rays (a test that uses invisible electromagnetic radiation to produce images of internal tissues, bones, teeth, and organs onto film or captured digitally on a computer) of the teeth may be taken to help in the diagnosis and treatment of the problem. The dentist may also use a device known as a transilluminator. This uses no radiation to check for cavities. 

What is the treatment for a toothache?

Specific treatment for a toothache will be discussed with you by your child's healthcare provider based on:

  • Your child's age, overall health, and medical history

  • Extent of the condition

  • Your child's tolerance for specific medicines, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

Treatment may include:

  • Antibiotics by mouth may be prescribed

  • Pain medicines may be prescribed

  • Warm salt water rinses to the mouth

  • Tooth extraction

  • Draining of an abscess, if present

  • Root canal (a surgical procedure that involves the removal of the damaged nerve and tissue from the middle of the tooth)

If the infection is severe, the child may need to be treated in the hospital and receive antibiotics through an intravenous (IV) catheter.

Medical Reviewers:

  • Kapner, Michael, DDS
  • Sather, Rita, RN