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What to Do When Your Child Has a Toothache at Night

What to Do When Your Child Has a Toothache at Night

Reviewed by Dr. David Sentelle, DMD, PhD, MPH

A toothache that wakes your child in the middle of the night can be stressful for everyone. In that moment, it’s hard to know what will truly help and what could make the situation worse. A few safe steps can ease discomfort until morning, and knowing the warning signs helps you decide when a child toothache emergency needs immediate care.

We care for growing smiles in Frisco, McKinney, and Prosper, TX with gentle, kid-focused dental care.

Table of Contents

What You Can Do Right Now to Help a Child’s Toothache at Night

If your child wakes with a toothache, focus on easing the pain and keeping them comfortable until morning.

  • Rinse with warm salt water: Mix a half teaspoon of salt in a cup of warm water. Have your child gently swish and spit. This can soothe irritated gums and help clear trapped food.
  • Use a cold compress on the outside of the cheek: Apply an ice pack for 10 to 15 minutes. Cold helps limit swelling and can temporarily dull pain. Avoid placing ice directly on the skin.
  • Give age-appropriate pain medicine if needed: Acetaminophen or ibuprofen can help manage discomfort when used exactly as directed for your child’s age and weight. Always follow dosing instructions.
  • Keep their head elevated: Propping up with an extra pillow can reduce pressure and make it easier for your child to rest.

What Not to Do

Some common “quick fixes” can actually cause harm, especially for kids.

  • Do not place aspirin on the tooth or gums: Aspirin can burn gum tissue and should never be used topically.
  • Avoid over-the-counter tooth gels with benzocaine: These gels can numb briefly but may be unsafe for young children and can mask symptoms that need professional care.
  • Do not use heat on the face: Heat can increase swelling and worsen infection-related pain.

When a Nighttime Toothache Needs Prompt Care

Most nighttime toothaches can wait until a dental office opens. In some situations, however, it is better to seek care sooner rather than later.

Contact a dentist or medical provider if your child has:

  • Swelling of the face, jaw, or around the eye
  • Fever or signs of illness along with tooth pain
  • Difficulty swallowing or breathing
  • Pain that continues to increase despite pain medicine
  • A tooth injury, such as a cracked, broken, or knocked-out tooth

These signs may indicate infection or injury that should be evaluated promptly.

What to Do After a Nighttime Toothache

Nighttime tooth pain does not always point to a serious problem, but it is worth paying attention to how symptoms change. If discomfort improves and does not return, no further care may be needed. If pain continues, becomes more frequent, or is accompanied by other symptoms, a dental exam can help determine what is going on.

To book an appointment at our pediatric dental office in McKinney, TX, call (214) 436-5555, request an appointment online or visit us at 5323 W University Dr #100, McKinney, Texas.

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FAQ

Why does my child’s tooth only hurt at night?

Tooth pain often feels stronger at night because lying down increases blood flow to the head, which can add pressure around a sensitive tooth. With fewer distractions, discomfort is also easier to notice. In many cases, the pain may be temporary, but ongoing nighttime pain can be a sign that the tooth should be checked.

What is the 3-3-3 rule for toothaches?

The 3-3-3 rule is a general guideline used to decide when tooth pain may need attention. It suggests contacting a dentist if pain lasts longer than three days, is severe enough to disrupt sleep for three nights in a row, or is accompanied by swelling, fever, or other symptoms. It is not a diagnosis, but it can help parents decide when follow-up care may be helpful.

Does a toothache always mean there is a cavity?

Tooth pain can have several causes, including temporary sensitivity, food trapped between teeth, gum irritation, loose or erupting teeth, or minor trauma. Cavities are one possible cause, but not every toothache points to decay. If pain continues or returns, a dental exam can help determine the reason.

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