The causes of painful teeth in children are very varied. With normal growth and the difference in the composition of the primary and adult teeth, it is sometimes difficult for the parent to distinguish between normal pain and real pain. The dentist is the only professional qualified to identify the source of the problem, questioning the patient and taking x-ray pictures if necessary. It will carry out tests to establish a precise diagnosis and propose a treatment adapted to the situation.

Pain in cold and sugar
The causes of pain or sensitivity to the stimulus of cold and sugar on a primary tooth are variable. The most common ones are: early or moderate decay, broken tooth, cracked tooth, tooth that has received a major trauma or repair that is too thick, defective, too deep or fallen. It is important to consult the dentist promptly if such symptoms occur.

Pain in hot weather
The causes of pain or sensitivity to heat stimulus are quite rare in primary dentition. Unlike an infected adult tooth that causes pain when warm, the pus contained inside the dead and infected primary tooth will drain more easily through the bone to the gum than in an adult. This natural phenomenon explains why primary teeth are generally not sensitive to heat during an infection. However, it is important to monitor for the appearance of any dents with or without yellowish discharge near a repaired primary tooth or one that has received a severe impact. In this situation, it is advisable to consult the dentist promptly.

It is important to remember that from the age of 6 years, the first adult molar erupts and can cause warm pain in certain situations. (See painful permanent tooth)

Pain with pressure or chewing
The causes of pain or sensitivity to pressure or chewing are variable in primary dentition. The most common causes observed on a single tooth are the presence of a normal eruption of the associated adult tooth. There is also a tooth that has received significant trauma, a broken or cracked tooth, a recent repair that does not fit properly on a tooth (overbite) or is defective or an infected tooth is present.

When pressure pain affects several teeth, the most common causes observed are the presence of tooth grinding (bruxism) or tooth clenching (clenching). In children, bruxism and tooth clenching tend to decrease and disappear naturally. It is less common for the dentist to intervene in these situations due to growth. An evaluation is still required. In less frequent situations, it is also possible that this pain is related to dental malposition, referred pain from the mouth joint or sinus congestion above the upper teeth.

Spontaneous pain (without doing anything)
The most common causes of spontaneous pain observed in primary dentition are the presence of an infected tooth, a deep cavity, a broken tooth or a cracked tooth. This type of pain should not be taken lightly. It is important to consult the dentist promptly if such symptoms occur. This type of pain often occurs as a result of repeated episodes of other types of dental pain ignored by the patient and suggests more serious consequences for the tooth.

The primary tooth is very painful, what should I do?

• Maintain impeccable dental hygiene to reduce the presence of bacteria in the mouth (brushing and flossing if possible);
• Gently rinse the mouth four times a day with an alcohol-free antiseptic (Péridex®, Peroxyl®);
• Alternately try to apply hot or cold compresses in periods of up to 10 minutes and see which one provides relief (inflammation is often relieved by cold, while muscle pain is relieved by heat and massage);
• It is important to see your dentist very quickly even if you can reduce pain. This relief is temporary and it is essential to find the cause in order to correct the problem at its source;
• Grandmother’s remedies, such as the application of a clove, pure essential oils or an acetylsalicylic acid (Aspirin®) tablet near the tooth in question, should be avoided. This can cause severe burns to the tissues around the painful tooth.