My 7-year-old son started complaining of a constant toothache about 12–24 hours ago.
He points to the lower molar area (I’ve attached the bitewing).
The pain is constant, not just when eating, and is mostly relieved by Nurofen but returns when it wears off.
We’ve already seen a dentist:
Bitewing taken (attached, sore tooth circled)
OPG done
No obvious decay, abscess, or pathology seen
No response to cold test
No pain on tapping
Dentist suggested it might be referred pain from the upper baby molars.
Other info:
No swelling (gum or face)
No recent illness
No food impaction
No grinding/clenching
Medications: Vyvanse, Intuniv, Risperidone
From what I can see, the lower molar is still developing and there are unerupted premolars + resorbing baby teeth in that area.
My questions:
Does this presentation fit eruption/inflammatory pain, or would you still suspect early pulp involvement somewhere?
How often do you see referred pain like this in kids with otherwise normal imaging and testing?
Would you just monitor for 24–48 hours, or push for further investigation now?
Appreciate any insight. It’s hard to know when to wait vs escalate when everything looks “normal” but he’s clearly in pain.