OBJECTIVES:

To describe the prevalence of and risk factors for recent toothache among US children and to estimate frequency of contact between children with toothache and their pediatric primary care providers (PPCP).

DESIGN:

Cross-sectional analysis of nationally representative data.

SETTING:

The 2007 National Survey of Children's Health.

PARTICIPANTS:

Population-based sample of parents/guardians of 86 730 children aged 1 through 17 years from 50 states and the District of Columbia.

OUTCOME MEASURE:

Parent-reported toothache in the last 6 months.

RESULTS:

A total of 10.7% of US children and 14% of children aged 6 to 12 years experienced toothache in the last 6 months. Poor and low-income minority children and those with special needs were significantly more likely to have had a toothache on multivariable analysis. Most children with toothache in the last 6 months had their own physician (88.9%) and had a preventive medical visit in the last year (88.1%), pointing to opportunities for PPCP to identify and intervene with children who have untreated dental decay and toothache.

CONCLUSIONS:

Toothache is not the universal experience it was before the advent of modern dentistry. Nevertheless, a substantial number of US children recently had a toothache, with noteworthy variability between states. There are opportunities for PPCP to address oral health prevention, assess for dental decay and toothache, and treat complications. We propose toothache as a potential quality indicator reflecting disparities in oral health for a population.