Odontogenic pain, or toothache, is highly prevalent in correctional facilities. When there is no dental sick call because the dental clinic is closed or the facility has no dental clinic, it is critical that midlevel providers and physicians triage and manage these patients until a dentist can resolve the problem. This article explores the etiology and diagnosis of toothache, presents the authors' opinion of the standard of care for managing these patients, and makes three recommendations: (a) access to timely and definitive dental treatment should be available to all inmates experiencing dental pain, (b) antibiotic use should be limited to patients with frank infection, and (c) progress of patients awaiting a dental appointment should be monitored with frequency consistent with the differential diagnosis.