Tooth Sensitivity in Children: Causes and Treatment

What is tooth sensitivity in children?

Tooth sensitivity is pain in a tooth that is set off by something touching it: cold or hot food, something sweet or acidic, a toothbrush, or a breath of cold air. The American Dental Association (ADA) explains that it starts when dentin, the layer under the enamel, loses its protective covering.⁠¹

Dentin is less dense than enamel and is threaded with microscopic tubules. When the enamel on the crown, or the cementum that covers the root, is worn, cracked or missing, those tubules let heat, cold and acidic or sticky foods reach the nerve inside the tooth.⁠¹

In children the weak point is often the enamel itself: a soft-enamel defect, decay, acid erosion or a chipped tooth can each expose dentin.⁠^1,2,7

What causes tooth sensitivity in children?

The ADA lists decay, fractured teeth, worn fillings, gum disease, worn enamel and exposed roots as causes of sensitive teeth. In children, an enamel defect called molar-incisor hypomineralization (MIH) belongs near the top of that list, because it is common and makes teeth sensitive from the time they come in.⁠^1,2,4

Read nextDiscolored teethWhite spots on teeth

What is molar-incisor hypomineralization, and why does it make teeth sensitive?

Molar-incisor hypomineralization (MIH) is a defect in the quality of the enamel on at least one of the four first permanent molars, often with permanent front teeth affected too. The enamel forms at its normal thickness but is poorly mineralized, so it is softer and more porous than healthy enamel.⁠²

It is common. A 2021 meta-analysis of 116 studies put its worldwide prevalence at 13.5%, with front teeth involved in 36.6% of cases, and the American Academy of Pediatric Dentistry (AAPD) cites US estimates of 10% to 13%.⁠^2,4

Sensitivity is one of its most frequent problems. The AAPD describes increased sensitivity to a current of air, to cold and warmth, and to toothbrushing, worst in teeth whose enamel breaks down soon after they come in.⁠²

How often it hurts depends on how it is measured. A 2024 systematic review of 15 studies found dentin hypersensitivity or toothache in 45% of patients with MIH and in 22% of affected teeth, though the certainty of the evidence was very low.⁠⁵

In a census of 631 eight-year-olds in Brazil, 34.7% of molars with MIH were hypersensitive, while only one of the same children’s unaffected molars was.⁠¹⁹

Why do MIH teeth hurt when a child brushes?

The porous enamel lets the brush, the water and the air reach the nerve, so brushing itself can sting. The AAPD warns that this makes good brushing hard and raises the risk of decay, in teeth that already carry a decay risk up to 4.6 times higher.⁠²

So a child who avoids brushing one area, or flinches at cold on a back tooth, is worth taking to the dentist: sensitivity to cold and to the brush is typical of MIH.⁠²

Why are MIH teeth hard to numb at the dentist?

The AAPD notes that MIH teeth are reported as difficult to anesthetize, and that repeated treatment can leave children with dental fear and anxiety. It lists hypersensitivity, difficulty numbing several teeth and dental anxiety among the reasons treatment under general anesthesia is often indicated.⁠^2,20

What causes MIH?

The exact cause is unknown. Suggested factors around pregnancy and early childhood include illness in the mother during pregnancy, premature birth, low birth weight, illness in infancy, high fever and antibiotic use.⁠²

Enamel defectsEnamel hypoplasiaDiscolored teeth by color

Can a cavity make a child’s tooth sensitive?

Yes, once the decay has advanced. The National Institute of Dental and Craniofacial Research (NIDCR) says early decay usually has no symptoms, and that advancing decay can cause a toothache or sensitivity to sweets, hot or cold.⁠⁶

Because early decay is silent, it is found by looking at a dental checkup rather than by waiting for pain. It is common: the CDC reports that more than half of children aged 6 to 8 have had a cavity in a baby tooth.⁠^6,21

Caught early, decay can be stopped or reversed with fluoride; once there is a cavity, dentists usually fill it. If decay reaches the inside of the tooth and it becomes infected, an abscess can form, with pain, facial swelling and fever.⁠⁶

Can acidic drinks make a child’s teeth sensitive?

Yes. The AAPD says frequent sports drinks, energy drinks and carbonated drinks can lead to enamel erosion and dental sensitivity, and that acidic foods such as sour candies and citrus fruits can also contribute to erosion.⁠⁷

Erosion is common. A 2015 systematic review of 22 studies estimated that 30.4% of children and adolescents aged 8 to 19 had erosive wear on their permanent teeth, and a 2022 review of children under 7 put it at 39.6%, at very low certainty.⁠^13,22

Reflux matters too. The preschool review found erosion more likely in children with digestive disorders, and the AAPD says children with signs of erosion benefit from an evaluation for gastroesophageal reflux disease (GERD).⁠^7,13

Plain water is the drink the AAPD recommends for hydration through childhood and adolescence.⁠⁷

Why is my child’s tooth sensitive after a fall or a knock?

A tooth that has been chipped, cracked or knocked loose can be sensitive or painful, and any injury to a tooth deserves a dental visit: the AAPD counts orofacial trauma among dental emergencies.⁠^1,9

International guidelines for injuries to baby teeth, endorsed by the AAPD, warn that loosened or displaced teeth and root fractures can cause severe pain, and that children may not complain about pain even when an infection is present.⁠¹⁴

For a fracture that reaches the nerve, a root fracture, or a tooth that has been loosened or pushed out of place, the guidelines call for referral within several days to a team experienced with children’s dental injuries.⁠¹⁴

What if a toddler’s tooth is pushed up into the gum after a fall?

A baby tooth driven up into the gum is called an intrusion. The guidelines no longer advise removing it straight away, because intruded baby teeth can come back down on their own, but this kind of injury is one of the most likely to affect the adult tooth developing above it, so it needs a dentist and follow-up visits.⁠¹⁴

The guidelines recommend pain relief such as ibuprofen or acetaminophen when pain is expected, and parents should watch for swelling of the gum, which can mean infection.⁠¹⁴

After a knockA gray or dark tooth after a fall

Is it sensitivity or a toothache that needs a dentist soon?

Sensitivity is pain that something sets off and that stops soon after it is gone. Pain that starts by itself, lingers, or comes with a pimple on the gum points to a problem inside the tooth, the AAPD’s guidance on diagnosing the pulp shows.⁠⁸

A dentist will ask where the pain is, how long it lasts, what sets it off and what eases it, and whether it wakes your child at night, so it helps to notice those details beforehand.⁠^8,18

When should a child with sensitive teeth see a dentist?

Book a visit for sensitivity that keeps coming back or for a toothache lasting longer than a day or two, and go promptly for severe pain, swelling, fever or any injury to a tooth.⁠^9,18

• Swelling of the face or gum

  Facial swelling and infection are dental emergencies, the AAPD says; contact a dentist right away.⁠⁹

• Fever, earache or pain on opening wide

  MedlinePlus advises seeking care for these alongside a toothache.⁠¹⁸

• Any knock to a tooth

  Orofacial trauma is a dental emergency, and an injured tooth can become infected without pain.⁠^9,14

• Pain that starts on its own or wakes your child

  Spontaneous pain suggests the inside of the tooth is involved.⁠^8,18

• One tooth that reacts to cold or brushing

  Often an affected molar with MIH, which needs early protection.⁠²

• Patches on new molars or front teeth

  Cream, yellow or brown patches are typical of MIH.⁠²

• Avoiding brushing one area

  Sensitive teeth that are brushed less are more likely to decay.⁠²

• Sensitivity that lasts beyond four weeks

  Sensitivity toothpaste labels advise seeing a dentist if it persists or worsens.⁠^10,11

Even without a problem, the AAPD recommends that every child have a dental home, with an exam and advice, by 12 months of age.⁠²³

How do dentists treat sensitive teeth in children?

Dentists treat the cause, and they also have treatments that calm the sensitivity itself: fluoride gel or varnish, silver diammine fluoride, sealants, and fillings or crowns that cover exposed dentin. The ADA notes that the right treatment depends on what is causing the sensitivity.⁠^1,2

What is a desensitizing dental treatment?

It usually means an agent applied in the dental office to reduce sensitivity, such as fluoride gel or varnish. SDF has been cleared by the US Food and Drug Administration as a dentin desensitizer in adults, and is used frequently to stop cavities.⁠^1,25

Dentists also use “desensitization” for something different: getting an anxious child used to the dental visit step by step, covered in the section on helping with the dentist below.⁠²⁶

How well do treatments for sensitive MIH teeth work?

The evidence in children is thin. A 2024 meta-analysis found that CPP-ACP, a paste made from a milk protein, reduced MIH sensitivity more than fluoride varnish, but its authors call the evidence limited and heterogeneous.⁠²⁷

The AAPD reports that SDF has reduced sensitivity and that desensitizing toothpastes and CPP-ACP have shown limited effectiveness. Relief matters day to day: a 2024 review reports that treatments for sensitivity had a positive impact on the oral health-related quality of life of children with MIH.⁠^2,20

At what age can a child use sensitivity toothpaste?

Sensitivity toothpastes are labeled for adults and children 12 and older. The labels of potassium nitrate sensitivity toothpastes tell parents of children under 12 to consult a dentist or doctor, and one says not to use it under 12.⁠^10,11,28

The research behind these toothpastes is in adults. A 2023 network meta-analysis of 32 trials in adults found that twice-daily toothpastes containing stannous, potassium (with or without stannous) or arginine can be recommended for dentin hypersensitivity pain.⁠²⁹

In children with MIH, the AAPD says desensitizing toothpastes have shown limited effectiveness, so a dentist’s treatment usually matters more than the paste.⁠²

What can you do at home for a child’s sensitive teeth?

Keep brushing twice a day with fluoride toothpaste, switch to a soft brush, and cut back on acidic drinks while you wait for the dental visit. Skipping the sore area makes things worse, because sensitive teeth that are brushed less decay more.⁠^2,7,16

• A soft-bristled brush. The ADA advises soft bristles, manual or powered, because firm or even medium bristles can damage gums and enamel.⁠¹⁶
• Gentle, thorough brushing of every tooth, including the sensitive one.⁠²
• Lukewarm water for brushing and rinsing, if cold water stings.
• Water between meals instead of sports drinks, energy drinks or soda.⁠⁷
• A note of what sets it off: which tooth, and whether cold, sweets or brushing; the dentist will ask what makes the pain worse or better.⁠¹⁸
• Pain relief until you can be seen. MedlinePlus says over-the-counter pain medicine can be used if you cannot see a dentist right away; ask a pharmacist or your child’s doctor which medicine and how much suits their age and weight.⁠¹⁸

Daily careBrushing from the first toothTooth grinding

What is oral defensiveness, and how is it different from sensitive teeth?

Oral defensiveness is a strong reaction against touch, taste, texture and temperature in and around the mouth, so a child resists toothbrushing, some foods or a dental exam even when the teeth are healthy. A dental review describes it as a cluster of behavioral symptoms with a theorized physiological basis, and calls it controversial.⁠^3,31

It is not a diagnosis on its own. The American Academy of Pediatrics (AAP) says sensory processing disorder generally should not be diagnosed, because there is no accepted framework, and that difficulty with sensory information is seen in autism, ADHD, developmental coordination disorder and childhood anxiety.⁠³²

• Sensitive teeth

  The pain is in one tooth or a few, often ones with patches, decay or a chip, and it comes from cold, sweets, air or the brush touching that tooth.⁠^1,2

• Oral defensiveness

  The dislike is of the whole experience: the brush in the mouth, the taste or foam of toothpaste, textures of food, or the lights, sounds and smells of a dental office.⁠^31,33

The two can overlap, so a dental exam comes first: the oral defensiveness review suggests sensory approaches when no other cause is apparent.⁠³

What are the symptoms of oral defensiveness in children?

Signs parents and dentists describe include gagging, refusing certain textures, smells or temperatures of food, resisting toothbrushing or the taste of toothpaste, and distress at dental visits.⁠^31,33,34

• Gagging or biting the cheeks while eating

  In a study of 62 children aged 3 to 10, tactile defensive children often gagged and bit their inner lips and cheeks.⁠³¹

• Refusing textures, smells or temperatures

  The same study found a pronounced aversion to food textures, smells and temperatures.⁠³¹

• Fighting the toothbrush

  Autistic children who are sensory over-responsive cooperate less with toothbrushing, at home and at the dentist.⁠^35,36

• Hating the taste or foam of toothpaste

  The AAPD suggests a nonfoaming toothpaste or another alternative when the taste or texture is intolerable.⁠³³

• Distress at the dentist

  Noise, light, smells, tastes and textures can overwhelm sensory processing and make a child defensive of dental care.⁠³³

• Very selective eating

  Children with autism are often described as picky or selective eaters, with sensory sensitivity a possible contributor.⁠³⁷

These signs are especially common in autistic children. In one dental study, about half of 39 autistic children were orally defensive, and in a survey of 396 parents, autistic children who were sensory over-responsive had more trouble with oral care at home and at the dentist.⁠^36,38

A similar link has been reported in a survey of parents of 367 children with Down syndrome.⁠³⁹

If mouth sensitivity limits what your child eats, makes brushing a daily battle or makes dental visits impossible, talk to your child’s doctor or dentist; the AAPD notes that help from other professions, such as occupational therapy, may be beneficial.⁠³³

Sensory signsDental signs of sensory differencesSensory over-responsivity

How can you help a child with oral defensiveness brush and see the dentist?

Small changes to tools and routine help most: a toothpaste the child can tolerate, gradual steps toward a full visit, and a dental office willing to adapt its lights, sounds and touch.⁠^26,33

1. A toothpaste they can tolerate. If the taste or texture of ordinary toothpaste is intolerable, the AAPD suggests a nonfoaming toothpaste, a fluoride mouthrinse, or another alternative applied with the brush.⁠³³
2. Practice at home. Parents can model opening the mouth and touching the cheek, and practice with a dental mirror.⁠²⁶
3. Gradual exposure. Desensitization works through a series of steps: a preparation book or video, an office tour, time in the dental chair, then an appointment.⁠²⁶
4. A sensory-adapted visit. Some offices dim the lights, play calm music, project moving images on the ceiling and offer a wrap or blanket for deep pressure; the AAPD lists this for autism, sensory processing difficulties and dental anxiety.⁠²⁶
5. A signal to pause. Agreeing on a signal, such as a raised hand, gives the child a way to stop briefly.⁠²⁶

Sensory-adapted dental care has the strongest evidence of these. In a 2023 randomized crossover trial of 162 autistic children aged 6 to 12, cleanings in a sensory-adapted room brought lower physiological stress and less video-coded distress than a regular room.⁠¹²

The evidence is still small. A 2024 meta-analysis of three studies confirmed lower physiological stress but found no clear difference in other behavioral measures, and a 2018 occupational therapy review rated the evidence for adapting the dental environment as moderate.⁠^40,41

In an earlier pilot trial of 44 children, half autistic, both groups reported less pain and sensory discomfort in the adapted room.⁠⁴²

Next stepSensory-friendly dentistryPreparing for a dental visitFind an occupational therapist

How can you prevent tooth sensitivity in children?

Prevent the causes: decay, erosion and injuries. That means fluoride toothpaste twice a day, fewer sugary and acidic drinks, early dental visits, and protection for new molars with MIH.⁠^2,7,21

• A dental home by 12 months, as the AAPD recommends.⁠²³
• Fluoride varnish, which prevents about a third of cavities in baby teeth, the CDC says.⁠²¹
• Sealants on back teeth, which the CDC says prevent 80% of cavities; for MIH molars the AAPD lists sealants among the first protections.⁠^2,21
• Water rather than sports drinks, energy drinks and soda between meals.⁠⁷
• A mouthguard for sports; helmets, face masks and mouthguards reduce dental injuries.⁠⁴³
• For teenagers, no mouth piercings, and whitening only with an adult supervising: piercings can fracture enamel, and whitening commonly causes sensitivity.⁠^17,44

What should you ask your child’s dentist about sensitive teeth?

Bring a list of your child’s medicines and a note of when the pain happens and what sets it off.⁠¹⁸

Related guides on DrSensory

• Tooth discoloration

  What each tooth color can mean, and when a dentist should look.

• White spots on kids’ teeth

  Early decay, MIH, fluorosis and hypoplasia, and how to tell them apart.

• Enamel hypoplasia

  Thin or pitted enamel and how to protect it.

• Dental signs of sensory differences

  How sensory processing shows up in the mouth.

• Sensory-friendly dentistry

  Dental visits for autistic and sensory-sensitive children.

• Sensory over-responsivity

  Strong reactions to touch, sound and other senses.

• Tooth grinding

  Why children grind their teeth and what to do.

• The first dental visit

  When to go and how to prepare.

• Dental and oral development

  Every DrSensory guide to children’s teeth and mouths.

Sources

1. American Dental Association (MouthHealthy). Sensitive teeth. Checked October 23, 2026.
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   Possible causes listed: “Tooth decay (cavities)”, “Fractured teeth”, “Worn fillings”, “Gum disease”, “Worn tooth enamel”, “Exposed tooth root”. “Dentin is less dense than enamel and cementum and contains microscopic tubules (small hollow tubes or canals). When dentin loses its protective covering of enamel or cementum these tubules allow heat and cold or acidic or sticky foods to reach the nerves and cells inside the tooth.” “Sensitive teeth can be treated. The type of treatment will depend on what is causing the sensitivity.” Treatments listed include desensitizing toothpaste, which “usually requires several applications before the sensitivity is reduced”; “Fluoride gel. An in-office technique which strengthens tooth enamel and reduces the transmission of sensations.”; a crown, inlay or bonding; a gum graft; and a root canal “If sensitivity is severe and persistent and cannot be treated by other means”.
2. American Academy of Pediatric Dentistry. Molar-incisor hypomineralization. The Reference Manual of Pediatric Dentistry. 2025:465–72 (adopted 2024). Checked October 23, 2026.
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   MIH is “demarcated hypomineralization affecting at least 1 to 4 first permanent molars and often associated with affected permanent incisors”. “Another frequent finding in teeth with MIH is increased sensitivity to a current of air and thermal (ie, cold, warm) and mechanical (eg toothbrushing) stimuli.” “Severity of hypersensitivity is significantly higher in teeth with structural disintegration immediately after tooth eruption.” “The risk of developing caries in affected teeth is up to 4.6 times higher than in teeth without MIH.” “reported US MIH prevalence estimates (10% to 13%)”. “Affected teeth with marked hypersensitivity present a challenge for the establishment of proper oral hygiene, leading to increased caries risk.” “They also are reported as being difficult to anesthetize”; “This can lead to children developing dental fear, anxiety, and dental fatigue due to the burden of care of multiple treatment visits.” “Treatment under general anesthesia often is indicated due to hypersensitivity, difficulty with anesthetizing multiple teeth, dental anxiety, and the complexity of restorative and/or surgical care.” “The use of SDF for prevention and pretreatment also has been effective in reducing sensitivity.” “While desensitizing toothpastes and agents such as casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) have been suggested to manage sensitivity”, “studies have shown limited effectiveness”. “Early treatment to manage hypersensitivity in newly erupted molars (with or without enamel loss) can be accomplished using SDF, glass ionomer sealants, fissure sealants, and restorations that do not require excessive etching, rinsing, and drying”. Stainless steel crowns may be used “to prevent tooth loss, control sensitivity”. “While the exact etiology of MIH is unknown”, suggested factors include maternal illness during pregnancy, premature birth, low birth weight, infant illness, high fever and antibiotic use. “Patients at increased risk for MIH benefit from frequent (every 3 to 6 months) periodic evaluations”.
3. Spira G, Kupietzky A. Oral defensiveness: children with a dysfunction of sensory regulation. Journal of Clinical Pediatric Dentistry. 2005;29(2):119–122. doi:10.17796/jcpd.29.2.cgp2830l073vh358 (PMID 15719914). Checked October 23, 2026.
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   “Oral defensiveness is a relatively newly discussed cluster of behavioral symptoms with a theorized physiological basis, which may manifest itself during a child's dental visit.” The authors aim “to acquaint dentists with this controversial disorder” and suggest interventions “when no other cause is apparent”.
4. Lopes LB, Machado V, Mascarenhas P, Mendes JJ, Botelho J. The prevalence of molar-incisor hypomineralization: a systematic review and meta-analysis. Scientific Reports. 2021;11(1):22405. doi:10.1038/s41598-021-01541-7 (PMID 34789780). “Overall, 116 observational studies were included”; “The pooled prevalence of MIH was 13.5%”; “Affected incisors were seen in 36.6%” of the cases. Checked October 23, 2026.
5. Santos PS, Vitali FC, Fonseca-Souza G, Maia LC, Cardoso M, Feltrin-Souza J, Fraiz FC. Dentin hypersensitivity and toothache among patients diagnosed with Molar-Incisor Hypomineralization: a systematic review and meta-analysis. Journal of Dentistry. 2024;145:104981. doi:10.1016/j.jdent.2024.104981 (PMID 38582436). Checked October 23, 2026.
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   “Fifteen studies were included in the qualitative analysis and fourteen in the meta-analyses.” “The overall prevalence of DH/toothache among patients with MIH was 45 %.” “The overall prevalence of DH/toothache per tooth was 22 %”; “The certainty of evidence was very low”.
6. National Institute of Dental and Craniofacial Research. Tooth decay. Checked October 23, 2026.
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   “In early tooth decay, there are not usually any symptoms.” “As tooth decay advances, it can cause a toothache (tooth pain) or tooth sensitivity to sweets, hot, or cold. If the tooth becomes infected, an abscess, or pocket of pus, may form, causing pain, facial swelling, and fever.” “Tooth decay can be stopped or reversed at this point.” “Dentists commonly treat cavities by filling them.”
7. American Academy of Pediatric Dentistry. Policy on nutrition and dietary counseling in the pediatric dental setting. The Reference Manual of Pediatric Dentistry. Latest revision 2026. Checked October 23, 2026.
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   “frequent consumption of acidic beverages such as sports drinks, energy drinks, and carbonated beverages can lead to enamel erosion and dental sensitivity”. “Likewise, acidic foods (eg, sour candies, citrus fruits) are potential contributors to enamel erosion.” “Patients with signs of erosion will benefit from evaluation for possible gastroesophageal reflux disease (GERD)”; “Plain drinking water has been recommended as the primary beverage for hydration throughout childhood and adolescence.”
8. American Academy of Pediatric Dentistry. Pulp therapy for primary and immature permanent teeth: indications and objectives. The Reference Manual of Pediatric Dentistry. Latest revision 2026. Checked October 23, 2026.
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   Diagnosis includes “questioning the patient/parent on the location, intensity, duration, stimulus, relief, and spontaneity of pain”. “Teeth exhibiting provoked pain of short duration relieved with over-the-counter analgesics, by brushing, or upon the removal of the stimulus and without signs or symptoms of irreversible pulpitis have a clinical diagnosis of reversible pulpitis.” Historically, signs such as “a history of spontaneous unprovoked pain, a sinus tract” led to “a clinical diagnosis of irreversible pulpitis or necrosis”.
9. American Academy of Pediatric Dentistry. Policy on emergency oral care. The Reference Manual of Pediatric Dentistry. Latest revision 2026. “Dental emergencies include, but are not limited to, facial swelling, infections, uncontrolled bleeding, pain, and orofacial trauma.” Checked October 23, 2026.
10. US National Library of Medicine, DailyMed. Drug label: Colgate Sensitive Complete Protection (potassium nitrate and sodium fluoride paste). Checked October 23, 2026.
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    Directions for “adults and children 12 years of age and older”; “children under 12 years”: “consult a dentist or physician”. “Stop use and ask a dentist if the problem persists or worsens. Sensitive teeth may indicate a serious problem that may need prompt care by a dentist.” “if pain/sensitivity still persists after 4 weeks of use, please visit your dentist.”
11. US National Library of Medicine, DailyMed. Drug label: Sensodyne Pronamel Intensive Enamel Repair (potassium nitrate and sodium fluoride paste). Checked October 23, 2026.
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    “builds increasing protection against painful sensitivity of the teeth to cold, heat, acids, sweets, or contact”; “children under 12 years of age: Consult a dentist or doctor.” “Sensitive teeth may indicate a serious problem that may need prompt care by a dentist.”
12. Stein Duker LI, Como DH, Jolette C, Vigen C, Gong CL, Williams ME, Polido JC, Floríndez-Cox LI, Cermak SA. Sensory adaptations to improve physiological and behavioral distress during dental visits in autistic children: a randomized crossover trial. JAMA Network Open. 2023;6(6):e2316346. doi:10.1001/jamanetworkopen.2023.16346 (PMID 37266941). Checked October 23, 2026.
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    “162 children (mean [SD] age, 9.16 [1.99] years; 136 [84.0%] male) with confirmed autism were randomized”; “Children had significantly lower physiological stress during dental care in SADE compared with RDE”; “Video-coded frequency and duration of behavioral distress (but not questionnaire) measures were significantly lower in SADE vs RDE”.
13. Yip K, Lam PPY, Yiu CKY. Prevalence and associated factors of erosive tooth wear among preschool children: a systematic review and meta-analysis. Healthcare. 2022;10(3):491. doi:10.3390/healthcare10030491 (PMID 35326969). Checked October 23, 2026.
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    Children below 7 years: “The overall estimated prevalence of dental erosion in children was 39.64%”, “with very low certainty of evidence”; “children with digestive disorders having dental erosion was significantly higher than those without such digestive disorders”; “more frequent intake of fruit juices and soft drinks correlated with erosive tooth wear”.
14. Day PF, Flores MT, O’Connell AC, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dental Traumatology. 2020;36(4):343–359. doi:10.1111/edt.12576 (PMID 32458553); endorsed by the AAPD and reprinted in its Reference Manual. Checked October 23, 2026.
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    “Luxation injuries, such as intrusion and lateral luxation, and root fractures may cause severe pain.” “The use of analgesics such as ibuprofen and/or acetaminophen (paracetamol) is recommended when pain is anticipated.” “Children may not complain about pain, but infection may be present.” Immediate extraction of an intruded baby tooth “is no longer advised due to (a) evidence of spontaneous re-eruption for intruded primary teeth”; “Intrusion and avulsion injuries are most commonly associated with the development of anomalies in the permanent dentition.” For pulp-involving fractures, root fractures and luxation injuries, “rapid referral within several days to a child-oriented team that has experience and expertise in the management of dental injuries in children is essential”.
15. Silva MS, Lima ANAN, Pereira MMA, Ferraz Mendes R, Prado Júnior RR. Prevalence and predictive factors of dentin hypersensitivity in Brazilian adolescents. Journal of Clinical Periodontology. 2019;46(4):448–456. doi:10.1111/jcpe.13097 (PMID 30825378). Checked October 23, 2026.
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    384 adolescents; diagnosis by self-report confirmed by tactile and evaporative tests. “The prevalence was 19.0%.” “Individuals with DH were more likely to report traumatic dental brushing, and presence of dental biofilm, non-carious cervical lesion, gingival recession and gyroversion in the affected teeth.”
16. American Dental Association (MouthHealthy). Toothbrushes. “Whether you use a manual or powered toothbrush, choose a soft-bristled brush. Firm or even medium-strength bristles may cause damage to your gums and enamel.” Checked October 23, 2026.
17. American Academy of Pediatric Dentistry. Policy on the use of dental bleaching for child and adolescent patients. The Reference Manual of Pediatric Dentistry. 2025:136–40. Checked October 23, 2026.
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    “Between 8% and 66% of patients experience” sensitivity after bleaching, “most often during the early stages of treatment”. The AAPD encourages “over-the-counter or dentist-dispensed at-home bleaching products used by young patients to be supervised by an adult”. “Overtreatment has been shown to harm tooth structure, which is of particular concern when bleaching products are used excessively by overzealous teens and young adults.”
18. MedlinePlus (US National Library of Medicine). Toothaches. Review date February 5, 2026. Checked October 23, 2026.
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    “Sometimes, pain that is felt in the tooth is actually due to pain in other parts of the body. This is called referred pain. For example, an earache may sometimes cause tooth pain.” Causes listed include “Sinus infection” and “Tooth trauma such as wear, injury, or fracture”. “You can use over-the-counter pain medicine if you can't see your dentist or primary health care provider right away.” Seek care for “a severe toothache”, “a toothache that lasts longer than a day or two”, or “fever, earache, or pain when opening your mouth wide”. The dentist asks, among other questions, “Does the pain wake you up at night?” and “Are there things that make the pain worse or better?”
19. Raposo F, de Carvalho Rodrigues AC, Lia ÉN, Leal SC. Prevalence of hypersensitivity in teeth affected by molar-incisor hypomineralization (MIH). Caries Research. 2019;53(4):424–430. doi:10.1159/000495848 (PMID 30677762). Checked October 23, 2026.
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    A census of 8-year-old schoolchildren: “In total, 631 children were assessed, of whom 102 had MIH-affected molars (16.1%).” “Hypersensitivity was recorded in only one control molar, while the prevalence of hypersensitivity in MIH-affected molars was 34.7%”; control molars were the unaffected molars of the same children.
20. Shields S, Chen T, Crombie F, Manton DJ, Silva M. The impact of molar incisor hypomineralisation on children and adolescents: a narrative review. Healthcare. 2024;12(3):370. doi:10.3390/healthcare12030370 (PMID 38338255). Checked October 23, 2026.
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    “Other concerns pertain to the clinical management of MIH and include difficulty in achieving local anaesthesia, increased dental fear and anxiety (DFA) and increased behaviour management problems.” “Interventions to alleviate hypersensitivity and improve aesthetics had a positive impact on the OHRQoL of MIH-affected children.”
21. Centers for Disease Control and Prevention. Oral health tips for children. Checked October 23, 2026.
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    “More than half of children aged 6 to 8 years have had a cavity in at least one of their baby (primary) teeth.” “Fluoride varnish can prevent one-third (33%) of cavities in the primary (baby) teeth.” “Applying dental sealants to the back teeth prevents 80% of cavities.”
22. Salas MM, Nascimento GG, Huysmans MC, Demarco FF. Estimated prevalence of erosive tooth wear in permanent teeth of children and adolescents: an epidemiological systematic review and meta-regression analysis. Journal of Dentistry. 2015;43(1):42–50. doi:10.1016/j.jdent.2014.10.012 (PMID 25446243). Checked October 23, 2026.
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    Population-based studies of ages 8 to 19: “Twenty-two papers were included in the systematic review. The overall estimated prevalence of tooth erosion was 30.4%”, “with high heterogeneity between studies”.
23. American Academy of Pediatric Dentistry. Perinatal and infant oral health care. The Reference Manual of Pediatric Dentistry. 2025:337–41. Recommends a dental home with “anticipatory guidance for infants by 12 months of age”. Checked October 23, 2026.
24. American Academy of Pediatric Dentistry. Chairside guide: silver diammine fluoride in the management of dental caries lesions. The Reference Manual of Pediatric Dentistry. 2025. “Caries lesions treated by SDF usually turn black and hard.” Consent covers “permanent staining of treated lesions”. Checked October 23, 2026.
25. American Academy of Pediatric Dentistry. Fluoride therapy. The Reference Manual of Pediatric Dentistry. 2025:372–8. Silver diammine fluoride “has been cleared by the US Food and Drug Administration as a dentin desensitizer in adults”. “It currently is used frequently to arrest cavitated caries lesions.” Checked October 23, 2026.
26. American Academy of Pediatric Dentistry. Behavior guidance for the pediatric dental patient. The Reference Manual of Pediatric Dentistry. 2025:379–99. Checked October 23, 2026.
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    “Systematic desensitization is a psychological technique that can be applied to modify behaviors of anxious patients in the dental setting.” “Patients are exposed gradually through a series of sessions to components of the dental appointment that cause them anxiety.” “Parents may model actions (eg, opening mouth and touching cheek) and practice with the child at home using a dental mirror.” Enhancing control: “The dentist provides the patient a signal (eg, raising a hand) to use if he becomes uncomfortable or needs to briefly interrupt care.” Sensory-adapted dental environments include “dimmed lighting, moving projections such as fish or bubbles on the ceiling, soothing background music, application of wrap/blanket around the child to provide deep pressure input”; indicated for “patients having autism spectrum disorder, sensory processing difficulties, other disabilities, or dental anxiety”.
27. Cavalcante BGN, Mlinkó É, Szabó B, Teutsch B, Hegyi P, Vág J, Németh O, Gerber G, Varga G. Non-invasive strategies for remineralization and hypersensitivity management in molar-incisor hypomineralization: a systematic review and meta-analysis. Journal of Clinical Medicine. 2024;13(23):7154. doi:10.3390/jcm13237154 (PMID 39685613). Checked October 23, 2026.
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    CPP-ACP “significantly reduced hypersensitivity compared to fluoride varnish”; “the high heterogeneity (I² = 83%) and wide confidence intervals limit the reliability of these findings”; “The current evidence base is limited and heterogeneous”.
28. US National Library of Medicine, DailyMed. Drug label: Crest Pro-Health Sensitivity Relief (sodium fluoride and potassium nitrate paste). Directions for “12 yrs. & older”; “do not use in children under 12 yrs.” Checked October 23, 2026.
29. Pollard AJ, Khan I, Davies M, Claydon N, West NX. Comparative efficacy of self-administered dentifrices for the management of dentine hypersensitivity: a systematic review and network meta-analysis. Journal of Dentistry. 2023;130:104433. doi:10.1016/j.jdent.2023.104433 (PMID 36753794). Checked October 23, 2026.
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    Randomized trials “conducted in adults diagnosed with DH”; “Thirty-two studies and 4,638 participants were included.” “Twice daily application of self-applied dentifrice containing formulations of stannous, potassium +/- stannous, or arginine can be recommended for the reduction of dentine hypersensitivity pain.”
30. American Dental Association. Toothpastes (Oral Health Topics). Checked October 23, 2026.
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    Toothpastes may contain ingredients “lessening tooth sensitivity”. “The ADA recommends that children use a smear of toothpaste (the size of a grain of rice) from the time the first tooth erupts until age 3 years. After that point, from 3 years to 6 years, children should use a pea-sized amount of paste.” “the ADA recommends that caregivers supervise children during brushing to ensure that the children spit rather than swallow the paste”
31. Smith AM, Roux S, Naidoo NT, Venter DJ. Food choice of tactile defensive children. Nutrition. 2005;21(1):14–19. doi:10.1016/j.nut.2004.09.004 (PMID 15729777). Checked October 23, 2026.
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    62 children aged 3 to 10: tactile defensive children showed “a pronounced aversion toward textures or consistencies, smells, and temperatures of food”; “They often gagged and/or bit their inner lips and cheeks.” “Tactile or oral defensiveness can be treated.”
32. Section on Complementary and Integrative Medicine; Council on Children with Disabilities; American Academy of Pediatrics; Zimmer M, Desch L. Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics. 2012;129(6):1186–1189. doi:10.1542/peds.2012-0876 (PMID 22641765). Checked October 23, 2026.
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    “Because there is no universally accepted framework for diagnosis, sensory processing disorder generally should not be diagnosed.” “Difficulty tolerating or processing sensory information is a characteristic that may be seen in many developmental behavioral disorders, including autism spectrum disorders, attention-deficit/hyperactivity disorder, developmental coordination disorders, and childhood anxiety disorders.”
33. American Academy of Pediatric Dentistry. Management of dental patients with special health care needs. The Reference Manual of Pediatric Dentistry. Latest revision 2026. Checked October 23, 2026.
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    “When sensory processing is overwhelmed by interaction within dental environment (eg. noise, light, sound, smells, tastes, textures), individuals may be defensive or unaccepting of dental procedures.” “Assistance from other health professions (eg, occupational therapy) may be beneficial.” “If a patient's sensory issues cause the taste or texture of over-the-counter toothpaste to be intolerable, a nonfoaming toothpaste, a fluoridated mouthrinse, or an alternative may be applied with the toothbrush to clean teeth.”
34. Stein LI, Polido JC, Mailloux Z, Coleman GG, Cermak SA. Oral care and sensory sensitivities in children with autism spectrum disorders. Special Care in Dentistry. 2011;31(3):102–110. doi:10.1111/j.1754-4505.2011.00187.x (PMID 21592164). Parents of 206 children with disabilities: “Among children with ASD, sensory sensitivities were associated with oral care difficulties in the home and dental office”. Checked October 23, 2026.
35. Khrautieo T, Srimaneekarn N, Rirattanapong P, Smutkeeree A. Association of sensory sensitivities and toothbrushing cooperation in autism spectrum disorder. International Journal of Paediatric Dentistry. 2020;30(4):505–513. doi:10.1111/ipd.12623 (PMID 32011037). 51 children aged 4 to 17: “SOR subjects showed less toothbrushing cooperation than SNOR subjects both at home and in the dental office.” Checked October 23, 2026.
36. Stein LI, Polido JC, Cermak SA. Oral care and sensory over-responsivity in children with autism spectrum disorders. Pediatric Dentistry. 2013;35(3):230–235. PMID 23756306. Checked October 23, 2026.
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    “Participants included 396 parents of 2- to 18-year-old children with ASDs or TD”; autistic children who were sensory over-responders “exhibited a significantly greater prevalence of oral care difficulty in the home and dental office”.
37. Cermak SA, Curtin C, Bandini LG. Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association. 2010;110(2):238–246. doi:10.1016/j.jada.2009.10.032 (PMID 20102851). Checked October 23, 2026.
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    A narrative review: “Children with autism spectrum disorders are often described as picky or selective eaters.” “The possible contributions of sensory factors, such as sensory sensitivity, to food selectivity are discussed.”
38. DeMattei R, Cuvo A, Maurizio S. Oral assessment of children with an autism spectrum disorder. Journal of Dental Hygiene. 2007;81(3):65. PMID 17908421. Oral assessments of 39 children with an autism spectrum disorder and 16 with other developmental disabilities: “Approximately half of the children with ASD were orally defensive.” Checked October 23, 2026.
39. Stein Duker LI, Martinez M, Lane CJ, Polido JC, Cermak SA. Association between oral care challenges and sensory over-responsivity in children with Down syndrome. International Journal of Paediatric Dentistry. 2022;32(4):546–557. doi:10.1111/ipd.12933 (PMID 34622519). Checked October 23, 2026.
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    367 children aged 5 to 14: “Parents of SOR children reported greater challenges than parents of SNOR children at the dentist's office and in the home, including challenging behaviors and sensory sensitivities.”
40. Tirupathi SP, Afnan L. Effect of sensory adapted dental environment (SADE) on physiological and behavioral parameters related to stress and anxiety in children with autism spectrum disorder (ASD) undergoing dental treatment: a systematic review and meta-analysis. Special Care in Dentistry. 2024;44(5):1346–1358. doi:10.1111/scd.13003 (PMID 38689539). Checked October 23, 2026.
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    Three studies met the review’s criteria: “Skin conductance level (parameter indicating physiological stress) is lower in SADE environment in children with ASD, other behavior stress related parameters there is no significant difference between SADE and RDE environments.”
41. Bodison SC, Parham LD. Specific sensory techniques and sensory environmental modifications for children and youth with sensory integration difficulties: a systematic review. American Journal of Occupational Therapy. 2018;72(1):7201190040p1–7201190040p11. doi:10.5014/ajot.2018.029413 (PMID 29280714). “moderate evidence supported sensory modifications to the dental care environment”. Checked October 23, 2026.
42. Cermak SA, Stein Duker LI, Williams ME, Dawson ME, Lane CJ, Polido JC. Sensory adapted dental environments to enhance oral care for children with autism spectrum disorders: a randomized controlled pilot study. Journal of Autism and Developmental Disorders. 2015;45(9):2876–2888. doi:10.1007/s10803-015-2450-5 (PMID 25931290). Checked October 23, 2026.
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    “Participants were 44 children ages 6-12 (n = 22 typical, n = 22 ASD).” “Both groups exhibited decreased physiological anxiety and reported lower pain and sensory discomfort in the SADE condition compared to RDE”.
43. American Academy of Pediatric Dentistry. Policy on prevention of sports-related orofacial injuries. The Reference Manual of Pediatric Dentistry. 2025:130–5. “Helmets, facemasks, and mouthguards have been shown to reduce both the frequency and severity of dental and orofacial trauma.” Checked October 23, 2026.
44. American Academy of Pediatric Dentistry. Adolescent oral health care. The Reference Manual of Pediatric Dentistry. 2025:342–53. Risks of oral piercing include “enamel fractures” and “periodontal recession”; “Piercing and the use of jewelry on intraoral and perioral tissues should be discouraged”. Checked October 23, 2026.

Medical disclaimer. This page is for general educational purposes and does not constitute medical or dental advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your child. Never start, stop, or change a dose without medical guidance.