Dental pain in childhood is often dismissed as a temporary inconvenience because it involves primary (milk) teeth and the expectation that permanent teeth will replace them. However, the consequences extend far beyond oral discomfort, influencing a child’s daily functioning, emotional well-being, and ability to learn.
What feels worse than skipping your child’s dental appointment?
Watching their grades slide.
And yet, what if these two disappointments are not strangers at all, but quiet collaborators?
Untreated dental disease doesn’t just ache in the mouth; it echoes through classrooms, attendance registers, and exam sheets. Beyond the obvious medical expenses, unresolved oral problems quietly drain time; time away from school, time away from learning, time away from focus.
Dental caries remains one of the most common chronic conditions of childhood. Far from being a “minor” ailment, it seeps into a child’s physical comfort, social confidence, and emotional well-being.1 Studies consistently show that children presenting with urgent dental needs often carry a heavy burden of decay, with toothache reported in more than half of such cases.2 When pain escalates, emergency care becomes the default, an option far costlier than routine dental visits and one that frequently signals delayed intervention.
But the real cost is not counted only in currency.
Children struggling with dental pain often experience embarrassment, anxiety, and social withdrawal. The classroom, once a place of curiosity, becomes a space of distraction. Concentration fractures, and attendance slides down. Academic performance follows the same trajectory.
Seirawan and colleagues gathered evidence from Los Angeles public school data, revealing a stark pattern: children suffering from toothache are significantly more than five times likely to miss school than their pain-free peers. They are also four times more likely to perform poorly academically.3 On average, dental problems alone account for multiple lost school days each year, not just for children, but for parents who must miss work or school to seek emergency care for them.
Broader analyses echo the same warning. Children with compromised oral health are far more likely to be absent due to dental pain or infection, and these absences translate directly into poorer school outcomes. The lesson here is blunt: pain does not pause for exams, and learning does not thrive in discomfort.
Historically, national estimates suggested tens of millions of school hours were lost annually to dental visits, a whopping 52 million to be precise!4 However, earlier data failed to distinguish between routine check-ups and emergency, unplanned care, masking the actual academic impact of preventable dental disease.
More recent national survey conducted by Naaval and Kelekar paint a clearer picture.5 Acute, unplanned dental visits alone account for tens of millions of lost school hours each year. Children with fair or poor oral health are several times more likely to miss school compared to those with healthier mouths. Socioeconomic differences further exacerbate this divide: children from lower-income families bear a disproportionate share of these lost hours, while their higher-income counterparts are less likely to miss school due to dental emergencies.
The takeaway is impossible to ignore.
Untreated dental pain is not just a health issue; it is an educational disruptor. A silent thief of classroom time. A barrier to attention, attendance, and achievement.
When we talk about academic performance, we often look upward, to curricula, teaching methods, or screen time. Perhaps it’s time we also look inward, starting with the mouth, where pain whispers before it roars, and where prevention could save not just teeth, but futures.
References
Hollister, Michael C., and Jane A. Weintraub. “The Association of Oral Status with Systemic Health, Quality of Life, and Economic Productivity.” Journal of Dental Education 57, no. 12 (December 1993): 901–912. https://pubmed.ncbi.nlm.nih.gov/8263237/.
Seu, Karen, Karyn K. Hall, and Elyse Moy. Emergency Department Visits for Dental-Related Conditions, 2009. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville, MD: Agency for Healthcare Research and Quality, 2006. Accessed December 23, 2025. http://www.ncbi.nlm.nih.gov/books/NBK116745/.
Seirawan, Hoda, Stephanie Faust, and Roseann Mulligan. “The Impact of Oral Health on the Academic Performance of Disadvantaged Children.” American Journal of Public Health 102, no. 9 (September 2012): 1729–1734. https://pubmed.ncbi.nlm.nih.gov/22813093/.
Gift, Helen C., Susan T. Reisine, and David C. Larach. “The Social Impact of Dental Problems and Dental Visits.” American Journal of Public Health 82, no. 12 (December 1992): 1663–1668. https://pubmed.ncbi.nlm.nih.gov/1456343/.
Naavaal, Shillpa, and Uma Kelekar. “School Hours Lost Due to Acute/Unplanned Dental Care.” Health Behavior and Policy Review 5, no. 2 (2018): 66–73. https://www.researchgate.net/publication/323322984_School_Hours_Lost_Due_to_AcuteUnplanned_Dental_Care.
