The Indonesian family life survey (IFLS) is used for formulating various government policies. Our preliminary study using data from the IFLS showed increase in the prevalence of toothache from 2007 to 2014. Hence, a need to analyse the factors associated with toothache using structural equation modelling (SEM) for identifying the direct and indirect association of factors with toothache was evident. The objective of this study is to analyse the complex relationships between toothache and its associated risk factors. This cross-sectional study was conducted on the data obtained from the IFLS in 2014. The IFLS data pertaining to toothache and its prevalence were analysed using the STATA software, and the multifaceted relationship was analysed using SEM. The prevalence of toothache among Indonesian children was 15.55% (1,959 of 12,595). SEM showed the direct association between toothache and age (p < 0.001) and parent awareness of children's health conditions (p < 0.005) and food consumption frequency (p < 0.001). Parents' education level and residential area showed an indirect association with toothache, mediated by socioeconomic status and parent awareness of children's health conditions (p < 0.001). We identified the multifaceted relationship between toothache and the social covariates. Parents' awareness of their children's health conditions mediated several indirect associations, highlighting its importance. Toothache could be the clinical consequence of several odontogenic causes including severe dental caries as well as of non-odontogenic factors 1-4. The pulp, a tissue of high neural density primarily rich in sensory nerve terminals, plays the key role in mediating odontogenic toothache, responsive to external stimuli, and in detecting potential damage to the tooth 5. A search across the MEDLINE electronic database for epidemiological studies related to dental pain (toothache) caused by dental caries (tooth decay) showed that toothache is highly prevalent among children, even in populations with historically low levels of dental caries. Toothache is consistently associated with dental caries experience across populations 6. The presence of toothache affects mastication 7 , speech 8 , and concentration in studies 8,9. The 2007 national survey of children's health analysed parent reported-toothaches in children and concluded that 10.7% children of the United States experienced toothache in previous 6 months 10. In Brazil, the prevalence of toothache in children between the ages of 6 and 12 years was 39% and during the previous month was 11% 11. A cross-sectional study set in 1,862 pharmacies in London between November 2016 and January 2017 reported that 6,915 parents visited the pharmacies seeking pain medications for their children. Most parents (65%) required