What should I do if my child falls and knocks out a tooth?

The important thing is to remain calm. Find the tooth/fragments if possible. If you cannot find the tooth, it may be intruded (pushed up into the bone) or it may have been swallowed (which may necessitate chest x-rays to confirm it is not lodged in the lungs). We will want to examine your child to assess the extent of the trauma.

Knocked Out Primary Tooth: Do not attempt to replant. Keep it light hearted and show your child enthusiasm that the tooth fairy will be coming early! We will still want to evaluate your child to assess any effects to the neighboring teeth, jaws and soft tissues.

Knocked Out Permanent Tooth: Find the tooth. Handle the tooth by the crown, not the root portion. You may rinse the tooth but DO NOT clean or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have your child hold the tooth in place by biting on a piece of gauze. If you cannot reinsert the tooth, transport the tooth in a cup containing your child’s saliva or chilled (low fat) milk. Let us see your child IMMEDIATELY! Time is a critical factor in saving the tooth.

Fractured Teeth: Find any tooth fragments. Check to see if there is any pulp exposure by looking for pink or red dots in the fractured area. If there is no pulp exposure, timing is not as crucial however your child’s teeth will be sensitive. Age appropriate Tylenol or Motrin may be given for any discomfort. We will want to evaluate your child to assess the injury and any effects to the neighboring teeth, jaws and soft tissues.

What should I do if my child is in pain?

Teething: From 6 months to age 3, your child may have sore gums when teeth erupt. Many children like a clean teething ring, cool spoon, or cold wet washcloth. Children may also get teething pain when the permanent first molars erupt (around 6 years of age) and when the 2nd permanent molars erupt (around 12 years of age). For children over the age of 1, non-steroidal anti-inflammatory medications (Advil, Motrin) help keep teething discomfort to a minimum.

Toothache or Abscess: Clean the area of the affected tooth thoroughly. Rinse the mouth vigorously with warm water or use dental floss to dislodge impacted food or debris. If the pain still exists, contact your child’s dentist. DO NOT place aspirin on the gum or on the aching tooth. To keep your child comfortable, children’s Advil, Motrin, or Tylenol may be sufficient until your child is able to come see us. If the face is swollen, apply cold compresses and contact us immediately.

Swollen, red gums, ulcers, inability to eat: This is most commonly primary herpetic stomatitis, a viral infection that usually has a two week course. Contact us so we may evaluate the condition. Keep your child hydrated with cool drinks, popsicles and a soft, bland diet (avoid acidic or salty foods). Tylenol, Advil, or Motrin is usually sufficient to keep your child comfortable. A 50/50 mix of Maalox and Benadryl may be applied topically to soothe the discomfort.

Cut or Bitten Tongue, Lip or Cheek: Apply ice to bruised areas. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If heavy bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take the child to hospital emergency room.

Lost/ Loose Crown or Spacer: If the crown/ spacer are loose or have come off, call the office for recementation as soon as possible. Save the crown/ spacer and bring it with you so we may try to refit it to the tooth. Keep the area clean.