Injuries to a Child's Tooth

Children can injure their teeth from falls or during play or sports activities. The injury may be to a baby (primary) tooth or an adult (permanent) tooth. A tooth may become cracked, chipped, or totally detached from its socket. Your child may have bleeding from the area, pain, or more sensitivity when a tooth is injured.

Treatment for an injured tooth

Specific treatment for an injured or knocked-out tooth will be determined by your child's dentist or healthcare provider. In general, the following guidelines can help you manage the situation:

• Remain calm and reassure your child that you can help.

• If the area is bleeding, place a small piece of folded gauze at the site. Have your child bite down or hold it in place with firm pressure.

• Offer your child a cold compress. This can help reduce swelling and pain.

• If a tooth is chipped or cracked, collect all the pieces of the tooth. Make sure a piece of tooth is not embedded in the lips, tongue, or gums.

• Contact your child's dentist right away for further follow-up and care. Sharp or ragged tooth edges may need to be smoothed. And further treatment may be needed to save the tooth. A loose tooth may need to be stabilized. A badly injured tooth or loose tooth that can't be realigned may need to be removed.

Treatment for a tooth that has been knocked out

Follow this advice of what to do about a knocked-out tooth: 

• Remain calm and reassure your child that you can help.

• If the area is bleeding, place a small piece of folded gauze at the site. Have your child bite down or hold it in place.

• Offer your child a cold compress. This can help reduce swelling and pain.

• Hold the tooth by the top of the tooth (crown), not by the bottom of the tooth (root). Plug up the sink to prevent losing the tooth down the drain. Then gently rinse the tooth with milk (don't scrub the tooth or use tap water as it contains chlorine and may injure the tooth). Milk is similar to the chemical makeup of teeth.

• Place the tooth back in your child's mouth in its socket if they will cooperate. Push down until the knocked-out tooth is level with the tooth on either side. Have your child bite down on a gauze pad placed over the tooth to keep it in place. This needs to be done quickly after the tooth has been knocked out. Follow this procedure for a permanent tooth. If a baby tooth has been knocked out, the best thing to do is to keep it moist and see the dentist right away.

• If you can't replace the tooth in your child's mouth, place it in a plastic bag with milk. Place the bag in ice. Or you can also have your child spit saliva into a cup and transport in your child's saliva. 

• Contact your child's dentist right away for further follow-up and care. If you can't reach the dentist, go directly to the emergency room. It is best to get care as soon as possible within 1 hour of the incident.

• If other injury to the mouth or teeth is suspected, X-rays of the area may be needed.

• Acetaminophen or ibuprofen may be given for mild pain, as needed, or as advised by your child's healthcare provider.

When should I call my child's dentist?

Call your child's dentist right away for:

• Any tooth injury that results in a loose or knocked-out tooth, a tooth that has sharp or ragged edges, or if a tooth is in pieces

• Any signs of infection following a tooth injury, such as fever, or increased pain, swelling, or drainage from the site

• Any concerns you have about the injury or if you have any questions

Preventing tooth injuries

The following are a few guidelines to help prevent tooth injuries in children:

• Teach your child not to walk or run while holding an object in their mouth.

• Teach your child not to suck or chew on hard, sharp, or pointed objects. This includes ice and hard candy.

• Have your child wear a mouth guard for sports activities that could result in injury.

• Never let your child use their teeth to cut or open things.