Here's What To Do When...
Accidents happen. Stay calm and take action. Injuries to the mouth, teeth and face happen all the time to adults and children. If the accident involved a blow to the head that caused any loss of consciousness for any duration, contact your physician immediately. Apply pressure with a clean towel or gauze for 10 minutes or until bleeding stops. Once everything is stabilized, focus on the teeth. Look for broken or missing teeth. In most cases, x-rays will be necessary to rule out serious injury to the teeth or jaw.
My Child's Tooth Is Dark or Discolored
Dark or discolored teeth are usually caused by nerve damage. Discoloration usually follows 2-3 weeks after the accident. If a tooth darkens after an injury, it's because the blood supply was damaged. Baby teeth usually lighten after about 6 months, and if the tooth isn't bothering your child, it can be left alone. If an adult (permanent) tooth changes color, that nerve might be dying and need root canal therapy. Adult teeth may change color any time after an injury. A pink tooth is rare and indicates internal resorption. Have dentist closely monitor the tooth for changes or signs of infection.
My Child's Baby Tooth Got Knocked Out (dental avulsion)
Contact the dentist immediately. Do not re-insert the tooth into its socket as this can damage the developing permanent tooth. This injury often happens between 7-9 years old, when the bone surrounding the tooth is still soft and resilient. This means there is less of a chance of a bone fracture around the tooth. Your dentist should then see your child to check and verify that everything else is fine.
My Child's Permanent Tooth Got Knocked Out - TIME IS OF THE ESSENCE! GET TO YOUR DENTIST IMMEDIATELY!
Fractured or Chipped Tooth
If a tooth is fractured or chipped in a traumatic accident, seek dental care immediately for x-ray and evaluation. Find the broken tooth fragment if possible, checking the lips for imbedded fragments. Apply pressure with a clean towel or gauze for 10 minutes or until bleeding stops. Rinse well with warm water and keep the mouth clean. Reduce pain and swelling with a cold compress. Take over-the-counter pain reliever. Do not apply aspirin to the gums. Simple chips can be smoothed or repaired with tooth colored bonding. Moderate fractures may be bonded for now, and later restored with crowns, veneers or onlays. Serious fractures may require root canal therapy or extraction.
Toothache symptoms include lingering sensitivity to hot and cold, constant throbbing pain, pain when chewing or touching the tooth, swelling, tenderness and fever. Toothaches occur when the nerve is damaged or inflamed. A damaged or inflamed nerve can be caused by tooth decay (cavities) or dental trauma like sports injuries, rough play, fights, teeth grinding or extensive dental work on sensitive teeth.
To help stop pain, give over-the-counter pain medicine, dosed appropriately for your child's age and weight. For toothaches originating from the gums, rinse with warm salt water and floss thoroughly to remove food stuck between teeth or in the gum pockets around teeth. Consult with your dentist to help determine if antibiotics are recommended. Schedule a complete dental exam to reveal the source of the toothache, if there is an abscess, or if an extraction is indicated.
Jaw Fracture or Severe Head Trauma
Stay calm and immediately seek medical attention. A severe head injury can be life-threatening. Facial fractures can block the air passage. An emergency medical team will probably reach you faster than you can get to a hospital.
Facial fractures usually involve the lower jaw, but can also include the upper jaw, cheeks, eye sockets or nose. Since children's bones are still soft, fractures are often incomplete and heal quickly. If you suspect a jaw fracture, stabilize the jaw with a necktie or towel around the head. Do not allow it to move. Apply cold compresses to stop swelling, and go to an oral surgeon or hospital emergency room immediately.
Tips to Reduce Your Child's Risk of Dental Injury:
First, make sure your child is conscious and breathing well. Next, contact your dentist immediately. Use a clean towel or gauze to control bleeding. Because bone surrounding baby teeth is very soft and teeth move easily within their sockets, the most common tooth displacement for toddlers is inward luxation.
Pushed Inward (Luxation)
During a fall, a child's tooth is usually pushed inward, towards the palate. This is less damaging to the developing tooth bud because as the crown portion of the tooth moves inward, the roots are pushed away from the developing tooth.
Pushed Up (Intrusion)
Intrusion (tooth pushed upward) is the most damaging displacement because the root of the baby tooth can be forced into the developing tooth bud, creating potential developmental issues or color changes in the future adult tooth. If the intrusion is less than 3mm, the baby tooth has an excellent prognosis and chance of re-erupting on its own. As long as the developing adult tooth bud is not injured, the baby tooth can be allowed to spontaneously erupt over 8-12 weeks. If re-eruption does not begin within 8 weeks, the baby tooth will need to be removed. If the intrusion is more than 6mm and displaced into the developing adult tooth, the tooth requires extraction to prevent further damage to the adult tooth bud. X-rays will show if the tooth is present, because a severely intruded tooth can appear to have been knocked out when it has been pushed all the way inside.
If an adult tooth gets displaced, gently try to reposition it back into the right place. Gently hold the tooth in place and seek immediate dental care. If a tooth gets displaced less than 5mm, there is a 50% chance that the nerve won't be damaged. These teeth may reposition themselves, but may also require orthodontic repositioning. It is possible that there could be a fracture of the bone surrounding the tooth during these displacements. If the tooth is very loose, and can be moved more than 2mm, a flexible wire and composite splint may be placed for 7-10 days to help stabilize it.
Cut Inside the Mouth
Cuts within the mouth must be cleaned well and checked for any foreign bodies. Contact your dentist immediately. If the cut is severe, get emergency medical attention immediately. A tongue cut usually requires stitches if the edges of the tissue do not line up cleanly. Any tears to the frenum (muscle attachments) will usually heal well, without long-term complications. Use an ice pack to reduce swelling, and give the appropriate over-the-counter pain medication if necessary.