Tooth Injury

TOOTH INJURY

Injury Definition

  • Injury to a tooth.

Types of Tooth Injuries

  • Loosened tooth - may bleed a little from the gums. Usually tightens up on its own.
  • Displaced tooth (usually pushed inward).
  • Chipped or fractured tooth.
  • Avulsed (knocked out) tooth - a dental emergency for permanent teeth.

FIRST AID Advice for Knocked-Out Permanent Tooth:

  • Transport the tooth in some milk or saliva (Milk is the best).
  • If over 30 minutes away, try to replace the tooth in the socket before coming in.
  • Note: Baby teeth can't be re-implanted.
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WHEN TO CALL YOUR DOCTOR

Call your doctor now (night or day) if:

  • You think your child has a serious injury.
  • Permanent tooth knocked out. (Reason: needs reimplantation ASAP; 2 hours is the deadline for tooth survival.) See FIRST AID
  • Permanent tooth is almost falling out.
  • Baby tooth is almost falling out. 
  • Bleeding won't stop after 10 minutes of direct pressure.
  • Tooth is greatly pushed out of its normal position.
  • Tooth that's pushed out of its normal position interferes with normal bite.
  • Severe pain.
  • Age less than 1 year old.

Call your doctor within 24 hours (between 9am and 4pm) if:

  • You think your child needs to be seen.
  • Baby tooth knocked out by injury. (Reason: can't be reimplanted but dentist will check for damage to permanent tooth.)
  • Tooth is slightly pushed out of its normal position.
  • Can see a chip or fracture line (crack)in the tooth.
  • Tooth sensitive to cold fluids.
  • Tooth feels very loose when you try to move it.

Call your doctor during weekday office hours if:

  • Tooth becomes a darker color
  • You have other questions or concerns.

Parent care at home if:

  • Minor tooth injury and you don't think your child needs to be seen.
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HOME CARE ADVICE

  1. Local Cold: For pain, apply a piece of ice or a Popsicle to the injured gum area for 20 minutes.
  2. Pain Medicine: If it still hurts, give acetaminophen (e.g. Tylenol) or ibuprofen.
  3. Soft Diet: For any loose teeth, offer a soft diet for 3 days. By then, it should be tightened up.
  4. Call Your Dentist If:
    • Pain becomes severe
    • Tooth becomes sensitive to hot or cold fluids
    • Tooth becomes a darker color
    • Your child becomes worse

And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.

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REFERENCES

  1. Creighton PR. Common pediatric dental problems. Pediatr Clin North Am. 1998; 45:1579-1600.
  2. Fried I and Erickson P. Anterior tooth trauma in the primary dentition: Incidence, classification, treatment methods, and sequelae: A review of the literature. ASDC J Dent Child. 1995;62:256-261.
  3. Layug ML. Interim storage of avulsed permanent teeth. J Can Dent Assoc. 1998;64(5):357-63, 365-369.
  4. McTigue DJ. Diagnosis and management of dental injuries in children. Pediatr Clin North Am. 2000;47:1067-1084.
  5. Nowak AJ, Slayton RL. Trauma to primary teeth: Setting a steady management course for the office. Contemp Pediatr. 2002;19(11):99-118.
  6. Shusterman S. Pediatric dental update. Pediatr Rev. 1994;15:311-318.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

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