Dental Injuries: What to Do if Your Child Knocks Out a Tooth

By Dr. Mohsen Alozaibi, Tiny Teeth Dental Center, Abu Dhabi

A slip at the pool, a fall from the scooter, a collision on the football pitch. Dental injuries are common in children, and they always seem to happen at the worst moment. Knowing a few simple steps in advance can make a real difference, especially if an adult tooth is knocked out.

First: stay calm and check your child

Your child will take their cue from you, so take a breath before you look at the mouth. Then check the whole child, not just the teeth.

Go to the emergency department straight away (or call 998 for an ambulance in the UAE) if your child lost consciousness, even briefly, or is vomiting, unusually sleepy, confused, has a worsening headache, or has bleeding that won't stop. A head injury comes before any tooth.

For cuts to the lip, tongue or gums, press firmly with clean gauze or a cloth for about 10 minutes. Mouth injuries bleed a lot and usually look worse than they are. A deep or gaping cut may need stitches.

A knocked-out BABY tooth

Do not try to put a baby tooth back. Replanting it can damage the adult tooth developing just above it. Keep the tooth if you find it (it helps confirm the whole tooth came out), control any bleeding, and contact your dentist the same day.

Not sure whether it's a baby or adult tooth? Front adult teeth usually come in around age 6 to 8. If in doubt, treat it as an adult tooth and call your dentist immediately.

A knocked-out ADULT tooth: every minute counts

1. Find the tooth and hold it by the crown (the white part you normally see), never by the root. 2. If it's dirty, rinse it briefly for a few seconds in milk or cold running water. Don't scrub it, wipe it or let it dry. 3. Put it back in the socket if you can, the right way round, and have your child gently bite on a clean cloth to hold it in place. The sooner, the better. 4. If you can't put it back, keep it moist in milk or in your child's own saliva (for example, spit into a small cup). An older child can hold it inside the cheek, but not a young child who might swallow it. Do not store it in plain water, which damages the root cells. 5. See a dentist immediately. The best results come when the tooth is back in place within minutes, and ideally the child is seen within 30 to 60 minutes.

Your dentist may also ask whether your child's tetanus vaccination is up to date.

Chipped, broken, loose or pushed-in teeth

• Chipped or broken tooth: look for the broken piece and keep it in milk or water. Sometimes it can be bonded back. If you see pink or red in the middle of the broken tooth, the nerve may be exposed, so be seen the same day.
• Loose or moved tooth: don't try to wiggle or straighten it yourself. Soft food and a dental visit are needed.
• Pushed-in tooth: a baby tooth pushed up into the gum often comes back down on its own over weeks, but it still needs checking to make sure the adult tooth underneath is safe.

After the injury: keep an eye on it

An injured tooth can look fine at first and then turn grey or dark weeks or months later, or develop a small pimple or swelling on the gum. This doesn't always mean trouble, but it does mean a follow-up. Your dentist will usually suggest a few review visits, sometimes with an X-ray, after any significant injury.

Prevention

• Mouthguards for contact sports such as football, basketball, martial arts and hockey. A custom-made guard usually fits best.
• Helmets for bikes, scooters and skates.
• Correctly fitted car seats on every trip, however short.
• Watch wet floors around pools and bathrooms, and soften sharp furniture edges for toddlers.
• Save your dentist's number in your phone today, so you aren't searching for it in a panic.