Pediatric Dental Emergencies & Trauma

If you face a dental emergency, give us a call immediately. If you need urgent treatment after hours, you can call our emergency number. We are always here to assist when your child's dental health is at risk. Below are tips on dealing with urgent dental situations. You may want to display this list on your refrigerator or store it near your emergency phone numbers for easy reference.
Bitten Lip or Tongue
If your child has bitten his lip or tongue severely enough to cause bleeding, clean the bite gently with water and use a cold compress (a cold, wet towel or washcloth pressed firmly against the area) to reduce or avoid swelling. Give us a call to help determine how serious the bite is.
Object Caught In Teeth
If your child has something caught between his teeth, use dental floss to gently remove it. Never use a metal, plastic, or sharp tool to remove a stuck object. If you are unable to remove the item with dental floss, give us a call.
Broken, Chipped, or Fractured Tooth
If your child has chipped or broken a piece off of his tooth, have him rinse his mouth with warm water, then use a cold compress to reduce swelling. Try to locate and save the tooth fragment that broke off. Call us immediately.
Knocked Out Tooth
If your child's tooth has been knocked out of his mouth, find the tooth and rinse it with water (no soap), taking care to only touch the crown of the tooth (the part you can see when it's in place). If you can, place the tooth back in its socket and hold it in place with a clean towel or cloth. If you can't return the tooth to its socket, place it in a clean container with milk. In either case, call us immediately and/or head to the hospital. If you act quickly it's possible to save a permanent, or adult tooth. Unfortunately, primary teeth are generally not re-implanted. If one of your child's primary teeth has been knocked out, you will want to schedule a visit to our practice as soon as possible so that your dentist can ensure that there are no fragments of tooth remaining.
Loose Tooth
If your child has a very loose tooth, it should be removed to avoid being swallowed or inhaled.
Toothache
If your child complains of a toothache, rinse his mouth with warm water and inspect his teeth to be sure there is nothing caught between them. If pain continues, use a cold compress to ease the pain. Do not apply heat or any kind of aspirin or topical pain reliever directly to the affected area, as this can cause damage to the gums. Children's pain relievers may be taken orally. Schedule an appointment immediately.
Broken Jaw
If you know or suspect your child has sustained a broken jaw, use a cold compress to reduce swelling. Call our emergency number and/or head to the hospital immediately. In many cases a broken jaw is the result of a blow to the head. Severe blows to the head can be dangerous and even life-threatening.
Avoiding Injury
You can help your child avoid dental emergencies. Child-proof your house to avoid falls. Don't let your child chew on ice, popcorn kernels, or other hard foods. Always use car seats for young children and require seatbelts for older children. And if your child plays contact sports, have him wear a mouthguard. Ask us about creating a custom-fitted mouthguard for your child. Finally, prevent toothaches with regular brushing, flossing, and visits to our office.
Traumatic Dental Injuries
While most traumatic dental injuries occur in children and teenagers, people of all ages can be affected, usually as a result of sports mishaps, automobile accidents, or bad falls. Regardless of the cause, it is important to visit your endodontist if you've experienced a traumatic dental injury in order to determine any necessary treatment. Any dental injury, even if apparently mild, requires examination by a dentist or an endodontist immediately. Sometimes, neighboring teeth suffer an additional, unnoticed injury that will only be detected by a thorough dental exam.
Chipped or Fractured Teeth
Chipped teeth account for the majority of all dental injuries. Most chipped or fractured tooth crowns can be repaired either by reattaching the broken piece or by placing a tooth-colored filling. If a significant portion of the tooth crown is broken off, an artificial crown or "cap" may be needed to restore the tooth.
Injuries in the back teeth often include fractured cusps, cracked teeth, and the more serious split tooth. If cracks extend into the root, root canal treatment and a full coverage crown may be needed to restore function to the tooth. Split teeth may require extraction.
Dislodged (Luxated) Teeth
During an injury, a tooth may be pushed sideways, out of, or into its socket. Your endodontist will reposition and stabilize your tooth. Root canal treatment is usually needed for permanent teeth that have been dislodged and should be started a few days following the injury.
Children between seven and 12 years old may not need root canal treatment, since their teeth are still developing. For those patients, your endodontist will monitor the healing carefully and intervene immediately if any unfavorable changes appear.
Knocked-Out (Avulsed) Teeth
If a tooth is completely knocked out of your mouth, time is of the essence. The tooth should be handled very gently, avoiding touching the root surface itself. If it is dirty, quickly and gently rinse it in water. Do not use soap or any other cleaning agent, and never scrape or brush the tooth. If possible, the tooth should be placed back into its socket as soon as possible. The less time the tooth is out of its socket, the better the chance for saving it.
Once the tooth has been put back in its socket, your endodontist will evaluate it and will check for any other dental and facial injuries. If the tooth has not been placed back into its socket, your endodontist will clean it carefully and replace it. A stabilizing splint will be placed for a few weeks. Depending on the stage of root development, your endodontist may start root canal treatment a week or two later.
Root Fractures
A traumatic injury to the tooth may also result in a horizontal root fracture. The location of the fracture determines the long-term health of the tooth. If the fracture is close to the root tip, the chances for success are much better. The closer the fracture is to the gum line, the poorer the long-term success rate. Sometimes, stabilization with a splint is required for a period of time.
Traumatic Dental Injuries in Children
Chipped primary (baby) teeth can be aesthetically restored. Dislodged primary teeth can, in rare cases, be repositioned. However, primary teeth that have been knocked out typically should not be replanted. This is because the replantation of a knocked-out primary tooth may cause further and permanent damage to the underlying permanent tooth that is growing inside the bone.
Children's permanent teeth that are not fully developed at the time of the injury need special attention and careful follow up, but not all of them will need root canal treatment. In an immature permanent tooth, the blood supply to the tooth and the presence of stem cells in the region may enable your endodontist to stimulate continued root growth.
Root Resorption
Resorption occurs when your body, through its own defense mechanisms, begins to reject your own tooth in response to the traumatic injury. Following the injury, you should return to your endodontist to have the tooth examined and/or treated at regular intervals to ensure that root resorption is not occurring and that surrounding tissues continue to heal.
With any traumatic dental injury, time is of the essence. Contact your endodontist immediately.
