Help! My Tooth Got Knocked Out!

It can happen on the playground. It can happen at soccer practice. It can even happen at home! You get a call that your child has a dental injury. What would you do? Knocked-out teeth account for about 15% of children’s dental emergencies (Pediatric Dentistry, Nov-Dec 1994). Being prepared for a dental emergency can mean the difference between saving or losing a tooth. Here are some tips on what to do for common dental injuries and emergencies.

Avulsion (knocked out tooth)

Avulsion is caused by trauma, and is a time-dependent injury. The best chance of saving the tooth requires reimplantation within 30 minutes. After the accident, every effort should be made to locate the tooth. Pick up the tooth by the crown, not the root. Gently rinse the tooth with water to remove debris, and if possible reposition in its socket. If the tooth cannot be replaced, place it in cold milk, saline, or water and transport immediately to the dentist. If a baby tooth is knocked out, treatment is usually not necessary and reimplantation could damage the permanent tooth bud formation.

Luxation (displaced tooth)

When a tooth has been pushed out of place, it often tears the nerve and blood vessels at the tip of the roots. There are three types of luxation: extruded, laterally displaced, and intruded. All three require immediate transfer to the dental office.

The extruded tooth looks longer than the surrounding teeth, and a laterally displaced tooth looks pushed back or pulled forward. If possible, the tooth should be repositioned using firm finger pressure. An intruded tooth looks shorter than the surrounding teeth. Do nothing. Transport immediately to the dentist.

Fracture (broken or chipped tooth)

If a tooth is totally broken in half, save the tooth fragment and transport using the same guidelines as avulsion (milk, saline, water). If the surface of the tooth has blood on it, it means the injury involves the pulp. Pulp exposure can be very painful, and limiting the nerve exposure to air, saliva, and temperature changes will help. See your dentist immediately.

Toothache

First, rinse the mouth with warm water. Floss to make sure food or foreign objects are not lodged between the teeth. If this does not work, call your dentist for an appointment.

Bitten tongue or lip

Apply direct pressure to the bleeding area with a clean cloth. If bleeding continues, go to your dentist or emergency room for an evaluation. A cold compress will help with swelling.

Problems with braces and retainers

Cover the irritating wires with beeswax, a small cotton ball or piece of gauze until you can get to the dentist or orthodontist.

Jaw and TMJ injury

See your dentist immediately if your teeth do not fit together, if there is pain in the jaw, eating is painful, or the jaw cannot be opened fully. A cold pack can be used to reduce pain and swelling.

Many dental injuries can be prevented or lessened by the use of a mouthguard. A properly fitted mouthguard is an important piece of athletic gear. It is recommended that everyone – from children to adults wear a mouthguard during any sport or recreational activity that might pose a risk of injury to the mouth.

The most important thing to remember in the event of any dental injury or emergency is, do not panic, or delay treatment. Familiarize yourself with the dental emergency tips and keep them handy. It might just save a tooth!

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