If your child has an accident, please call our office as soon as possible. Children are subject to accidents frequently. In order to accommodate an injured child, our schedule may be delayed. Please accept our apologies in advance should this occur during your appointment. We would do exactly the same if your child were ever in need of emergency treatment.

Trauma to Baby Teeth
Due to the active nature of children, trauma to the primary teeth (baby teeth) is very common. Most accidents to your child's baby teeth look bad, but may not require immediate attention. Swelling is to be expected and may look worse 12-24 hours after the injury. We have included descriptions of the most common types of trauma to help guide you through this stressful event until you can contact us.

• Tooth is knocked out  
  Clinical signs: The whole baby tooth is gone from its socket.
  Treatment: Control bleeding with firm pressure from a cloth. Locate the tooth and save for visual inspection by your child’s dentist. DO NOT attempt to reinsert the tooth into the socket. If you are uncertain if the tooth is a baby or permanent tooth, place the tooth in milk and contact us as soon as possible. Provide over-the-counter pain medicine and soft diet as needed. Contact us for evaluation.

• Tooth is gray or brown in color
  Clinical signs: Tooth appears darker in color. Up to 70% of injured baby teeth can darken. A dark baby tooth does not always require treatment. These teeth are at a higher risk for dental abscess (infection).
  Treatment: Over-the-counter pain medicine if pain is associated with the discoloration.  Clinical examination and x-ray by us to evaluate for a dental abscess.

• Tooth hit but not loose
  Clinical signs: These teeth will sometimes exhibit some bleeding along the gum line but no real mobility of the tooth. These teeth will often be sore for 1-3 days but have a very good prognosis. Discoloration may be noted at any time after the trauma.
  Treatment: Soft diet and over the counter pain medicine (Tylenol) are indicated for initial treatment. Contact us for an evaluation.

• Tooth hit and loose
  Clinical signs: These teeth will usually exhibit bleeding and bruising of the gum tissue but appear to be in proper position. They may “wiggle” back and forth or side to side. These teeth will often be sore for several days and have a guarded prognosis. Usually they will tighten back to normal in 1-2 weeks. Discoloration may be noted at any time after the trauma and is fairly common with this type of trauma.
  Treatment: Minimize movement as soon as possible. Check to see if your child can close his teeth together normally. Firm pressure from a washcloth to control bleeding of the gum tissue, soft diet, and over the counter pain medications are indicated as needed. Contact us for an evaluation.

• Tooth hit and knocked out of position
  Clinical signs: These teeth will appear out of position either forward, back, extruded or intruded. Bleeding and bruising of the gum tissue is to be expected. The tooth may or may not be mobile. These teeth will often be sore for 1-2 weeks. Discoloration may be noted at any time after the trauma and is fairly common with this type of trauma.
  Treatment: If the tooth is forward or back, attempt to reposition the tooth with firm finger pressure if possible. Check to see if your child can close his teeth together normally. Firm pressure from a washcloth to control bleeding of the gum tissue, soft diet, and over the counter pain medications are indicated as needed. Contact us for an evaluation.

• Tooth hit and broken
  Clinical signs: These teeth will appear chipped. They may be sensitive to cold and hot. Bleeding from the center or inside of the tooth indicates a fracture into the nerve of the tooth and a poor prognosis for its survival.
  Treatment: Limit exposure to hot or cold foods or drinks. Over-the-counter pain medicine as needed. Contact us for an evaluation.

Knocked Out Permanent Tooth: Find the tooth. Handle the tooth by the crown, not the root portion. DO NOT clean or handle the tooth unnecessarily.  Gently rinse but do not scrub the tooth and if possible, replace it back in the socket. If this-is impossible, place the tooth in milk or wet cloth and call the office immediately. If the tooth is fractured, please bring any pieces you can find. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have the patient hold the tooth in place by biting on a gauze. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient’s saliva or milk. If the patient is old enough, the tooth may also be carried in the patient’s mouth. The patient must see a dentist IMMEDIATELY!  Time is a critical factor in saving the tooth.

Toothache: Clean the area of the affected tooth thoroughly. Rinse the mouth vigorously with warm water or use dental floss to dislodge impacted food or debris. If the pain still exists, contact your child's dentist.  DO NOT place aspirin on the gum or on the aching tooth. If the face is swollen apply cold compresses and contact your dentist immediately.

Cut or Bitten Tongue, Lip or Cheek: Apply ice to bruised areas. If there is bleeding apply firm but gentle pressure with a gauze or cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take the child to hospital emergency room.

Remember: Most of these situations require you to “keep your cool” apply firm pressure with a soft cloth to control any bleeding., ice to control any swelling, a soft diet for your child, and over the counter pain medicine for pain management. The gum tissues of the mouth are very vascular and bleed very easily. Luckily, most bleeding can be controlled quickly with firm pressure with a washcloth within 10-15 minutes. Contact the Emergency Room as soon as possible if your child experiences prolonged or uncontrolled bleeding or unconsciousness as a result of the trauma. The pain and swelling will often reach its peak 24-48 hrs after the trauma but should gradually improve thereafter. Baby teeth are notorious for developing a dental abcess (infection) after trauma.

It is important to call our office to schedule an appointment as soon as possible so that we can evaluate and discuss the extent of the trauma.

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Cary, NC Pediatric Dentists - Dr. Robert Moran and Dr. Richard Brooks
Dentistry for infants, children, young adults, and patients with special needs ~ Cary, North Carolina