If a permanent tooth has been knocked out, it’s best to get the tooth re-implanted within 30 minutes if possible. Though this is the ideal course of treatment, there are many documented cases of successful re-implantations after the tooth has been out for a longer period of time. You should attempt to make contact with our office within 30 minutes, or go to the nearest emergency room if you can’t get to our office or if you’re out of town.

Here’s what to do with the knocked-out tooth:

• Hold the tooth by the crown, not the root. Do not try to clean the tooth or handle it more than absolutely necessary.
• If the tooth is not dirty or fractured, put it back in the socket and have the child hold it there by biting on gauze or a clean cloth. There’s no need to worry if you don’t place it exactly right, because it’s better for the tooth to be in the socket than not.
• If the tooth is dirty, fractured, or if you can’t get it in the socket, put it in a cup with milk or the child’s saliva as you take the child and the tooth to the dentist as quickly and safely as possible. If the child is old enough to do so without swallowing, he can hold the tooth in his mouth to transport it.

If a primary or baby tooth has been knocked out, we do not recommend saving it. Trying to re-implant a primary tooth creates too great a risk to the forming permanent teeth. Still, we recommend that you take your child to the dentist as soon as possible to make sure that no additional damage has been done to other teeth or the jaw from the impact.

If a tooth has been chipped or fractured, it’s important to bring your child to the dentist as quickly as possible to evaluate the trauma, regardless if the tooth is primary or permanent. Chips and small fractures compromise the protective hard enamel of the tooth, which allows bacteria to enter the pulp and nerve of the tooth where it can cause infection. The tooth must be sealed in order to keep the bacteria away.

For a larger fracture, the pulp of the tooth may be directly involved, so immediate treatment is required to maintain the tooth’s vitality. In most cases, the tooth cannot be completely restored after trauma, but the main objective is to protect the tooth from bacteria and allow it to heal successfully. After several weeks, you should make another appointment for an esthetic and functional restoration for the affected tooth.

In situations where the displaced tooth fragment is available, the dentists can often bond it back to the broken tooth at the initial emergency appointment—which is always the preferred option. So, if you are able to locate the tooth fragment, then bring it with you and the child to our office.

If your child has cut or bitten his or her tongue, lip, or cheek, there can be alarming bleeding, swelling, and discomfort.

Here’s what we recommend you do:

• Apply direct pressure to the bleeding area using a clean cloth.
• If swelling is present, use a cold compress to reduce the pressure building up in the area and lessen the discomfort; sometimes a popsicle works well for children.
• Give your child appropriate dosages of Tylenol® or Motrin® to reduce the swelling and relieve the discomfort.
• Check the area to see if there is a fractured tooth with a fragment possibly embedded in the cheek or tongue. If you need help checking the area, go to the dentist as soon as possible.

If your child complains of a toothache, it’s important that you check for the cause. Here are our recommended actions:

• Check the area for a possible source of pain, such as food impaction, an erupting tooth, or a “hole” or cavity in a tooth.
• If you think you see a cavity, you should come to the dentist as soon as possible. An untreated cavity that’s causing pain can
  quickly develop into an abscess, which can cause serious medical problems if left untreated.
• Try brushing and flossing to dislodge any food that may be stuck between the teeth.
• Rinse the irritated area with warm salt water, and place a cold compress on the face if it is swollen.
• To treat dental pain, Ibuprofen and Acetaminophen (Motrin® and Tylenol®) are the primary choices. Orabase® is a good
  over-the-counter medication for pain related to the gum tissue. Though you may have heard of applying aspirin directly to
  gums, please DO NOT DO THIS, as the aspirin can cause severe burns to the fragile tissue.

If your child receives an injury to the jaw, you should take him or her to the emergency room for immediate care, and then come to our office as soon as possible. The dentist will check for fractures in the jaw and perform a dental exam to locate any secondary fractures in the teeth. Depending on the extent of the injury, the dentist may need to consult with an oral surgeon to provide your child with the best care.