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First Aid for Dental Trauma

Published by , on Oct 30, 2014

When a trauma occurs to a baby tooth, the permanent teeth forming under the gums may also be affected. Knowing what steps to take following a dental trauma can make a huge difference in protecting a child’s teeth. In the steps outlined below, Pediatric Dentist Dr. Patrice B. Wunsch provides a general overview of what to do and what to consider when a child’s tooth is chipped, moved or knocked out. This information is based on American Academy of Pediatric Dentistry Guidelines. For additional dental care tips, visit their website at aapd.org.



Baby tooth trauma

What to do if the following occurs to a baby (primary) tooth

Chipped baby tooth

  • Contact your child’s dentist or go to the nearest emergency room.*

  • An x-ray of the tooth will be made.

  • The child may require an extraction (tooth removal) or no treatment.

  • The child should be monitored by the dentist every six months.

Baby tooth has moved to different position

  • Contact your child’s dentist or go to the nearest emergency room.*

  • An x-ray of the tooth’s position will be made.

  • If the child’s bite is affected, the tooth may need to be repositioned or removed (extracted).

  • If the child’s bite is not affected, immediate treatment may not be needed, but the child should be observed by their dentist every six months.

Baby has been tooth knocked out

  • Do not reimplant the tooth (i.e., do not return the tooth to its original site).

  • Take child to the nearest emergency room.

  • Follow up with the child’s dentist as soon as possible.

 Special focus: Trauma to a permanent tooth bud
Beneath the baby tooth is the permanent tooth bud (new tooth forming under the gums) and sometimes when there is trauma to the baby tooth, the permanent tooth bud can be affected. The consequences of permanent tooth bud trauma may include:

  • Malformation of the affected permanent tooth

  • Impacted teeth (teeth that are blocked as they pass through gums)

  • Failure of permanent teeth to erupt (pass through gums)

  • White or yellow-brown discoloration of the crown (part of tooth that is visible in the mouth)

  • Missing enamel on the permanent incisors (front teeth)

Consultation with the child’s dentist after trauma to the baby tooth is necessary to ensure that the baby tooth is not in a position that will affect the permanent tooth bud. This is why one should not reimplant a baby tooth! Following the traumatic event, the dentist will have an x-ray made of the tooth or affected area to use as a baseline diagnostic aid. The child will then be seen for regular follow-ups to monitor both the traumatized baby tooth and permanent tooth bud.

What to watch for after dental trauma
Parents should watch for possible complications following pediatric dental trauma. Complications may include swelling (usually on the gum above the traumatized tooth) or increased mobility (the tooth becomes loose). Many times children may not complain about pain even though an infection may be present. Parents should check in with their dentist if concerned about complications.

Permanent tooth trauma

What to do if a child knocks out a permanent tooth…

  • Make sure the child is alert and keep the child calm.

  • The chance of recovery for the permanent tooth depends greatly on what you do right after the accident. In most cases, returning the tooth to its original site (reimplanting) should occur as soon as possible after the tooth is knocked out.

How to reimplant a tooth

  • Find the tooth and pick it up by the crown (enamel-covered top part of tooth) and avoid touching the root (part of tooth that is usually covered by gums).

  • If the tooth is dirty, wash it for 5 to 10 seconds under cold running water.

  • If the child is cooperative, either the child or guardian can reimplant the tooth by gently placing it back into the socket.

  • Contact your child’s dentist or go to the nearest emergency room.*

However, there are situations when reimplantation should not be attempted. Reimplantation is not recommended if the:

  • Affected tooth has a severe amount of tooth decay

  • Child is not cooperative

  • Child has a severe medical condition such as an immune system disorder or heart condition

In situations where reimplantation is not possible or not recommended, transport the tooth in a storage medium.

How to transport a tooth in a storage medium

  • If you are unable to reimplant the tooth, place the tooth into milk or another suitable storage medium such as saliva, isotonic saline or a tooth preservation kit. Do NOT store the tooth in water.

  • The tooth can also be transported in the child’s mouth if the child is alert and conscious and able to keep the tooth inside his or her lip or cheek.

  • If the child is very young, he or she could swallow the tooth so in this case it is advisable to have the child spit into a container and place the tooth in it.

  • Contact your child’s dentist or go to the nearest emergency room.*

Pediatric dentists are trained to manage pediatric dental trauma and are experienced in working with young patients in an emergency situation. CHoR’s pediatric dentistry team covers all dental needs, from checkups and cleanings to dental surgery. Take a virtual tour of CHoR’s Brook Road Campus dental clinic.

*If dental trauma occurs during dental office business hours and the child does not show any signs of dizziness or nausea, call the child’s dentist for an emergency visit. If dental trauma occurs after hours, call the nearest emergency room to discuss the accident and the child’s current condition. If the child shows any signs of dizziness and/or nausea, take them to the nearest emergency room.

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