Emergencies

Sometimes your child will experience a dental emergency, so we provide the following information to help you know what to do in various situations.

Dental Accidents: Broken or Knocked-Out Teeth: If your child is unconscious, find help and call 911 immediately. If your child is conscious, check your child and try to determine what happened and what was injured. Apply pressure with clean towels or gauze to sites where there is bleeding. Cold compresses can also help.

Broken Tooth: An immediate evaluation will be necessary to determine if the fracture in the tooth caused exposure to the tooth’s nerve. If the broken tooth is a permanent tooth, try to find and save the broken piece so that your dentist can reattach it.

Dislodged Tooth: If your child has a tooth that is dislodged from its place but not completely knocked out, apply gauze to the bleeding area and call our office immediately. We will assess the injury and discuss the proper course of treatment with you. Permanent teeth will require repositioning and stabilization promptly.

Knocked-Out Permanent Tooth: Here are steps you need to take to increase the outlook for saving the tooth:

• Find the tooth.
• Handle the tooth only by the crown (the portion you would normally see in the mouth) and not the pointed root. Be careful not to scrape the root surface because tissues that cover it are what help the tooth survive the injury.
• Let your child rinse the mouth with water. If the tooth itself is dirty, rinse it in water briefly. The recommended approach is to use a small container with water in it. If you’re using a sink, be sure to put the drain stopper in place first.
• Keep the tooth moist. The best way to preserve the tooth is to reinsert it in its socket, even if you are not able to seat it in all the way. Have your child bite on a folded piece of gauze to hold the tooth in place. The next best option is to store the tooth in a special solution created to preserve it. This solution is found in containers called “Save a Tooth” . (See http://www.save-a-tooth.com). These are usually available at schools that have sports programs. If you cannot reinsert the tooth, and you are unable to find a preservative, place the tooth in milk. The final option is saliva. If the patient is old enough, the tooth may be held inside the mouth by the check.
• The child must be seen immediately by your dentist in order to stabilize the tooth. In this kind of dental emergency, time is a critical factor for the success of the treatment.

Knocked-Out Baby Tooth: Try to find the tooth. Clean your child’s mouth with a soft, wet cloth. Have your child bite on a piece of gauze to help stop the bleeding. It is important to have your child examined to determine if the whole tooth fell out or if only a part of it was knocked out. We will need to evaluate possible injury to the underlying permanent teeth. Knocked-out baby teeth are usually not replanted because of potential for subsequent damage to developing permanent teeth.

Oral Pain and Sores: If your child complains about pain in a certain area of the mouth, try to locate where the pain is. Most children are able to point to the area “where it hurts”. However, the pain source is not always a tooth. Your child may have bitten the cheek, tongue or lips. Even if the injury went unnoticed at the time it occurred, it can still be painful while the area is healing. Sometimes the pain is from a canker sore (white spot) in the area where the injury occurred. Canker sores can occur spontaneously and be quite painful. Although these injuries are usually self-limiting, it is important to have your child evaluated to rule out other possibilities such as dental abscesses or systemic diseases.

Toothache:  When your child points to a certain tooth and says “it hurts”, clean the area thoroughly with warm water. Gently use dental floss to remove any food debris that may be present. The pain may be caused by a cavity although sometimes cavities may not be visible except on a dental X-ray. Another possible source of the pain could be under an existing filling. You can give your child a children’s Tylenol or Motrin, according to package directions. However a comprehensive examination will be needed to properly evaluate the situation.

Bleeding After Loss of a Baby Tooth: After a baby tooth falls out, there is usually some bleeding. A minor case of bleeding stops within a minute or two. However, if bleeding continues, have your child bite down firmly on a clean piece of gauze for 15 minutes. This pressure will usually stop the bleeding. If needed, repeat the process with a new gauze pad every 15 minutes. Contact our office if you feel that the bleeding has gone on for longer than normal.

Broken Appliance: If a broken appliance can be removed easily, please remove it. If it cannot be removed, cover the sharp or protruding portion with cotton balls, gauze or soft chewing gum (sugarless gum is preferred). Schedule an appointment for your child. Although we recommend that you let us know immediately if an existing space maintainer becomes loose, this situation is not considered a dental emergency.