Injuries to children’s teeth are common. Injuries can range from minor chipping to a knocked out tooth. Both baby teeth and permanent teeth can be injured. When giving first aid treatment to a toddler or young child with a tooth injury, the goal is to prevent additional harm to the permanent teeth that are developing below the baby teeth.
Causes of tooth injuries
Children may injure their teeth as a result of falls, playground accidents, flying objects, such as Frisbees and balls, or sport-related injuries.
Types of tooth injuries
Your child may have the following type of tooth injury:
- minor chip
- major chip
- serious fracture that exposes the nerve and blood vessels in the centre of the tooth
- a displaced tooth: the tooth is forced upward, downward, or to the side
- a knocked out (avulsed) tooth
Treatment of tooth injuries
If your child has a loose tooth or a minor chip, take him to the dentist. Your child’s dentist will assess the damage and smooth any sharp edges.
If your child has broken, loosened, or knocked out a permanent tooth, this is considered an emergency. For a completely knocked out tooth, before you take your child to the dentist, gently rinse the permanent toothin water and immediately place it back in the tooth socket. In some cases a knocked-out permanent tooth can be saved if it is replaced right away in its proper position in the mouth. Your child should keep the tooth in place with a finger or by biting on a gauze pad.
If you cannot put the tooth back into the tooth socket, place the tooth in milk. Do not place the tooth in water, carbonated soda, or salt water. Pack the glass in a cooler with some ice and take it and your child to the dentist right away.
If a child develops a toothache, in the first instance, book an appointment with your dentist. If an infection is present this needs to be treated quickly so try to avoid delaying an appointment.
The steps outlined below can also be followed for temporary relief:
- Have your child rinse their mouth thoroughly with warm salt water (add a teaspoon of table salt to a glass of water) and use dental floss to gently remove any food or debris that may be lodged between the painful teeth.
- Do not use a sharp or pointed instrument in trying to remove any debris as this may damage teeth or injure your child.
- Paracetamol may be given for pain until the child can be seen by the dentist. Paracetamol should be swallowed rather than placed on the aching tooth or gum.
- If there is swelling present, place a cold compress on the outside of your child’s cheek to minimise the swelling.
Broken Braces or Retainers
If you have braces and a broken wire causing pain or irritation, cover the loose end with wax, a small cotton ball, piece of gauze or chewing gum and get to the orthodontist as soon as possible.
If your child’s orthodontic retainer becomes broken or bent and does not fit properly, do not wear it again until it has been repaired or adjusted by your orthodontist.
Knocked Out Tooth
If a tooth is knocked out, remain calm and act quickly. The following steps should be taken:
- Carefully find the tooth, handle it by the crown only (not the root) and ensure it is clean. The crown is the smooth white part of the tooth that is normally visible in the mouth.
- If the root is dirty, and your child is calm and conscious, see if they can gently suck the tooth clean. Alternatively, rinse the tooth in milk or very briefly, in water.
- Immediately replant the tooth in the socket making sure the tooth is facing the right way around. Time is critical and immediate replacement is best, and ideally should not be delayed more than 30 minutes.
- Hold the tooth in place. Aluminium foil may be used to help stabilise the tooth, or the patient can bite gently on gauze or a soft cloth.
- If you are unable to replant the tooth, keep it moist by putting it in a cup of milk, sealing it in plastic wrap or placing it in the patient’s mouth next to the cheek, if the patient is able to do so.
Seek Immediate Dental Treatment – Time is Critical. Points to remember:
- Do not hold the tooth by the root surface
- Do not scrape or rub the root surface
- Do not let the tooth dry out
- Do not put the tooth in ice
- Avoid rinsing or storing the tooth in water for more than one or two seconds
- Do not remove any tissue or gum fragments from the tooth
To help prevent against a broken or knocked out tooth always ensure your child is fitted with a custom made mouthguard when participating or training in contact sports.
Cut or Bitten Tongue, Lip or Cheek
For any injuries that result in bleeding, apply pressure directly to the injured area with a clean cloth or gauze pack. This will help to control the bleeding. However, if bleeding does not stop within about 15 minutes, take your child to the emergency room or your dental surgery. If the injury is severe it may require stitches. To minimise swelling, you can apply ice or cold compresses to your child’s face at the site of the injury.
With any dental injury, always seek professional advice from a dentist, or if a dentist is not available, seek advice from a healthcare professional.