Published: Jan. 26, 2010
Updated: June 2, 2010
By Matthew Tarnowski
Kids being kids, accidents are unavoidable. Sometimes those accidents involve a blow to a child’s mouth. Teeth can be broken, loosened, or knocked out completely.
If this happens, it’s important to know what steps to take to give the best possible chance of saving a damaged tooth.
According to Martha Ann Keels, DDS, PhD, division chief of Pediatric Dentistry at Duke, injuries to children’s teeth are both common and preventable.
“The good news is most dental injuries can be avoided. But if an accident does occur, don't worry –- most times even a tooth that’s been knocked out completely can be saved if proper care is taken in the first 20 minutes,” Keels said.
Dental trauma can occur any time. The most common types of injuries are the results of toddlers falling down and children and teens injured while playing sports.
According to Dr. Keels, the peak period for trauma to primary, or baby teeth, is between 18 to 36 months –- a time when children are curious, yet uncoordinated.
With permanent teeth, sports accidents are the most common cause of dental trauma, especially in teenagers. Swinging arms and elbows and butting heads are common causes of injuries in football, baseball, and basketball.
Keels said that parents of cheerleaders should also take caution, as dental injuries in that sport are skyrocketing.
“No matter what type of injury occurs, the first 20-30 minutes are crucial in determining if a tooth can be repaired or saved,” Keels said. Steps to take depend on the type of tooth that has been injured and what kind of injury occurred.
If the tooth has been knocked backwards or out of position but is still in the socket, simply wash your hands, then pinch the crown of the tooth and snap it back into place. The teeth on either side will guide it into position.
Use a cold compress (a cold, wet towel or washcloth pressed firmly against the area) to reduce swelling, then go to the dentist -- the same day if possible. The dentist will then fine-tune the placement of the tooth.
If possible locate the fragment of the broken tooth, wash it gently with water, then go to the dentist as soon as possible.
If the tooth has been shattered or more than half of the tooth is broken, find the tooth fragments and go to the dentist immediately. The dentist can re-bond your tooth fragment with special tooth glue. If the fracture is over half the tooth, then the nerve of tooth may be exposed and need immediate treatment to protect the nerve.
If a baby tooth has been knocked out, don’t worry about replacing it. Clean the child’s mouth gently with water and use a cold compress to reduce swelling. Then make an appointment with your child's dentist to determine how serious the injury is.
If it’s a permanent tooth, it’s critical that you put it right back into the socket within 20 minutes to avoid serious nerve damage. Even if you’re a bit squeamish, you must get the tooth back into the socket.
“Just think to yourself: You can get it done. You’re saving a smile, “ said Dr. Keels.
If for some reason you can't get the tooth back in, place it in milk or saline. These liquids help protect the delicate cells around the root much better than water. The important thing is to keep the tooth moist but avoid washing or rubbing it, and avoid touching the root.
Most dentists have an emergency number to call in case of such and emergency. It’s important to have a dental home -- a dentist dedicated to your child's oral health -- and maintain regular visits. You don’t want your child’s first visit to the dentist to be for a potentially frightening situation such as this.
Dental injuries can be the cause of lifelong expense, yet most can be prevented.
If you have a toddler, childproof your home by placing gates across stairs and padding sharp edges of tables.
A mouth guard is mandatory for teens who are active in sports or other activities like skateboarding. While a store bought guard is a good start, a custom-fitted mouth guard provides much more protection.
Parents are often concerned about the appearance of their child after he or she suffers a dental injury. However, if you provide first aid after an accident and visit your dentist regularly as your child grows up, beginning at your child's first birthday as recommended by the American Academy of Pediatric Dentistry (AAPD), you can correct almost any problems arising from dental trauma, Keels said.
For more tips, visit the AAPD's Parent Resource Center at www.aapd.org/parents.