What to Do If Your Child Has a Dental Trauma

A lot of children, especially young ones, will fall and bump their teeth without any obvious break in the tooth. Sometimes the teeth are broken, pushed backwards, inwards into the gums, outwards down into the mouth, or they don’t move at all. This can happen with or without bleeding of the surrounding gum tissue as well. Depending on the severity of the impact, sometimes, quick treatment is indicated and sometimes we simply monitor the teeth. In all cases, we need to contact the emergency dentist, in order to examine the child, evaluating the underlying roots of the teeth and surrounding bone because even if the tooth doesn’t appear broken, there could be damage underneath the gums.

Types of Dental Trauma 

All types of dental trauma can happen to both milk teeth and permanent teeth.  The consequences of dental trauma to milk teeth are usually less severe than those for permanent teeth, because eventually, milk teeth will fall out and replaced with permanent ones..

The serious consequence of trauma to a milk tooth occurs when the trauma affects the underlying permanent tooth as its crown is just developing below the milk tooth.  If an injury occurs which forces the milk tooth ( called baby tooth as well) into the developing permanent tooth during this formation stage, the permanent tooth can be deformed.

The majority of injuries to teeth occur on the front of the face and affect front teeth.  It is possible for a back tooth to be injured if a child is hit from the side, as well.

a)Dental Trauma that changes position of the tooth

When force from an injury moves a tooth, it needs to be addressed quickly.

It could be pushed up inside the gums, coming out of the gums, or protruding at an unusual angle.  It is very common to have bleeding in the gums around a tooth that has been moved.


Milk Teeth & Permanent Teeth

In general, the treatment for this type of injury is the same for baby teeth and permanent teeth.  In severe cases, the baby tooth may be extracted.

2-What to Do

1-Call your dentist immediately.

2-Attempt to move the tooth back to its normal position using light finger pressure only (gently).

3-Whether you are able to reposition it or not, go to the dentist, so, he/she evaluate the case.

3-Home Care management & Follow-up

Your child will need a soft diet for a period of a few days up to two weeks.  The goal is no additional pressure on the injured tooth as it is healing.  You may need to give your child over-the-counter pain reliever, ask your dentist.

Follow-up with your dentist in 3 months, to evaluate the healing and the health of the tooth and its surrounding structures.

4-What Are The Possible Long-Term Consequences

When a tooth moves, it is possible that the nerve of the tooth has been damaged.  In many cases, the nerve supply can recover, and the tooth heals.  In other cases, the nerve inside the tooth dies. A dead nerve must be removed, and the tooth needs a root canal.

The injury to the surrounding structures may also damage the connection between the tooth and the jaw bone, which occur via periodontal ligaments.  A condition called ankylosis often develops because of this trauma, in which the tooth becomes fused to the bone and is unable to move.  This is a major concern in orthodontic treatment, when you desire to move that tooth.

b)Chipping or Breaking a Tooth

If a tooth is chipped, particularly if it’s a permanent tooth, try to find the broken fragment and place it in plastic bag until you’re able to come to the office. There is no need to store the fragment in milk, but sometimes the fragment can be reattached to the tooth again, if this looks possible with the dentist. If the chip was severe, causing expose of the nerve of the tooth, then, treatment should be addressed as soon as possible.

Babies chip their front teeth frequently as they’re learning to walk and chewing on everything. Small chips are usually nothing to worry about, especially if your child is completely asymptomatic, but it’s good idea to call the dentist to have a look at your child.

In general, an injury to a tooth that causes a portion of the tooth to chip or break off, has a milder consequences than a tooth that is moved or knocked out.


Baby Teeth vs. Permanent Teeth

In general, the treatment of this dental trauma is the same for baby teeth and permanent teeth.  Minor cases will be restored with filling material. In severe cases, a permanent tooth will need a root canal, and the baby tooth may be extracted.

2-What to Do

-Call your dentist immediately.

-Try to locate any fragments of the tooth, and bring them with you.

-Whether you are able to find it or not, go to evaluate the depth of the chip and determine whether or not the nerve is affected.

3-Home Care management & Follow-up

If you have the tooth fragment, your dentist can reattach it to the tooth.  If not, he can rebuild the tooth back to its normal shape and size.

Your child will need a soft diet for a period of a few days.  You may need to give your child over-the-counter pain reliever, ask your dentist.

Follow-up with your dentist in 3 months.

4-What Are The Possible Long-Term Consequences

-The force to the tooth, which chipped it, could also have an impact on the nerve supply of the tooth, as noted above.  Your dentist will monitor the tooth closely for any signs of a death of the nerve.  If a root canal become necessary, your dentist will guide you in the steps involved in treatment.  It is important to know that the nerve inside a tooth could die at any point in the future, even decades later.

-The tooth could also become ankylosed.

Tooth is Knocked Out

If your child completely loses a permanent tooth, this is very critical to see a dentist ASAP. The sooner your child is seen, the better the chances of a full recovery for that tooth.

Find the tooth and pick it up by the crown (the part that is usually visible in the mouth), this step is very important as not to touch the root if you can avoid it. Rinse off the tooth with water, but resist to scrape or scrub it clean.

For an older child, place the tooth back into the socket the right way and have your child bite on gauze or some tissues to hold it in place until getting to the dentist. If you can’t get the tooth in properly, have your child hold the tooth in their cheek so the saliva will keep the root clean and moist.

If your child is too young to handle keeping the tooth in their cheek without swallowing it, it’s important to still keep the tooth moist and milk is recommended.

If the tooth that is lost is a baby tooth, do not try to place the tooth back into the socket. This can damage the permanent tooth underneath and reimplantation of baby teeth does not have high success rates.

It is still important to call your dentist right away to rule out any other injuries.

A tooth that is completely knocked out needs immediate action!  The longer you wait, the less chance the tooth has of surviving.


Baby Teeth vs. Permanent Teeth

There is no treatment for knocked out baby teeth.  The child will have a space in that tooth’s site until the permanent tooth comes in.

For a permanent tooth, reattachment of tooth can be successful if action has been taken quickly..

2-What to Do

-Call your dentist immediately.

-Hold the tooth by the crown ONLY.  Do not touch the root.  If you can, put the tooth back into the socket after very gently rinsing off any dirt or debris.  If you are unable to put the tooth back into the child’s mouth, place it in a cup with milk or saliva.  That’s right: fill up a cup with enough spit to cover the tooth.  Saliva is the best thing to keep the cells and fibers on the knocked-out tooth alive until it can be reimplanted into the mouth.

Whether you are able to reinsert it or not, go immediately to the dentist. The sooner the tooth is reimplanted, the better the chances of its full healing.

3-Home Care management & Follow-up

Follow the recommendations noted above.  The dentist will follow-up with you more frequently to confirm healing and reattachment of the tooth.

4-What Are The Possible Long-Term Consequences:

The consequences noted above, a dead nerve and ankylosis, are both highly likely when a tooth is completely knocked out.  Another possible consequence is failure of the tooth to reattach.  In this case, it is necessary to extract the tooth and replace it with a dental implant.

Adhering to your dentist’s prescribed follow-up schedule will keep you informed of any of these consequences as they occur.


As you can see from the instructions listed above, getting in to see your dentist as soon as possible is very important! As soon as an injury happens.  Dr. Miski will treat your child’s emergency and give you all the information you need for the right follow-up care.