Your child has broken or knocked out one of his permanent teeth… now what?

July 20, 2015

By the time a child is 16, it is highly likely that they have had some type of injury to their front teeth. It is the upper front teeth that are most vulnerable, as they typically take the full impact of an accidental fall or active sports injury. Fortunately, most do not result in the complete loss of the tooth. Nevertheless, it is important for parents, teachers and coaches to know what procedures are important to follow should a child’s tooth be fractured, chipped, broken or knocked out.

Confirm that the tooth is a permanent one. First (or baby) teeth should typically not be replanted, however if it is a second (adult) tooth, saving it is of primary importance. To permit the best possible chance of a successful healing, follow these steps:

1. Stay calm and work to keep the child calm. Check carefully to see if there are any other injuries. If so, and the injuries could be serious, do not hesitate to call a paramedic.

2. If the tooth is knocked out, locate, and holding it firmly by the crown, rinse gently in milk. A less desirable alternative is a saline water solution. Do not touch or scrub the root part of the tooth.

3. If possible, put the tooth straight back into place in the mouth. Try to do this as soon as possible – ideally within the first five minutes. Use a gauze or cloth to help the child hold the tooth in place. If repositioning the tooth proves too difficult, place it in a glass of milk, or a small dish of the child’s own saliva. For an older child, an alternative would be to have them transport it between their molar teeth and cheek, as long as they understand the importance of not swallowing the tooth.

4. Arrange to see your dentist or get to the hospital as soon as possible, even if you cannot locate the broken piece, or missing tooth. Fractured, broken or chipped teeth are also considered dental emergencies. Follow the same procedures for any part of the tooth that may have separated.

5. On arrival, and after a medical history, the dentist will do a complete assessment. As mentioned earlier, the best chance to save the tooth comes with repositioning as soon as possible. Prognosis and treatment options will be discussed. An antibiotic and/or tetanus shot may be prescribed.

6. Regardless of treatment considerations followed, gentle tooth brushing remains critical to healing. Add a saline rinse or a mouthwash as recommended by the dentist to minimize chance of infection.

7. Your dentist will typically need to see the child for recovery progress in a week to ten days.

Prevention is always best, and while you cannot protect children from every mishap, injuries to the mouth caused by contact sports can be greatly reduced and minimized by the use of a mouth guard. Santé & Highbury Dental’s clinical staff are trained to produce custom-fitted mouth guards, which are proven to be safer and more comfortable that off-the-shelf models.