Injuries to the teeth in children can occur from falls or during play or sports activities. The injury may be to a primary (baby) tooth or a permanent tooth. A tooth can be cracked, chipped, or totally detached from its socket. Your child may experience bleeding from the area, pain, or increased sensitivity when a tooth is injured.

Treatment for an injured tooth

Specific treatment for an injured or knocked-out tooth will be determined by your child's dentist or doctor. In general, use the following guidelines to help immediately manage the situation:

• Remain calm and reassure your child that you can help.

• If the area is bleeding, place a small piece of folded gauze at the site and have your child bite down or hold it in place with firm pressure.

• Offer your child cool water or an ice pop to suck on to help reduce swelling and pain.

• If a tooth is chipped or cracked, collect all the pieces of the tooth. Make sure a piece of tooth is not imbedded in the lips, tongue, or gums.

• Contact your child's dentist for further follow-up and care. Sharp or ragged tooth edges may need to be smoothed, and further treatment may be needed to preserve the tooth. A loose tooth may need to be stabilized. A badly injured tooth or loose tooth that cannot be realigned may need to be removed.

Treatment for a tooth that has been knocked out

• Remain calm and reassure your child that you can help.

• If the area is bleeding, place a small piece of folded gauze at the site and have your child bite down or hold it in place.

• Offer your child cool water or an ice pop to suck on to help reduce swelling and pain.

• Hold the tooth by the crown (top of the tooth), not by the root (bottom of the tooth). Plug up the sink to prevent loosing the tooth down the drain and gently rinse the tooth with milk (do not scrub the tooth or use tap water as it contains chlorine and may injure the tooth). Milk is similar to the chemical makeup of teeth.

• Place the tooth back in your child's mouth in its socket if he or she will cooperate. Push down until the knocked out tooth is level with the tooth on either side. Have your child bite down on a gauze pad placed over the tooth to keep it in place. This needs to be done quickly after the tooth has been knocked out.

• If you cannot replace the tooth in your child's mouth, place it in milk or inside your own mouth, between your cheek and teeth to be bathed in saliva. Be careful not to swallow the tooth. You can also have your child spit saliva into a cup and transport in your child's saliva if you are worried about him or her swallowing the tooth. 

• Contact your child's dentist immediately for further follow-up and care.

• If other injury to the mouth or teeth is suspected, X-rays of the area may be needed.

• Acetaminophen or ibuprofen may be given for discomfort, as needed, or as advised by your child's doctor.

When should I call my child's dentist?

Call your child's dentist for:

• Any tooth injury that results in a loose or knocked-out tooth, a tooth that has sharp or ragged edges, or if a tooth is in pieces.

• Any signs of infection following a tooth injury such as fever, or increased pain, swelling, or drainage from the site.

• Any concerns you have about the injury or if you have any questions.

Preventing tooth injuries

The following are a few guidelines to help prevent tooth injuries in children:

• Teach your child not to walk or run while holding an object in his or her mouth.

• Teach your child not to suck or chew on hard, sharp, or pointed objects.

• Have your child wear a mouthguard for sports activities that could cause injury.