How to Handle a Dental Emergency

We all know the importance of preventive dental care in children to prevent dental decay - this includes brushing twice a day with a soft-bristled toothbrush, flossing once a day, and seeing the dentist for regular dental check-ups, but did you know that’s not enough to prevent a dental emergency? 

Dental emergencies happen quickly and unexpectedly. It can be as simple as falling off a scooter, tripping up the stairs, or taking an elbow to the face while playing a contact sport. When these things happen, you will need to act quickly and calmly.

Will you be prepared if or when one occurs in your child? This article aims to give you an overview of common dental emergencies and their treatments. I’ll discuss with you management of cracked or broken teeth, avulsed (fallen out) teeth, and intruded or displaced teeth (teeth which have moved up into the gums or out of position due to trauma).

Prevention is Key

Wearing a mouth guard while playing contact sports can prevent many dental traumas. In fact, about 22,000 kids aged 18 and younger experience sports-related dental traumas each year. For this reason, the American Academy of Pediatric Dentistry (AAPD) encourages the use of custom fabricated dental mouthguards while playing any contact or collision sports. Purchasing an over-the-counter sports guard may provide some protection but will not protect the teeth as well as one made by your child’s dentist.

For more information on sports mouth guards, speak to your child’s dentist.

Cracked or Broken Teeth

If a tooth is cracked or broken, the American Academy of Pediatrics and American Dental Association (ADA) recommends rinsing the mouth with warm water and applying a cool compress to keep any swelling down. You should contact your child’s dentist or go to the nearest emergency room for evaluation.

The severity of the crack or break is the determining factor for which treatment is indicated. If the fracture extends into the nerve, treatment will be more extensive than for a fracture which  is just enamel based. Evaluation by the dentist is a must to make this determination.

Avulsed Teeth

Tooth avulsion is when a tooth is knocked out of the tooth socket completely; treatment will depend on whether the tooth is permanent or primary.

If a primary or baby tooth is knocked out, do not reimplant it – this could affect the development of the permanent tooth underneath the gums. You can, however, take the tooth with you to the dentist when you present for evaluation of the injury.

When a permanent tooth is knocked out,  reimplantation of the tooth should occur as soon as possible for the best long-term outcome of the tooth. According to the AAPD, a permanent tooth that’s been reimplanted within 20 minutes of injury stands the best chance for success. If you’re not able to safely reimplant the tooth at the site of injury, place the tooth in a storage medium like dairy milk or an ADA approved tooth preservation product and get to the dentist or emergency department right away for reimplantation there.

A word of note when handling the tooth, only pick it up by the crown – handling it by the root could contaminate it and should be avoided. Prompt evaluation by a dentist is necessary whether you reimplant the tooth yourself or have a professional do it.

Intruded or Displaced Teeth

An intruded or displaced tooth is one that has been pushed up inside the gums or moved out of position by a dental injury. For a full assessment of the damage, a dental x-ray is generally indicated to see if surrounding teeth have been affected by the trauma.

Again, treatment will be determined by whether the tooth is permanent or primary. If the affected tooth is a primary tooth, your child’s dentist may recommend extraction. For a permanent tooth, the treatment options will be discussed at length to determine the best outcome for your child.

Keep Your Cool and Keep in Mind

Keeping your cool during a dental emergency is not always easy, but the calmer you can stay for your child, the better. You will also want to assess your child’s overall health and check for other head injuries if a fall or hit to the face occurred.

If you do not have an established dental home for your child, now is a good time to find your child a dentist. This way you know who to contact in the event of an emergency and have someone to discuss sports guards options with if your child plays organized sports.

Being prepared for a dental emergency is your best defense.

About the Author

Katie Steger, BSDH — Katie is a dental hygienist and mom and the founder of @healthyteeth.fortots, an Instagram  platform designed to provide early childhood oral health education and support to parents with dental anxiety. Katie is passionate about oral health education, the impact of nutrition on the developing dentition, and educating parents and families on strategies to make oral hygiene more accessible. Resources can be found on her website: www.KatieRDH.com