Symptoms
DEFINITION
Types of Tooth Injuries
- Loosened tooth - may bleed a little from the gums. Usually tightens up on its own.
- Displaced tooth (usually pushed inward)
- Chipped or fractured tooth
- Avulsed (knocked out) tooth - a dental emergency for permanent teeth
First Aid Advice For Knocked-Out Permanent Tooth
- To save the tooth, it must be reimplanted as soon as possible (2 hours is the outer limit for survival). Right away is best. If more than 30 minutes away from dental or medical care, replace the tooth in the socket before coming in. Use the following technique:
- Rinse off the tooth with saliva or water (do not scrub it).
- Replace it in the socket facing the correct way.
- Press down on the tooth with your thumb until the crown is level with the adjacent tooth.
- Have your child bite down on a wad of cloth to stabilize the tooth until you can reach your dentist.
- Note: Baby teeth can't be re-implanted.
Transporting a Knocked-Out Permanent Tooth
- If unable to put the tooth back in its socket, follow these instructions:
- It is very important to keep the tooth moist. Do not let it dry out.
- Transport the tooth in milk or saliva (Milk is best per American Dental Association 2003)
- MILK TRANSPORT OPTION 1 (best): Place tooth in a small plastic bag with some milk. Put the plastic bag in a cup of ice.
- MILK TRANSPORT OPTION 2: Place tooth in a cup of cold milk.
- SALIVA TRANSPORT OPTION 1: Put the tooth inside the child's mouth. (Be careful not to swallow it) (EXCEPTION: Age less than 12 years old)
- SALIVA TRANSPORT OPTION 2: Put the tooth in a cup and keep tooth moist with child's saliva (spit).
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Should I Call?
WHEN TO CALL YOUR DOCTOR
Call Your Dentist or Doctor Now (night or day) If
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- You think your child has a serious injury
- Permanent tooth knocked out (Reason: needs reimplantation ASAP; 2 hours is the deadline for tooth survival) --See FIRST AID
- Permanent tooth is almost falling out
- Baby tooth is almost falling out
- Bleeding won't stop after 10 minutes of direct pressure
- Tooth is greatly pushed out of its normal position
- Tooth that's pushed out of its normal position interferes with normal bite
- Severe pain
- Age under 1 year old
- You think your child needs to be seen urgently
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Call Your Dentist Within 24 Hours (between 9 am and 4 pm) If
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- You think your child needs to be seen, but not urgently
- Baby tooth knocked out by injury (Reason: can't be reimplanted but dentist will check for damage to permanent tooth)
- Tooth is slightly pushed out of its normal position
- Can see a chip or fracture line (crack) in the tooth
- Tooth feels very loose when you try to move it
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Call Your Dentist During Weekday Office Hours If
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- Tooth sensitive to cold fluids
- Tooth becomes a darker color
- You have other questions or concerns
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Parent Care at Home If
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- Minor tooth injury and you don't think your child needs to be seen
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Care at Home
HOME CARE ADVICE FOR MINOR DENTAL INJURIES
- Local Cold: For pain, apply a piece of ice or a popsicle to the injured gum area for 20 minutes.
- Pain Medicine: If it still hurts, give acetaminophen (e.g., Tylenol) or ibuprofen.
- Soft Diet: For any loose teeth, offer a soft diet for 3 days. By then, it should be tightened up.
- Call Your Dentist If:
- Pain becomes severe
- Tooth becomes sensitive to hot or cold fluids
- Tooth becomes a darker color
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
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Photo Example
First Aid - Tooth - Transport in Milk
It is very important to keep the knocked out (avulsed) tooth moist. Do not let it dry out. Transport the tooth in milk or saliva. These images show how to transport the tooth in milk.
- Milk Transport - Method 1 (best): Place tooth in a small plastic bag with some milk. Put plastic bag in a cup of ice.
- Milk Transport - Method 2: Place tooth in a cup of cool milk.
First Aid - Tooth - Knocked Out
To save the tooth, it must be put back in the socket (reimplanted) as soon as possible. Two hours is the outer limit for survival. Right away is best.
Here are the steps for putting the tooth back in the socket:
- Step 1: Rinse off the tooth with saliva or water. Do not scrub the tooth.
- Step 2: Replace it in the socket facing the correct way. Press down on the tooth with your thumb until the crown is level with the adjacent tooth.
- Step 3: Lastly, bite down on a wad of cloth to stabilize the tooth until the injured person can be seen by a dentist. If your dentist is not immediately available, then go to the emergency department.
If the tooth cannot be put back in its socket: Place the tooth in either milk or saliva to keep it from drying out, and go right away to the dentist. Again, If your dentist is not immediately available, then go to the emergency department.
Special Note: Even if you get the tooth back in the socket right away, only time will tell whether the tooth will live. It may not.
First Aid - Tooth - Transport in Saliva
It is very important to keep the tooth moist. Do not let it dry out. Transport the tooth in milk or saliva. These images show how to transport the tooth in saliva.
- Saliva Transport Method 1: Put the tooth in the mouth inside the cheek. (Only fully alert adults should use this method.)
- Saliva Transport Method 2: Put the tooth in a cup and keep tooth moist with saliva (spit).
Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.
Last Review Date: 6/1/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Version Year: 2012
Copyright 1994-2012 Barton D. Schmitt, M.D.
