Children's Hospital Colorado

Tooth Injury

Urgent or Emergency Care?

If you believe your child needs immediate attention and you have concerns for a life-threatening emergency, call 911. Not sure what counts as urgent and what's an emergency when your child is sick or injured? When it can't wait, know where to take your kids.

Help Me Decide

  • Injury to a tooth

Types of Tooth Injuries

  • Loosened Tooth. May bleed a little from the gums. Usually tightens up on its own.
  • Displaced Tooth. Usually pushed inward. Needs to be seen.
  • Chipped Tooth. Minor fracture with small corner of tooth missing tooth. The fracture goes to the dentin (yellow color), not the pulp (red color). Not painful. See dentist during office hours.
  • Fractured Tooth. The fracture goes down to the pulp. The pulp is where the blood supply and nerves to the tooth are located. The main finding is a red dot or bleeding in the center of the tooth. Very painful. Needs a root canal to save the tooth.
  • Knocked-Out Permanent Tooth. Also called an avulsed tooth. A dental emergency. Needs to be re-implanted within 2 hours.
  • Knocked-Out Baby Tooth. It cannot be re-implanted. See during dental office hours.

Symptoms

  • The main symptom is pain.
  • Minor bleeding from the gums may occur.

Go to ER Now

  • Bleeding that won't stop after 10 minutes of direct pressure

Call Dentist or Doctor Now

  • Permanent (adult) tooth knocked out. Reason: needs to be put back within 2 hours to survive.
  • Permanent (adult) tooth is almost falling out
  • Baby tooth is almost falling out
  • Tooth is pushed far out of its normal place
  • Tooth that's pushed out of its normal place makes it hard to chew
  • Severe pain and not better 2 hours after taking pain medicine
  • Age less than 1 year old
  • You think your child has a serious injury
  • You think your child needs to be seen, and the problem is urgent

Call Dentist Within 24 Hours

  • You think your child needs to be seen, but the problem is not urgent
  • Baby tooth knocked out by injury. Reason: can't be put back. But, dentist needs to check for damage to permanent tooth inside the gum.
  • Tooth is slightly pushed out of its normal place
  • Chip or crack in the tooth
  • Tooth feels very loose when you try to move it

Call Dentist During Office Hours

  • Cold fluids cause tooth pain
  • Tooth turns a darker color
  • Crown or cap comes off. Note: save the crown for the dentist.
  • You have other questions or concerns

Self Care at Home

  • Minor tooth injury

Care Advice for Minor Dental Injuries

  1. Cold for Pain:
    • For pain, put a piece of ice or a popsicle on the injured gum.
    • You can also use a cold pack on the cheek.
    • Apply for 20 minutes.
  2. Pain Medicine:
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  3. Soft Diet:
    • For any loose teeth, offer a soft diet.
    • Avoid foods that need much chewing.
    • You can go back to a normal diet after 3 days. By then, the tooth should be tightened up.
  4. What to Expect:
    • Tooth pain most often goes away in 2 or 3 days.
  5. Call Your Dentist If:
    • Pain becomes severe
    • Cold fluids cause tooth pain
    • Tooth turns a darker color
    • You think your child needs to be seen
    • Your child becomes worse

Care Advice for Minor Dental Injuries

First Aid - Tooth (Child's) Knocked-Out  Transport
  • To save the tooth, it must be put back in its socket as soon as possible. 2 hours is the outer limit for survival. Right away is best. If more than 30 minutes away from dental care, try to replace the tooth. Put it back in the socket before going to the dentist. Use the method below:
  • Rinse off the tooth with saliva or water (do not scrub it).
  • Replace the tooth into the socket, facing the correct way.
  • Press down on the tooth with your thumb. Do this until the crown is level with the tooth next to it.
  • Have your child bite down on a wad of cloth. This will help to keep the tooth in place until you can reach your dentist.
  • Note: Baby teeth can't be re-implanted.

If not able to put the permanent 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.
  • Milk Transport Option 1 (best). Place the tooth in a small plastic bag with some milk. Put the plastic bag in a cup of ice.
  • Milk Transport Option 2. Place the tooth in a cup of cold milk.
  • Saliva Transport Option 1 - for Child 12 Years or Older. Put the tooth inside the child's mouth. Be careful not to swallow it.
  • Saliva Transport Option 2. Put the tooth in a cup. Keep the tooth moist with child's saliva (spit).

Disclaimer

The information contained in these topics is not intended nor implied to 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.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

  • Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
  • Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
    • You can have a conversation with your child's doctor.
    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

If you think that your child is having a medical emergency, call 911 or the number for the local emergency ambulance service NOW!

And when in doubt, call your child's doctor NOW or go to the closest emergency department.

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