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 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 greatly pushed 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
  • 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 - 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 of the tooth. 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 ER.

Special Notes:

  • Even if you get the tooth back in the socket right away, only time will tell whether the tooth will live. It may not.
  • Baby teeth cannot be re-implanted.
First Aid - Tooth - Transport in Milk

It is very important to keep the knocked out 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 - 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).

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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Copyright 2000-2018. Schmitt Pediatric Guidelines LLC.

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