Teeth are important for facial structure, eating, smiling and can be a big part of a kid’s confidence. But in the United States, 32% of facial and dental injuries are sports related. Whether it’s a chip, knock out (avulsion) or fracture, tooth injuries often happen in contact sports such as hockey, or sports with facial impact that don’t require protection such as basketball or baseball.  Once children lose their primary or “baby” teeth around the age of 7, they only get one set of permanent teeth. If lost, not only does that cause immense pain but can cost thousands of dollars to fix. Our experts explain what to do if a tooth comes out, how to prevent tooth injuries and other things to consider during an accident. 

What do I do when the tooth comes out?

It’s the last game of the baseball season, and your child takes a baseline hit to the mouth. You notice his front tooth is missing. What can you do? 

1. Keep the athlete calm. The pain and shock of the accident, or even seeing the tooth, can cause your child to panic. Try providing pressure and ice to the injury as soon as possible to control bleeding. It’s normal for a clot to form in the socket where the tooth once was and should be left alone.
2. Never re-implant a primary tooth. If your child loses their “baby” tooth, it’s important to keep it out as it can disrupt the permanent tooth behind it.
3. Always pick a tooth up by the crown (chewing side), never the root. Picking up the tooth by the root can damage the nerve.
4. If the tooth is dirty, rinse with water, milk, saliva or saline while avoiding touching the root. To prevent infection, you should never re-implant a tooth into its socket if it’s dirty.
5. Re-implantation of the tooth by a dentist.  Once clean, re-implantation involves putting the tooth back in the socket, if possible. Dentists suggest an optimal time of 30 seconds to 5 minutes to prevent cell death.  Once the tooth is implanted, get to the dentist immediately for further evaluation. 
6. Get to the dentist as soon as possible. 

What do I do if I can’t re-implant the tooth?

There may be a clot already formed in the socket of where the tooth once was, or maybe a fracture preventing insertion of the tooth. In that case: 

• Keep the tooth somewhere moist. The longer a tooth is out of the mouth, the less likely it can be implanted successfully. You can store the tooth in their cheek, milk, saline or a tooth preservation kit if your team has one on hand. If nothing else, water can work in a pinch but isn’t suggested. 

• Control bleeding as best as possible with pressure. 

• Go to the dentist as soon as possible for re-implantation and further evaluation. 

How do I prevent this from happening?

Sometimes accidents happen, and this type of injury is hard to avoid in any sport. But the most important factor in limiting the incidence of this is proper facial protection and use of an approved mouth guard. Even if your child’s sport doesn’t require facial protection, it’s highly advised to always use mouth guards that fit properly. That means the guard fits snug against your child’s top teeth without having to hold it in with their tongue, and it should fit naturally onto your lower teeth. In addition to providing proper protection,  frequent dental screenings can help identify risks for avulsions such as poor dental habits, gum disease, orthodontics or loose teeth. 

Additional things to consider

While the main concern during a dental injury is ensuring the tooth is re-implanted quickly, it’s important to consider other injuries or problems that can occur: 

• Athletes may have a concussion as part of the hit. Your child should be evaluated for signs of a concussion and monitored for further symptoms. 

• Do not place the tooth in an unconscious athlete for fear of aspiration or choking. 

• Have an emergency action plan for your family, including a dentist that can take emergency appointments.