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Home › Articles › Health Issues › Children's Dental Emergencies

Children's Dental Emergencies

A Parent's Guide to Chips, Fractures and Tooth Avulsions

By Shannon McKelden

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Loose Teeth
When Nancy Klein's 13-year-old daughter went up for a header in a soccer game she made contact with more than the ball. "The other girl's cheek hit Emily square in the mouth and knocked her right front tooth back at about a 45-degree angle," says Klein from Charlottesville, Va.

They reacted appropriately by packing the tooth with ice and going to see their dentist. The tooth was pulled gently back into place and braced to the other front tooth. Klein says Emily suffered no permanent damage to the tooth and now it is as good as new.

"Primary teeth are much more likely to be loosened or displaced than 'fractured' because younger children tend to have supporting bone structures that are less dense and spongier," Dr. Vann says.

Even if a tooth is only loosened, a dental examination is still important to assure there is no permanent damage to tooth or root, which may not always be visible to the naked eye. As with all dental trauma, X-rays are likely to be needed to assess the injury.

Avulsion
The recommendation for a knocked-out tooth has been to put it into milk and head for the dentist. That still stands, though both Drs. Landgren andVann agree that the child's saliva (even bloody) works if milk is not available. The International Association of Dental Traumatology even suggests that the tooth can be tucked between cheek and gum for transport, though obviously only in an older child not in danger of choking on the tooth.

The best thing to be done for an avulsed permanent tooth, though, is to put it back into the socket. The tooth should first be rinsed with water, but not scrubbed. The root of the tooth should not be touched. Gently replace the tooth in the socket if able and hold it with sterile gauze or a clean washcloth.

Most important, seek dental help immediately. "The prognosis for avulsed teeth quickly decreases the longer the tooth is out of the socket," Dr. Landgren says.

Primary vs. Permanent
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