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How to Handle Tooth Trauma

Accidents happen, but quick actions can save smiles

As summer comes to a close and children are getting ready to head back to school, it is important for parents, guardians, and caretakers to remember that dental emergencies can happen any time and in any place. According to the 2013 Delta Dental Children's Oral Health Survey,1 one out of ten children ages 10 or 11 has had a tooth emergency such as a knocked-out tooth, chipped tooth, or a loosened permanent tooth at home or at school.

“Dental emergencies can range from biting the lip or tongue to more severe cases such as a completely knocked-out permanent tooth,” says Dr. Shannon Mills, DDS, vice president for professional relations and science at Northeast Delta Dental. “It is important that caretakers and family members know how to react quickly to a dental emergency, especially in the case of a permanent tooth that has been knocked out.”

The primary concern should be getting the child in to see a dentist. Time is crucial if you want the dentist to be able to reinsert and salvage the natural tooth. Ideally, a child needs to be seen within 30 minutes of the accident.1

Whether a tooth is knocked out at school, home, or while participating in a sport, here are several steps to ensure it is saved – or at least in optimal condition – by the time the child can see the dentist.

  • First, check to make sure the child does not have a serious head, neck or other orofacial injury (i.e., a concussion, broken jaw, etc.). If there is a head, jaw, or neck injury, take the child to the emergency room immediately.
  • Do not replace a displaced baby tooth! Trying to reinsert it could damage the permanent tooth coming in behind it.
  • To avoid infection, the tooth should be held by the crown, not the root. The crown is the part of the tooth that is visible while it is in the mouth. You want to leave the root intact, and touching it with your hands could pass bacteria.2
  • Rinse any debris off the tooth under room temperature water. Do not scrub the root! Once the tooth is free of loose dirt and debris, try to reinsert it, asking the child to hold it in place using a piece of gauze if necessary.3
  • If the tooth cannot be successfully reinserted, it needs to stay moist until the child can visit a dentist. Store the tooth in a clean container and cover it with milk or room temperature water to prevent it from drying out.4 These liquids are not ideal but are often the only ones readily available.
  • If you are a school nurse or your child frequently plays contact sports, purchase an emergency bag that includes a “save-a-tooth” kit (available at most drugstores.) These contain a solution that is better at preserving any live cells on the tooth root until the dentist can put the tooth back into the socket.

“Tooth injuries are not life threatening in most cases; however, sometimes they can have long-lasting effects on the child's appearance and self-confidence, so it is important to act quickly in the event of a dental emergency,” says Dr. Mills.

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1 Morpace Inc. conducted the 2013 Delta Dental Children's Oral Health Survey. Interviews were conducted nationally via the Internet with 926 primary caregivers of children from birth to age 11. For results based on the total sample of national adults, the margin error is ±3.2 percentage points at a 95 percent confidence level.
2 “Saving a Knocked-Out Tooth.” American Association of Endodontists.
http://www.aae.org/patients/patientinfo/references/avulsed.htm. Accessed 2010.
3 “Medical Encyclopedia: Broken or Knocked Out Tooth.” U.S. National Library of Medicine and the National Institutes of Health, February 22, 2010. www.nlm.nih.gov/medlineplus/ency/article/000058.htm. Accessed 2010.
4 “Dental Emergencies.” American Dental Association. http://www.ada.org/370.aspx. Accessed 2010
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