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While dental injuries and urgent dental situations can be a source of worry for both children and parents, it's important to know that they are quite prevalent. Statistics show that approximately one in three children will experience some kind of dental injury, and a larger number will encounter a dental emergency.
Children face two primary periods of heightened risk for dental trauma. The first is during the toddler years (roughly 18-40 months) as they begin to explore their environment. The second is during the pre-adolescent and adolescent years, when sports injuries become a common occurrence.
The following section details some of the most frequent dental emergencies seen in childhood, along with practical advice on how to manage them.
Toothache
A common issue for children of all ages, a toothache usually signals an underlying problem. In young children, trapped food can cause discomfort; try gently removing it with a toothbrush, a clean finger, or floss. If the pain persists, consult the pediatric dentist. Common culprits for toothaches include: cracked teeth, cavities, dental injuries, and wisdom tooth eruption in teens.
How you can help:
- Gently rinse the mouth with lukewarm water. Avoid applying any medications or heat to the affected tooth or gums.
- Inspect for and remove any lodged food particles.
- Apply a cool compress to the outside of the face in the painful area to reduce swelling.
- Seek advice from your pediatric dentist.
Dental avulsion (knocked-out tooth)
If your child’s tooth has been completely knocked out, immediate contact with the pediatric dentist is essential. Generally, reimplanting knocked-out baby teeth isn't recommended as it can harm the developing permanent tooth bud.
However, pediatric dentists will always try to reimplant a knocked-out permanent tooth, provided it hasn't sustained irreparable damage. The success rate is highest if done within one hour of the incident, so speed is crucial!
How you can help:
- Locate the tooth. Handle it by the crown (the part you see), avoiding touching the root.
- Gently rinse off any dirt with water, without scrubbing or scraping.
- For older children, try to reinsert the tooth into its socket gently or have them hold it in their cheek pouch. For younger children, place the tooth in milk or saliva (don't try to reinsert it to prevent swallowing).
- Keeping the tooth moist during transport is vital for successful reimplantation.
- Get to your pediatric dentist (if possible) or the Emergency Room immediately – time is critical for saving the tooth.
Dental intrusion (tooth pushed into jawbone)
Sometimes, a dental injury forces a tooth (or teeth) upwards into the jawbone. A lesser degree of intrusion (under 3mm) generally has a better outlook, but each case is unique. Often, the impact can damage the tooth's supporting ligaments and fracture its socket.
If you suspect dental intrusion in either a primary or permanent tooth, immediate contact with the pediatric dentist is necessary. Depending on the extent of the intrusion, the dentist may wait for the tooth to reposition naturally or perform root canal therapy to preserve its structure.
How you can help:
- Gently rinse your child’s mouth with cool water.
- Apply ice packs to the outside of the face in the affected areas to reduce swelling.
- Offer age-appropriate pain relief like acetaminophen (Tylenol).
- Contact your pediatric dentist if possible, or proceed to the Emergency Room.
Tooth luxation/extrusion/lateral displacement (tooth displacement)
Tooth displacement is categorized as “luxation,” “extrusion,” or “lateral displacement,” depending on the tooth’s orientation after injury. A luxated tooth remains in the socket but is angled abnormally, often with an underlying jawbone fracture. The pulp remains intact about half the time.
“Extrusion” refers to a tooth partially pulled from its socket. Primary tooth extrusions in young children often heal spontaneously. However, any displaced permanent tooth requires dental treatment to save it and prevent infection. Contacting the pediatric dentist is crucial if displacement is suspected.
How you can help:
- Apply a cold, moist compress to the affected area.
- Offer age-appropriate pain relief (e.g., Children’s Tylenol).
- Contact your pediatric dentist immediately.
Crown fracture
The crown, the visible part of the tooth, is often the site of trauma. Fractures range from minor enamel cracks (usually not urgent) to pulp exposure (requiring immediate treatment).
While X-rays help the pediatric dentist assess severity, any change in tooth color (like pinkish or yellowish hues inside) is an emergency sign. Minor fractures may need sealant, while severe ones might require pulp treatment. Contacting the pediatric dentist is important for any crown fracture, as jagged enamel can irritate and infect soft tissues.
How you can help:
- Gently rinse your child’s mouth with lukewarm water.
- Apply a cold, moist compress to the affected area.
- Offer strong age-appropriate pain relief (e.g., Children’s Tylenol).
- Visit your pediatric dentist or the Emergency Room based on availability and injury severity.
Root fracture
A root fracture, caused by direct impact, isn't visible externally. Dental X-rays are needed for diagnosis. Depending on the fracture’s location and the child’s discomfort, the tooth may be monitored, treated, or, in severe cases, extracted.
How you can help:
- Apply a cold, moist compress to the affected area.
- Offer age-appropriate pain relief (e.g., Children’s Tylenol).
- Contact your pediatric dentist.
Dental concussion
A tooth that’s been bumped or knocked but isn't loose or broken is “concussed.” Common in toddlers, it can cause temporary or permanent discoloration. Unless the tooth turns black or grim (indicating a dying tooth that may need a root canal), emergency treatment isn't usually required.
Injured cheek, lip or tongue
For a bleeding cut or bite on the cheek, lip, or tongue, apply firm, direct pressure with a clean cloth or gauze. Apply ice to reduce swelling. If bleeding is uncontrollable, go to the Emergency Room or call a medical professional immediately.
Fractured jaw
If a broken jaw is suspected, proceed immediately to the Emergency Room. Keep the child’s jaw still; for a young child, gently tie a scarf lengthwise around the head and jaw to prevent movement.
Head injury/head trauma
For any head trauma, proceed immediately to the Emergency Room, even without loss of consciousness, to rule out delayed concussion and internal bleeding.
If you have questions about dental emergencies, please ask your pediatric dentist.
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