Emergency Care

There are a number of different types of dental emergencies. The most common injuries are broken front teeth or displaced front teeth.
If your child breaks a baby tooth, treatment is usually pain management in nature, as most broken front baby teeth require no treatment. If the break is severe enough, treatment is either a root canal and crown if the tooth is needed or extraction.
If your child falls and there is bleeding, locate the source of the bleeding. A very common injury is the tearing of the small piece of tissue that attaches the upper lip to the gum between the front teeth (maxillary frenulum). Usually the bleeding can be stopped with direct pressure on the outside of the upper lip with a cold compress. If the bleeding is still actively flowing after 15-20 minutes of direct pressure, sutures may be required.
If you child’s injury involves dislocation of the baby tooth (subluxation), the risk of damaging the permanent tooth is too great to warrant splinting the baby teeth. The rule of thumb is that unless the dislocation prevents your child from closing down all the way, I do not recommend repositioning the tooth. If the tooth is extremely mobile, I may recommend extraction. An xray may be indicated to check for root fractures, depending on the age of the child.
If your child’s injury involves dislocating the baby tooth up into the gum(intrusion), I recommend patience, as these teeth usually drop down on their own. The concern is whether the permanent tooth was damaged during this injury. An xray will not usually be beneficial.
If your child’s injury involves dislocating a permanent tooth, I must determine how loose the tooth is in order to determine if splinting is the best course of action. Please contact my office immediately if there is noticeable mobility.
If your child breaks a permanent tooth, try to locate the fragment that has broken off. If you are able to locate it, keep it damp. Many times I can reattach the fragment. If I can not reattach the fragment, I can repair the fracture with a resin material.
If your child breaks a permanent tooth, you and I must determine if the fracture involves the nerve. If there is bleeding from the inside of the tooth, your child should be seen as soon as possible. Treatment involves covering the exposed nerve or may involve a root canal. The longer the nerve is exposed to the bacteria in the mouth, the more likely your child will need a root canal.
If your child knocks out a baby tooth (avulsion), do not replant it. Stop the bleeding with direct pressure and depending on your child’s age, you may need an xray to confirm the tooth came out in its entirety.
If your child knocks out a permanent tooth, time is of the essence. Locate the tooth, touching it only by the crown. DO NOT TOUCH or SCRUB THE ROOT. It must be kept moist in order to allow for replantation. The tooth can be stored and transported in milk or placed in your cheek. Some schools have special liquids for this purpose. Contact my office immediately. If your child in unable to be transported to a dentist or emergency room within a reasonable amount of time (ideally replantation is done within 1 hour of the injury), you may be instructed on how to replant the tooth on site.
Once a permanent tooth is replanted, it will be splinted in place and the tooth will require a root canal. I will guide you through the process.

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