Injury Definition

• Loosened tooth - if mild, usually tightens up on its own (may bleed a little from the gums).
• Displaced tooth (usually pushed inward).
• Chipped or fractured tooth.  To prevent permanent pulpal damage, fractures into the pulp need to be treated within 24 hours.
• Avulsed (knocked out) tooth - a dental emergency for permanent teeth.

Call Your Dentist Now (night or day) If

• You think your child has a serious injury.
• Permanent tooth knocked out (reason: needs reimplantation ASAP; 2 hours is the deadline for survival). First Aid Advice: transport the tooth in some saliva or milk.  If over 30 minutes away, try to replace the tooth in the socket before coming in.
• Permanent tooth is almost falling out.
• Baby tooth is almost falling out.  
• Bleeding won't stop after 10 minutes of direct pressure.  
• Tooth is greatly pushed out of its normal position.
• Tooth that's pushed out of its normal position interferes with normal bite.
• Severe pain.  
• Age less than 1 year old.

Call Your Dentist Within 24 Hours (between 9 and 4) If

• You think your child needs to be seen.
• Baby tooth knocked out by trauma (reason: can't be reimplanted but dentist will check damage to permanent tooth).
• Tooth is slightly pushed out of its normal position.
• Can see a chip or fracture line in the tooth.
• Tooth sensitive to cold fluids.  
• Tooth feels very loose when you try to move it.

Call Your Dentist During Weekday Office Hours If

• You have other questions or concerns.

Parent Care at Home

• Mild tooth injury and you don't think your child needs to be seen.

Home Care Advice for Mild Dental Injuries

1. Local Cold:  For pain, apply a piece of ice or a Popsicle to the injured gum area for 20 minutes.
   
     
2. Pain Medicine:  If it still hurts, give acetaminophen or ibuprofen.
   
   
3. Soft Diet:  For any loose teeth, offer a soft diet for 3 days. By then, it should be tightened up.
   
   
4. Call Your Dentist If:
   
   Pain becomes severe.
   
   Tooth becomes sensitive to hot or cold fluids.
   
   Tooth becomes a darker color.
   
   Your child becomes worse or develops any of the "Call Your Dentist" symptoms.

Parent Care for Pediatric Symptoms. Copyright © 2000. Barton D. Schmitt, MD, FAAP