Tooth Fracture/Knocked Out Tooth

By: J. Shahangian, DDS, MS- San Diego Board Certified Pediatric Dentist

Broken, Fractured, Displaced Tooth
Dental emergencies can happen at any moment.  If your child is injured and looses a tooth, it is imperative to stay calm.  Call my office immediately to assess whether the tooth is a primary or permanent tooth.  Permanent teeth should only be held by the crown and never by the root.  Try to reinsert the tooth into the socket, holding the tooth by the crown.  An effective technique for keeping the tooth in place is biting down on a piece of wet clean gauze.  If you are not able to keep your child’s tooth in place, then make sure to deposit the tooth in saline, milk, or your child’s saliva until you arrive at my office,  or if necessary, the emergency room.

In case your child breaks a tooth, the first thing you must do is to help your child rinse his/her mouth to remove any debris and blood.  Next, place a cold cloth on the gums, or cheek that is closest to the injury to minimize any swelling.  Please call our office immediately if this happens.

In the case of a minor tooth fracture, I can either leave the tooth alone, or smooth it out.  In more serious cases, I may need to restore the tooth if the pulp has been severely damaged.   I recommend that parents take precautions, such as feeding your child soft foods and making sure your child abstains from using the fractured tooth.    Fractures that are moderate include damage to the tooth including the enamel, dentin (the actual bony part of the tooth), and even the pulp (this includes the blood vessels and nerve of the tooth).  If there is damage to the pulp, a root canal may be necessary to save the tooth.  The way to do this procedure is to add a filling or a permanent crown.

In extreme cases of tooth fractures, there may be a slim chance that there will be no recovery and a total loss of the tooth.[1]

What If a Tooth Gets Knocked Out During Sports?
Imagine this scenario; your child is swimming in the pool.  Suddenly, your child rises to the surface, and accidently bangs his/her tooth on the ledge of the pool.  The front tooth is knocked out and falls to the bottom of the pool.

Imagine another scenario; your child is playing in his/her school basketball team.  Unexpectedly, a player from the opposing team rams in, hitting your child’s mouth, instantly knocking out her/his tooth.

The first thing to do is to remain calm.  If you are able to act promptly, you may be able to save your child’s tooth.

First-aid steps in case of a loose or fallen tooth:

  • The first step is to pick up the tooth.  You must hold the tooth by the crown, and not the root.  Next, try to place the tooth back into the socket.  If the tooth is not able to stay in place, then put the tooth in saline, milk, or even your child’s saliva.
  • Washout your child’s mouth with water, and then apply cold compresses to the injured area to minimize swelling.  This also makes treatment much easier.
  • If your child’s tooth is only loose, then try to push the tooth back into place, and stabilize it by having your child bite down on wet gauze.

After these emergency preventive measures have been taken, call and make an appointment with me as soon as possible.  The sooner your child seeks treatment, the more likely I will be able to save your child’s tooth.[2]

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