An official website of the United States government
Here's how you know
A .mil website belongs to an official U.S. Department of Defense organization in the United States.
A lock (lock ) or https:// means you’ve safely connected to the .mil website. Share sensitive information only on official, secure websites.

Home : News : Commentaries : Display
NEWS | Feb. 9, 2016

Managing child dental trauma

By Dr. Jill Watson and Dr. Benjamin Rush 633rd Dental Squadron

Imagine a child just fell at the park.  What to do if the tooth is broken, out of place or knocked out?  The two most common causes of dental trauma are accidental falls and sports; therefore, children are at a higher risk of dental trauma.  Below is an overview of the most common types of dental trauma and what parents need to know.

With any head or facial trauma, if there are lacerations, bleeding, loss of consciousness or change in behavior, take the child to the emergency room immediately.  Teeth are very important, but secondary to the overall well-being of a child.  Take a child to the dentist immediately if the following has occurred- tooth has a large fracture with bleeding inside tooth, tooth is out of position or extremely loose or the tooth has come out completely. 

· Fractured tooth: If a piece of the tooth is missing, the dentist may be able to re-attach it or re-create it with filling material.  If a small piece of tooth is missing and the child doesn't have pain, this is not an emergency but should be addressed as soon as possible.  Be wary that a child doesn't cut their tongue or lip on a sharp edge until the dentist is able to repair the fracture.    If there is a larger piece missing and red or bleeding is visible in the middle of the remaining tooth, this requires immediate treatment.  Go immediately to a dentist or the ER and bring any pieces of tooth remaining. 

· "Bruised tooth": If the tooth has been hit with force but did not fracture, it may be "bruised".  The tooth may or may not appear to be loose.  Either way, other injuries should be treated and a dentist should examine the tooth periodically to make sure the tooth remains healthy.  It is possible that many years down the road, the tooth will become unhealthy and may begin to change color.  Regular dental visits will help identify and treat this early.  If the tooth is loose enough that you fear it will displace or fall out, go to a dentist or the ER.  Otherwise, make a dentist appointment as soon as possible.

· Displaced tooth: If the tooth was hit hard enough and did not fracture, it may be out of position.  It may be too far forward or backward or into or out of its socket.  It is possible the root of the tooth is fractured or the bone is fractured.  Avoid displacing the tooth any further and limit the child from touching the area.  Bring the child to a dentist or the ER.  The dentist may reposition the tooth and "splint" it with wire to the neighboring teeth for a limited time.  As with a "bruised" tooth, it is possible that the tooth may become unhealthy many years after the injury.  Therefore, a child should inform any future dentists of the injury in order to observe that tooth.

· Missing or avulsed tooth: If the tooth was knocked out, immediate action can help save the tooth.  Try not to touch the root of the tooth and do not clean off the tooth as the cells left on it can help it survive.  It is important to keep the cells on the root healthy by storing the tooth in a proper liquid while bringing the child to a dentist or the ER.  The best liquid is one designed specifically to store a tooth (such as "Save a Tooth"), which can be obtained at a variety of retailers and can be kept in the first aid kit at home, in the car or in a coach's bag for sports events.  Milk is the next best liquid.  Do not store the tooth in water.  If there are no other options, the child can store the tooth in their mouth, just be careful they do not swallow it, or they can put the tooth into a cup.  A dentist may replant the tooth and "splint" it with wire to the neighboring teeth.  They may also prescribe antibiotics or other medications.  If possible, bring the child's immunization record, as the ER and dentist will want to make sure the child's immunizations are up to date and may supplement them if required.  The dentist may follow up periodically to ensure the tooth returns to normal.  As with bruised and displaced teeth, it is possible that the tooth will require additional treatment. 

Proper immediate management of dental trauma is critical.  However, the most successful form of protection is prevention.  Through 6-month checkups, thorough home care and proper protection during play and sports children's teeth have the potential to grow into healthy adult teeth.