How to Care for Your Child with Dental Injuries

This leaflet will provide you with helpful information about dental injuries, common causes, diagnosis and treatment and home care advice.

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What is a dental injury?

Children of all ages can get hurt in their mouths, but most of the time, these injuries are preventable. Most of children get better from mouth and dental injuries without any problems.
To make sure things go well, it is important to get help quickly and regular follow up on the mouth and dental injuries.

What cause dental injuries?

  • Falls
  • Sport Injuries
  • Fights
  • Bicycle accidents
  • Car accidents
  • Children who trip or is pushed with an object in the mouth

When should I seek help for my child?

You must reach out to a healthcare provider either by visiting in person or calling if you are concerned about your child’s condition, and if your child experiences any of the following:

  • Pain, tenderness, or sensitivity to hot/cold or pressure in a tooth
  • A broken, loose, or missing tooth after injury
  • Bleeding that does not stop after applying pressure for 10 minutes
  • Pain in the jaw when opening or closing the mouth
  • Difficulty swallowing or breathing
  • An object stuck in the roof of the mouth, cheek, tongue, or throat (do not remove the object)
  • A large or gaping cut inside the mouth or on the face
  • Weak, numb, or has blurred vision or slurred speech
  • Has fever
  • Has any of the following signs of infection after mouth or injury such as:
    • Fever (temperature above100.4 F/38 C)
    • Redness
    • Pus discharge
    • Increasing pain and drooling.
    • Neck pain or stiffness.
    • Cannot fully open the mouth
    • Chest pain

How dental injuries are diagnosed?

The doctor will:

  • Ask few questions about your child’s health
  • Examine your child
  • Decide if more investigation is needed
  • Request X ray to know exact nature of tooth and surrounding soft tissue injury if needed.

How is dental injury treated?

The treatment of dental injuries depends upon:

  • Child age
  • Types of the injuries   

What are the types of Dental injuries?

  • Primary tooth (baby tooth)
  • Permanent Tooth (adult tooth) are not usually present before six or seven years of age.

What are the types of injured primary teeth?

1. Dislocated, loose, knocked out primary teeth:

  • It is the most common injuries of the front primary teeth.
  • The focus is on preventing future damage to the permanent teeth.
  • Your child’s dentist will examine your child to check on the severity of injury and choose the best approach, which may include:
    • Leaving the tooth in place and monitored with follow up visits
    • Removing the tooth to avoid inhalation.
  • It is important not to be replanted knocked-out primary teeth.

2. Broken primary teeth:

  • Your child’s dentist will examine your child and choose the best approach, which may include:
    • If the damage is minor, the dentist would provide advice and recommend follow up appointments
    • The dentist may smooth the edges of the broken tooth and plan for further repair.
    • In situations where the nerves or blood vessels might be affected, the dentist may use placing special dressings and coverings on the teeth to protect and promote healing.  

What are the types of injured permanent tooth?

1. Dislocated, loosened, and knocked out permanent teeth

  • If the permanent tooth has been knocked out but is still intact, you should attempt to 're-implant' it back into its gum socket.
  • You should do this at home before your leave to your emergency dentists, but teeth can be replanted within one hour.

Following are the important steps for replanting a tooth:

  • Handle the tooth carefully by the top (crown)
  • Do Not touch or hold the root
  • Do not be scrub or sterilize the tooth
  • Rinse it in milk.  Avoid water, as it will damage the root cells
  • Place the tooth by hand back in your child’s gum socket
  • Ask your child to bite down on a clean handkerchief to keep it in place until reaching the emergency department
  • Take your child to the dentist emergency immediately

If you are unable to replant the tooth into the socket:

  • Store the tooth in container or plastic bag in cold milk or child’s saliva and take it to the emergency dentist
  • The dentist will reposition and splint the loose teeth
  • Do Not store it in water, because this will reduce the chances of successful healing of the reimplanted tooth.
  • The longer the tooth stays out of the mouth, the less chance it has of surviving.

2. Broken permanent tooth:

  • Broken teeth that are sensitive to hot or cold need to be treated urgently.
  • Save any broken pieces in water as they might be put back
  • Broken teeth can be fixed with a special material called composite resin

What is the pain relief and antibiotic needs for dental injuries?

1. Pain relief:

  • If your child has pain related to a mouth or tooth injury, the child may apply a piece of ice or frozen popsicle to the area.
  • If your child’s doctor advises giving medicine, you can give.
    • Paracetamol (any brand) or Ibuprofen (any brand)   
    • Follow the instruction on the medicine package for the correct dose for your child.
    • Do not give your child Aspirin as this can cause serious problems.

2. Antibiotics:

  • Antibiotics are not usually required for children with dental or mouth injuries.
  • Antibiotics will be considered in children with:
    • Complicated mouth wounds, and needs stitches
    • Heart conditions to prevent a heart infection

3. Tetanus prevention:

  • A dose of tetanus vaccine may be necessary depending upon the child’s tetanus immunization status.
  • Please inform your doctor if your child is not fully vaccinated.

4. Oral hygiene and diet:

  • After a tooth or mouth injury, keep the area clean especially the teeth, even if the teeth and gums are sensitive or tender or the brushing causes slight gum bleeding.
  • If a child’s tooth is loose or the mouth is sore, a soft diet is recommended for several days.
  • Avoid sucking on a pacifier or finger should for the first 10 days.
  • Children who have stitches in the mouth should avoid spicy or salty food.

My child took a knock to their milk teeth. Will their adult teeth be affected?

  • Possibly. Adult teeth develop inside the gums from the time the child is a baby until they are ready to come through, usually aged around 8.
  • Harming a milk tooth during this time might change the adult tooth underneath, causing things like:
    • Discoloration
    • Change in the tooth's shape or how it will stick out

My child tooth has been knocked down into the gum. Will it correct itself?

  • This is called an “intrusion injuries” and what happens next depends on your child age.
  • If your child’s roots are still growing, the tooth might fix itself in a few weeks.
  • If not, a brace can gently move it back into position
  • If your child’s root is fully grown, it is harder to fix.
  • If the blood supply to the tooth’s core of your child tooth is cut off, then the tooth might die
  • If this happens, a brace can help to move it back into place, but you will also need a root canal to keep the tooth healthy

When to go to the Emergency Department?

  • If your child has sustained other injuries like head of facial wounds
  • If you child has other medical problems like bleeding disorders

How can I get medical advice about my child dental injury?

  • To Make appointment with the emergency dentist please call 16000
  • Visit your local primary health care center
  • After the first dentist appointment you will be advised about any future follow up appointments if needed.
  • Injuries to the permanent teeth, will require long-term follow up and care at intervals to be decided by your child’s dentist.