Dental Emergencies

No parent ever wants to see their child in pain; however, pediatric dental emergencies can sometimes occur. It is important to determine the difference between a dental emergency which requires immediate action, and the discomfort of a toothache which can be handled with a scheduled appointment.

Toothaches are common in children of all ages and rarely occur without cause. Common causes of toothache include: tooth fractures, tooth decay, tooth trauma, and wisdom teeth eruption (adolescence). If your child has a toothache, please follow the steps below:

  1. Cleanse the area using warm water.  Do not medicate or warm the affected tooth or adjacent gum area.
  2. Check for impacted food and remove it as necessary using a clean finger, dental floss or a toothbrush.
  3. Apply a cold compress to the affected area to reduce  any swelling that occurs.
  4. Offer a pediatrician-approved pain relief such as Tylenol.
  5. If pain persists, contact our office during normal business hours to seek advice.

The following are dental emergencies and require immediate action. Please be prepared to bring your child to our office during normal business hours, or the emergency room if our office is closed. Here are some of the most common dental emergencies, as well as steps to follow to resolve the issue and have the best possible outcome.

Knocked Out Tooth (Dental Avulsion)

If a tooth has been knocked-out of the child’s mouth completely, it is important to contact us immediately because time is an important factor in saving and re-implantation of a tooth. In general, Dr. Joe does not attempt to re-implant avulsed primary (baby) teeth, because the re-implantation procedure itself can cause damage to the tooth bud, and thereby damage the emerging permanent tooth. Please contact our office so the doctor can assess the impact on the emerging permanent tooth.

If an adult tooth has been knocked out, Dr. Joe will always try to re-implant the tooth, unless the trauma has caused irreparable damage. The re-implantation procedure is almost always more successful if it is performed within one hour of the avulsion and parents follow the following steps:

  1. Recover the tooth. Do not touch the tooth roots! Handle the crown only.
  2. Gently rinse off dirt and debris with water. Do not scrub or scrape the tooth.
  3. For older children, insert the tooth into its original socket using gentle pressure, or encourage the child to place the tooth in the cheek pouch. For younger children, place the tooth in a glass of milk or saliva. Do not try to put the tooth back in a young child’s mouth, as they may swallow it.
  4. Keep the tooth wet during transportation. Moisture is critically important for re-implantation success.
  5. Visit us immediately during normal business hours. After-hours, please take the child to the Emergency Room. Time is critical in saving the tooth.

Dental Intrusion (tooth pushed into jawbone)

Sometimes, dental trauma forces a tooth (or several teeth) upwards into the jawbone. Often, the force of the trauma is great enough to injure the tooth’s ligament and fracture its socket.

If you suspect or observe that dental intrusion has occurred, it is important to contact our office as soon as possible.  Depending on the nature and depth of the intrusion, Dr. Joe will either wait for the tooth to descend naturally, perform root canal therapy to preserve the structure of the tooth, or refer the child to another qualified dental specialist.

How you can help:

  1. Rinse the child’s mouth with cold water.
  2. Place ice packs around affected areas to reduce swelling.
  3. Offer a pediatrician-approved pain relief such as Tylenol.
  4. Contact our office during regular business hours, or take the child to the Emergency Room immediately during after-hours.

Tooth Displacement (Luxation, Extrusion)

Tooth displacement is generally classified as “luxation,” “extrusion,” or “lateral displacement,” depending on how the tooth is angled after the trauma. A luxated tooth remains in the socket with the pulp intact some of the time. However, the tooth protrudes at an unnatural angle and the underlying jawbone is oftentimes fractured.

The term “extrusion” refers to a tooth that has become partly removed from its socket. In young children, primary tooth extrusions tend to heal themselves without medical treatment. However, dental treatment should be sought for permanent teeth that have been displaced in any manner in order to save the tooth and prevent infection. It is important to contact our office if displacement of a permanent tooth is suspected.

How you can help:

  1. Place a cold, moist compress on the affected area.
  2. Offer a pediatrician approved pain relief such as Tylenol.
  3. Contact our office during regular business hours, or take the child to the Emergency Room immediately during after-hours.

Broken Tooth (Crown Fracture)

The crown is the largest, most visible part of the tooth.  In most cases, the crown is the part of the tooth that sustains trauma.

If your child's tooth is broken, Dr. Joe can readily assess the severity of the fracture using dental X-rays. Any change in tooth color (for example, pinkish or yellowish tinges inside the tooth) is an emergency warning sign. Minor crown fractures may require the application of dental sealant, whereas more severe crown fractures sometimes require pulp treatments. Jagged enamel can irritate and inflame soft oral tissues, causing infection.

How you can help:

  1. Rinse the child’s mouth with warm water.
  2. Place a cold, moist compress on the affected area.
  3. Offer a pediatrician approved pain relief such as Tylenol.
  4. Pack the tooth with a material that can be near a tooth but will eventually break down, such as a wet paper towel.
  5. Contact our office during normal business hours, or take the child to the Emergency Room immediately during after-hours.

    Root Fracture

    A root fracture is caused by direct trauma, and isn’t noticeable to the naked eye, and may often present as a toothache. If a root fracture is suspected, dental x-rays need to be taken. Depending on the exact positioning of the fracture and the child’s level of discomfort, the tooth can be monitored, treated, or extracted as a worst case scenario.

    How you can help:

    1. Place a cold, moist compress on the affected area.
    2. Offer a pediatrician approved pain relief such as Tylenol
    3. Contact our office during normal business hours for instructions and next steps.

    Dental Concussion

    A tooth that has not been dislodged from its socket or fractured, but has received a bang or knock, can be described as “concussed.” Typically occurring in toddlers, dental concussion can cause a tooth to discolor permanently or temporarily.  Dental concussion does not require treatment unless the tooth turns black or dark (indicating that the tooth is dying and may require root canal therapy). Contact our office during normal business hours if your child's tooth becomes black or dark.