TOOTH INJURY Injury Definition Injuries to the teeth Types of Teeth Injuries Loosened Tooth: If mild, it usually tightens up on its own (may bleed a little from the gums). Displaced Tooth: Any tooth that has been pushed out of normal position (displaced) needs to be seen by a dentist to assess the damage. Displaced teeth that interfere with biting, chewing, or closing of the mouth need to be repositioned within 4 hours for reasons of comfort and function. Mild displacement can wait for 24 hours for assessment. Knocked-out Tooth: This is a dental emergency. The knocked-out tooth needs to be placed back in its socket at soon as possible, ideally within one hour. Chipped or Fractured Tooth: All need to seen by a dentist. A fracture that enters into the pulp (center) of a tooth is referred to as complicated; the tooth is usually painful or sensitive to hot and cold. You may be able to identify a complicated tooth fracture by noticing a small red dot or pink blush (the pulp) in the fractured area. To prevent permanent tooth damage, fractures into the pulp need to be treated within 3-4 hours. FIRST AID for Knocked-out Tooth To save the tooth, it must be put back in its socket as soon as possible (2 hours is the outer limit for survival). Use the following technique: Rinse off the tooth with saliva or water. Do not scrub the tooth. Replace it in the socket facing the correct way. Press down on the tooth with your thumb until the crown is level with the adjacent tooth. Lastly, bite down on a wad of cloth to stabilize the tooth until you can be seen by a dentist. Transporting a Knocked-out Tooth Follow these instructions if you are not able to put the tooth back in its socket. It is very important to keep the tooth moist. Do not let it dry out. Transport the tooth in saliva or milk. WHEN TO CALL YOUR DOCTOR FOR TOOTH INJURY Call 911 Now (you may need an ambulance) If Knocked out (unconscious) Major bleeding that can't be stopped Call Your Dentist Now (night or day) If: You think you have a serious injury Knocked-out tooth (see First Aid and Transport information) Tooth is almost falling out Tooth is greatly pushed out of its normal position Tooth that's pushed out of its normal position interferes with normal bite Chipped tooth is missing a large piece, or a red dot is visible inside the chipped area Bleeding won't stop after 10 minutes of direct pressure Severe pain Call Your Dentist Within 24 Hours (between 9 am and 4 pm) If: You think you need to be seen 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 Self Care at Home If Minor tooth injury and you don't think you need to be seen Back to Top HOME CARE ADVICE FOR MINOR TOOTH INJURIES Local Cold: For pain, apply a piece of ice or a Popsicle to the injured gum area for 20 minutes. Pain Medication: For pain relief, take acetaminophen every 4-6 hours (e.g. Tylenol; adult dosage 650 mg) OR ibuprofen every 6-8 hours (e.g. Advil, Motrin; adult dosage 400 mg). Do not take ibuprofen if you have stomach problems, kidney disease, or other contraindications to using this type of anti-inflammatory drug. Do not use if pregnant. Do not use ibuprofen for longer than 7 days without consulting your PCP. Do not take acetaminophen if you have liver disease. Read the package instructions thoroughly on all medications that you take. Soft Diet: If you have any loose teeth, eat a soft diet for 3 days. After 3 days, they should be tightening up. Call Your Dentist If: Pain becomes severe Tooth becomes sensitive to hot or cold fluids Tooth becomes a darker color You become worse or develop any of the "Call Your Doctor" symptoms. Back to Top Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information. Adult HouseCalls Online. Copyright © 2000-2005 David Thompson, M.D. FACEP Reviewed 10/2005 Revised 7/2004 View Index of Topics