Community Health Network

Tooth Injury
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First Aid - Tooth - Transport in Milk

First Aid - Tooth - Knocked Out

First Aid - Tooth - Transport in Saliva

Definition

Injury to a tooth

Types of Tooth Injuries

Loosened tooth - may bleed a little from the gums. Usually tightens up on its own.
Displaced tooth (usually pushed inward)
Chipped or fractured tooth
Avulsed (knocked out) tooth - a dental emergency for permanent teeth

First Aid:

First Aid Advice For Knocked-Out Permanent Tooth

To save the tooth, it must be reimplanted ASAP (2 hours is the outer limit for survival). Right away is best. If > 30 minutes away from dental or medical care, encourage the caller to replace the tooth in the socket before coming in. Use the following technique:
Rinse off the tooth with saliva or water (do not scrub it).Â
Replace it in the socket facing the correct way.Â
Press down on the tooth with your thumb until the crown is level with the adjacent tooth.
Have your child bite down on a wad of cloth to stabilize the tooth until you can reach your dentist.
Note: Baby teeth can't be re-implanted.

Transporting a Knocked-Out Permanent Tooth

If unable to put the tooth back in its socket, follow these instructions:
It is very important to keep the tooth moist. Do not let it dry out.
Transport the tooth in milk or saliva (Milk is best per ADA 2003)
MILK TRANSPORT OPTION 1 (best): Place tooth in a small plastic bag with some milk. Put the plastic bag in a cup of ice.
MILK TRANSPORT OPTION 2: Place tooth in a cup of cold milk.
SALIVA TRANSPORT OPTION 1: Put the tooth inside the child's mouth. (Be careful not to swallow it) (EXCEPTION: Age < 12 years)
SALIVA TRANSPORT OPTION 2: Put the tooth in a cup and keep tooth moist with child's saliva (spit).

Should I
Call?

Care at
Home

When to Call Your Doctor

	Call Your Dentist or Doctor Now (night or day) If
	You think your child has a serious injury Permanent tooth knocked out (Reason: needs reimplantation ASAP; 2 hours is the deadline for tooth survival) --See FIRST AID Permanent tooth is almost falling out Baby tooth is almost falling out Bleeding won't stop after 10 minutes of direct pressure Tooth is greatly pushed out of its normal position Tooth that's pushed out of its normal position interferes with normal bite Severe pain Age under 1 year old
	Call Your Dentist Within 24 Hours (between 9 am and 4 pm) If
	You think your child needs to be seen Baby tooth knocked out by injury (Reason: can't be reimplanted but dentist will check for damage to permanent tooth) Tooth is slightly pushed out of its normal position Can see a chip or fracture line (crack) in the tooth Tooth feels very loose when you try to move it
	Call Your Dentist During Weekday Office Hours If
	Tooth sensitive to cold fluids Tooth becomes a darker color You have other questions or concerns
	Parent Care at Home If
	Minor tooth injury and you don't think your child needs to be seen

Symptom
Description

Care at
Home

HOME CARE ADVICE FOR MINOR DENTAL INJURIES

Local Cold: For pain, apply a piece of ice or a popsicle to the injured gum area for 20 minutes.
Pain Medicine: If it still hurts, give acetaminophen (e.g., Tylenol) or ibuprofen.
Soft Diet: For any loose teeth, offer a soft diet for 3 days. By then, it should be tightened up.
Call Your Dentist If:
- Pain becomes severe
- Tooth becomes sensitive to hot or cold fluids
- Tooth becomes a darker color
- Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Symptom
Description

Should I
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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.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 6/27/2008

Content Set: Pediatric HouseCalls Online