Primary Tooth Injury: How to Care for Your Child

Primary or "baby" teeth are a child's first set of teeth. They start to fall out when kids are around 6 years old. Then the permanent adult teeth come in over the next 15 years. Most baby tooth injuries don't need treatment. But some do to prevent damage to the adult teeth growing underneath them.

Use these instructions to care for your child and know what to watch for.

• Your dentist talked to you and your child and discussed any treatments that were done. Follow your dentist's recommendations for when to follow up and if your child needs to see any dental specialists.

• For bleeding where the tooth was injured, put cold water on a piece of gauze, paper towel, or washcloth and gently press on the gum.

• If your child is uncomfortable:

  • Wrap a piece of ice in a thin cloth and place it on the gum.

  • Give acetaminophen (such as Tylenol^® or store brand) or ibuprofen (such as Motrin^®, Advil^®, or store brand) if your dentist says it's OK. Follow the package directions for how much to give and how often.

• If your child's tooth is sensitive, they should eat soft foods and avoid anything too hot or cold.

• Make sure your child keeps their teeth clean (with your help if needed):

  • Children under 3 years old should brush twice a day with a soft toothbrush with a smear (the size of a grain of rice) of fluoride toothpaste.

  • Children 3 years old and older should brush twice a day with a pea-size amount of fluoride toothpaste.

  • If your child has teeth that touch each other, they should floss every day. Ask your dentist if your child should avoid flossing near the injured tooth.

If your child injures the tooth again or gets another baby tooth injury, call your dentist right away. If you don't have a dentist or can't get in touch with yours, take your child to the emergency room (ER). Certain tooth injuries need treatment right away, even in baby teeth.

If you aren't sure if the tooth is a baby tooth or adult tooth, rinse it with milk or your child's saliva (spit) and gently place the tooth back into the gum socket where it came out. Then take your child to the dentist or ER right away.

If your child has a very loose, dangling baby tooth, ask your health care provider or dentist if you should pull it out or have them pull it out. Sometimes having a loose tooth is a choking risk if it falls out and a child breathes it in.

Your child:

• gets another tooth injury

• has a tooth that changes color

• has tooth pain or sensitivity for more than a few days after the injury

• has gum bleeding that lasts more than a day after the injury

• has signs of an infection, such as a bump in the gums, swollen or red gums, pus coming from the gum, tooth pain or sensitivity, or fever

• is losing teeth before they're 4 years old

• has adult teeth coming in next to baby teeth

What can happen from a baby tooth injury? Most baby tooth injuries don't cause any problems. But rarely, an injury can cause the adult tooth underneath it to come in stained, misshapen, or in the wrong position. This can happen from direct injury to the adult tooth or an infection at the root of the baby tooth that develops after the injury. Getting treatment right after a tooth injury makes these problems less likely to happen.

How are baby tooth injuries treated? If the tooth injury leaves a jagged edge, a dentist can sand it down. If the tooth is chipped, the dentist may reattach the chip or fill it in with a tooth-colored material. If a tooth comes out early and leaves a gap, the dentist may suggest a spacer to keep the rest of the teeth in place until the adult tooth comes in. A fake tooth can be attached to the spacer, if desired. More serious injuries (such as when the tooth gets pushed into the gum) may need a dental procedure, including possibly taking the tooth out.

What can help prevent tooth injuries? Young children like to explore their world, so not all tooth injuries can be prevented. But these steps can help:

• Teach kids to never walk or run with anything in the mouth, such as a toothbrush or pencil.

• To help prevent falls, keep floors free of tripping hazards and use gates at the top of stairs.

• Older kids who play sports should follow all safety recommendations, including wearing a helmet and mouthguard.