A Parent's Guide for Trauma to a Baby Tooth

Tooth injuries are not just traumatic to the tooth and child, but also to the parents. As a parent myself, I can tell you I have been there. And as a dentist, my fear of teeth-related injuries were heightened, coupled with a first-born son who I was told by the nurses had "strong muscle tension" the day he was born; who learned to walk at ten months old; who ran with a soccer ball by 12 months old. If I could log on here the number of injuries, we would never get around to the guide. All of this to say, I hear you. More importantly, I feel you. I felt every one of my son's falls in my bones. It is why I wrote a parent's guide for trauma to a baby tooth. To reassure parents that this is common, and there is a way to navigate through it.

First Moments After Trauma to a Baby Tooth

It isn't easy, but the first thing to do is to stay calm. DO NOT PANIC. Your child needs you during this scary (possibly painful) time. They look to you for strength, and confidence that it'll be okay. (It will, it just doesn't feel that way in the moment. This is normal.)Taking a deep breath, speaking quietly and moving slowly helps.

After you've controlled your emotions, control the bleeding. Blood might be coming from the tooth, tongue, gums, or lips. Trying to figure out where it is coming from is difficult, especially if your child is crying or squirming. Forget about finding out. Focus on stopping the blood. Pressure is best. Grab a soft towel or paper towel, and gently put pressure. Of course, a frantic child will not let you do that, which is why step one comes first. If you cannot calm them down or they wont allow you to hold pressure, try the next step.

Get some ice. If compresses are impossible, try to hand your little one an ice cube. Most kids love holding ice. Tell them to gently touch the ice cube to their mouth or tooth. Ice slows the swelling. Swelling to the area will help with healing, but if it happens too fast, it can be uncomfortable. The ice can calm them down.

If that still does not work (it did not for my son until he was older than 2 years old), give them a cold popsicle. Let them suck on that and it will help. Most toddlers cannot resist a tasty treat.

A note on the cold: twenty minute intervals are recommended. While we do not want extreme swelling, we do want the body to do it's thing. Swelling happens because the healing mechanism is being rushed to the site by the circulatory system.

What might you find?

After the scene has settled, let's talk about what you may find. Take a look, and if possible take a photo. A photo right after the injury will help a dentist see the entire picture. Here are common findings after an injury involving teeth:

• Loose Tooth

• Chipped Tooth

• Pushed-In Tooth

• Knocked-out tooth

• Lacerated gum or lip

• Bitten tongue

• Purple gums

Next Steps After Bleeding is Controlled (Usually Within the First Hour)

• Schedule an appointment with the dentist. Same day appointments are best. They can take an x-ray to make sure the adult tooth growing underneath the baby tooth was not injured. That is our main concern.

• If a tooth is loose or pushed into the gum, do not try to move it. This is to protect the adult tooth underneath. An x-ray will confirm the positioning of the tooth before any movement is made.

• Leave wiggly teeth be. The dentist can take an xray to determine if we keep the tooth. Sometimes, the gum and bone around the tooth loosen up due to the impact. This is the best case scenario! Both reattach around the baby tooth over time. However, it is possible that the tooth is loose because it cracked at the root. In which case, taking it out will be the best treatment.

• Avoid cold and sugary foods, especially if a tooth is loose or chipped. These can make a tooth very sensitive. Even ice cold water can cause a ZING!

• Avoid hard or sticky foods. Soft foods are the preferred option. Pureed foods, soups, smoothies, mashed potato and yogurt are all great options.

• If a baby tooth was knocked out, do not reinsert it. While restoring avulsed teeth is possible, it should only ever be done with adult teeth. Reinserting a baby tooth can injure the adult tooth growing underneath the gums. If you want, store it in a container with milk or saliva, and bring to the dentist as soon as possible to verify.

When to go to the ER

There are some instances where the injury is very severe. It is definitely recommended that you call the ER if any of the following is happening.

• Severe laceration or cut. If bleeding cannot be stopped after 20 minutes of pressure, consider the ER. Also consider this if excessive bleeding goes down the throat.

• If the child is having trouble breathing, go to the ER. There could be an obstruction or injury to the airway.

• Usually a fall that affects teeth also involves the head. If the child loses consciousness, says they feel dizzy, or vomits, take them to the ER.

I'd like to end it on a positive note. And that is that falls are common in little kids. You are not the first family to experience this. Many times, nothing needs to happen, and the tooth heals itself. Monitoring may be the only thing needed.

If you found this information helpful, you may want to join our community of parents. We share parental advice, oral health tips, habits for your child's developmental stage, and the best tools to keep teeth healthy.