Short answer: In a dental injury in a child, the child's general condition is checked first. If a permanent tooth has been completely knocked out, it is held by the crown, not the root; if it is dirty, it is rinsed for a few seconds under cold water and, if possible, put back in place; if that is not possible, it is stored in milk and you go to a dentist immediately. A knocked-out baby tooth, however, is not put back. Broken pieces should be kept, and in every case you should see a dentist the same day.
A fall at the playground, a slip off a bike or a collision in the schoolyard... Dental injuries in children are common, especially when they are learning to walk and during school age. In such a moment, the parent staying calm and knowing the right steps significantly affects the chances of saving the tooth. In line with the general recommendations of the International Association of Dental Traumatology, this guide summarizes in plain language what needs to be done in the first minutes.
First of all: if the child has hit their head and there are signs such as loss of consciousness, vomiting, dizziness or bleeding from the nose or ears, the tooth is secondary and you should go directly to the emergency room.
What should you do if a tooth has been completely knocked out?
If you are sure the completely knocked-out tooth is a permanent tooth, it should be put back in place right away if possible, or stored in a suitable liquid while you go to the dentist without delay. Every minute the tooth stays dry outside the mouth increases the risk of damage to the living cells on the root surface. We can summarize the answer to what to do if a tooth is knocked out step by step as follows:
- Find the tooth and hold it by the crown. Hold the tooth by the white part that is visible in the mouth; do not touch the root under any circumstances.
- If it is dirty, rinse it briefly. Hold it under cold running water for no more than about 10 seconds. Do not brush it, scrub it or use soap or alcohol.
- Try to put it back in place. If the child allows it, gently put the tooth back into its socket facing the right way and ask them to bite on a clean handkerchief or gauze.
- If you cannot put it back, store it in a suitable liquid. Cold milk is the most readily available option. Saline solution can also be used. Storing it in water is not recommended; the tooth must never be wrapped in a dry napkin.
- Go to the dentist immediately. Ideally, you should reach a dentist within the first 30-60 minutes after the incident.
For young children, carrying the tooth in the mouth, inside the cheek, is not recommended because of the risk of swallowing it; milk is a safer option in this case. Whether the child's tetanus vaccination is up to date should also be shared with the dentist.
What is the first aid for a broken or cracked tooth?
The first thing to do for a broken tooth is to find the broken piece, store it in water or milk and see a dentist the same day. In many cases, the broken piece can be bonded back onto the tooth. First aid steps for a broken tooth:
- Gently rinse the mouth with lukewarm water and check for cuts on the lips, tongue or gums.
- If there is bleeding, apply light pressure with a clean gauze pad.
- To reduce swelling, apply something cold wrapped in a cloth to the cheek.
- If you could not find the broken piece and there is a cut on the lip, tell the dentist; the piece may be lodged inside the lip.
The depth of the fracture matters. Small fractures involving only the enamel layer are not urgent but do require a checkup. If a pink or red dot is visible on the broken surface, the tooth's nerve tissue may be exposed; in this case, you should go to the dentist without waiting. Even if there is no visible problem, teeth that have taken a blow may have cracks; X-rays are taken at the examination if necessary.
What should you do about a loosened tooth?
A tooth that is wobbly, pushed forward or backward or appears to be pushed into the gum after a blow should not be touched, and you should see a dentist the same day. Trying to push the tooth back into place with your finger or checking it by wiggling it can cause further damage to the root and surrounding tissues.
The situations that can be seen with a loosened tooth are:
- Slight wobbliness and tenderness: Usually heals with a soft diet and follow-up.
- The tooth changing position: The dentist can reposition the tooth and temporarily splint it to the neighboring teeth.
- The tooth being pushed into the bone: If the tooth looks short, it may have been pushed upward; this requires a detailed assessment.
For a few days after the injury, soft foods should be preferred, biting with the injured tooth should be avoided and oral hygiene should be maintained with a soft brush. A doctor or pharmacist should be consulted about the use and dosage of pain relievers.
What is different about injuries to baby teeth?
The basic rule for baby tooth injuries is this: a baby tooth that has been completely knocked out is not put back in place. The reason is that the permanent tooth developing right behind the baby tooth can be damaged during replantation.
Points to watch for in baby tooth trauma:
- Keep the knocked-out baby tooth and take it to the dentist; it helps determine whether the tooth came out completely and whether a broken piece remains in the mouth.
- Stop the bleeding with light pressure using a clean gauze pad.
- Watch the color of the tooth in the weeks after the injury. Graying or darkening of a baby tooth can indicate that the nerve has been affected.
- If you notice swelling, a pimple-like bump or a bad smell on the gum, go back for another checkup.
Because baby tooth injuries can affect the development of the permanent tooth underneath, they should be evaluated by a dentist even if they appear minor and monitored when necessary.
What happens at the dentist, and why is follow-up important?
At the dental examination, the type of injury is determined, X-rays are taken if necessary and treatment is planned according to the condition of the tooth. Teeth that have been put back or have changed position can be temporarily splinted to neighboring teeth with a thin wire or a flexible splint for a few weeks to heal. Broken teeth can be repaired by bonding or with a filling; if the nerve tissue has been affected, additional treatment may be needed.
The effects of trauma do not always appear immediately. For this reason, the dentist schedules follow-up appointments in the weeks and months after the injury. At these checkups, the vitality of the tooth, color change, whether there is root resorption and, in baby tooth injuries, the development of the permanent tooth underneath are monitored. Keeping follow-up appointments even when there are no symptoms allows possible problems to be caught early.
Preventing injuries: sports mouthguards
A significant proportion of dental trauma in children can be prevented; the most effective way to do this is to wear a mouthguard in sports with a risk of contact. In activities such as soccer, basketball, martial arts, hockey, skateboarding and skating, a mouthguard reduces the impact transmitted to the teeth and jaw.
- Custom mouthguards: Made by the dentist from an impression of the mouth; they fit better and affect speech less.
- Ready-made mouthguards: Easy to get; however, their fit may be limited.
- Children in orthodontic treatment: For children with braces or aligners, the choice of mouthguard should be made together with the orthodontist.
At home, fitting guards on table corners, being careful with slippery floors, using an appropriate car seat in the car and wearing a helmet while cycling are simple but effective measures. Upper front teeth that tilt noticeably forward also increase the risk of trauma; for this reason, an early orthodontic evaluation can be helpful for children with this condition. For other common questions, you can see our frequently asked questions page.
When should you see a dentist in Ankara after a dental injury?
If a permanent tooth has been completely knocked out, minutes matter and a dentist should be reached immediately; for fractures, loosened teeth or baby tooth injuries, an examination on the same day is recommended. If you notice discoloration, swelling or pain in the tooth weeks after the injury, do not neglect to come back for a checkup. Directions and appointment information for our polyclinic in Park Oran Ofis in Oran, Çankaya, can be found on our contact page.
Frequently asked questions
How soon should a knocked-out permanent tooth be put back?
The shorter the time the tooth spends outside the mouth, the greater the chance of saving it. If possible, it should be put back right away, or stored in milk while you reach a dentist within the first 30-60 minutes.
Is a knocked-out baby tooth put back in?
No, a baby tooth that has been completely knocked out is not put back, because doing so can damage the permanent tooth developing underneath. Still, the child should be taken to the dentist and checked.
What liquid should a knocked-out tooth be stored in?
The most practical option is cold milk; saline solution can also be used. The tooth should not be kept in water and should not be wrapped in a dry napkin.
Why does a tooth that took a blow change color?
A blow can affect the nerve and blood vessel tissue inside the tooth. Graying or darkening that develops over weeks can be a sign of this and should be evaluated by a dentist.
