What to do if your child knocks out their tooth?

Handle the tooth only by its crown – avoid touching the root.

Most importantly, remain calm so that your child isn’t freaked out more than they already are.

Probably one of the most traumatic experiences for both children and parents is when a child falls on their face and knocks out their front tooth. Remembering  that quick and calm action can save the tooth and help you deal with the situation better. here are some guidelines:

1. If the tooth is one of the four front baby teeth (deciduous teeth), there is NO NEED to reimplant it (ie do not replace it in the socket).  Front baby teeth do not hold space for the adult teeth that will begin to erupt at age six, and the early loss of one of these teeth rarely causes harm to the adult dentition.

2. Any avulsed tooth must be reimplanted in the socket within 60 minutes if the reimplantation is to have a reasonable chance of working. 

• This may be done at the site of the accident by any adult including the patient himself provided the tooth is fairly clean and provided it slips back into the socket easily with light finger pressure.  If the tooth goes back into its proper position so that the patient may bite down without pushing the tooth out of its normal alignment, then the process has been successful. PLEASE ensure that it faces the right direction.
  • If the tooth is dirty, simply have the patient remove all dirt with their own saliva.  Have the patient suck fairly hard on the tooth.  Be sure that the patient spits out blood and debris after each sucking action.  This removes dirt and will hopefully dislodge any clot that may have formed in the socket making it easier to reimplant the tooth.
  • You still must take the patient to a dentist, but the major emergency has been averted and there is less urgency associated with the emergency.
• If the tooth cannot be replaced in the socket (for any reason), then there are three ways to transport the tooth to the dentist’s office:
  • Have the patient remove dirt and debris by sucking on the tooth as above and then have the patient store the tooth in their own mouth in the pouch between the cheek and the top back teeth.  Transport the patient to a dentist ASAP.
    • This is NOT advisable if the child is under the age of six since the child may swallow the tooth.  If this is the case, proceed to the next two options.
  • Place the tooth is a cup of clean saline (salt water).  You may make saline by placingone and a half teaspoons of salt in four cups of clean water.  Tap water is acceptable, but bottled water may be cleaner if it is IMMEDIATELY available.  The saline has the advantage of acting to clean off the tooth.  Transport the tooth and patient to the dentist ASAP.
  • Place the tooth in a cup of fresh milk (any fat content).  This has nearly the same advantages as saline.  Transport the tooth and the patient to the dentist ASAP.
  • Most importantly, only handle the tooth by the crown and avoid touching the root of the tooth.

The tooth should ideally be splinted to the adjacent teeth by your dentist and the patient should avoid biting directly on this area. in the case of dummy-sucking children, please refrain from giving the child the pacifier to suck on as it perpetuates continuous movement and decreases the chances of success.

Salt water rinsing and gentle brushing with a super-soft brush help keep the inflamed gums healthier and keep infections at bay which would decrease chances of success.

The tooth will then need to be monitored and in most cases the damaged nerve will need to be treated.

Most importantly, remain calm so that your child isn’t freaked out more than they already are. The mouth and face bleed excessively, that is normal, but they heal equally fast to just hang in there.