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Child Mouth Injuries: What To Do?

By Lone Tree Pediatric Dentistry - May 28, 2021

As a parent myself I know how scary it can be to see my children fall and injure their mouth, and I’m their dentist!  These incidents are not pretty.  The child is panicked, the parent is panicked, and we learn quickly that head and mouth injuries tend to bleed A LOT.  On top of all of this we can’t see the source of the injury.   Did they lose a tooth?  Is it their lip?  Did they bite their tongue?  Oh no, what if they permanently damaged their teeth and their smile, forever?!  When your child needs urgent dental treatment, I am here to help.  However, it is nice to know what needs to be done after the panicked feeling subsides.

The most common dental trauma scenarios and/or questions I address, often after office hours or on the weekends, are:   

My child bumped their mouth into their friend’s head and they are bleeding.  Do I need to go to the ER?

More than likely you do not.  Calmly have your child rinse their mouth with water so you can see what is going on.  I always have my patient’s parent’s text me a photo so I can provide better guidance and, if needed, a trip to the dental office.  The impact may loosen the tooth but that doesn’t always mean the tooth is damaged.  Loosening of the tooth is often accompanied by bleeding along the gumline and mobility of the tooth.  After a short time, we hope it will go back into place and we will elect to monitor the tooth until the adult tooth takes its place. 

My child’s baby tooth is knocked out?  Is this okay since it is not an adult/permanent tooth?

Similar to the approach above, I recommend my patients call me as soon as possible.  A baby tooth should not be replanted (or put back in the child’s gums) because of the potential damage or subsequent damage to the developing adult/permanent tooth.  An x-ray will help decipher next steps.  But baby teeth are just as important as adult teeth.  They pave the way for the eruption of a healthy adult tooth.  Without them the adult tooth doesn’t know where to go.  Also, if a baby tooth has a cavity, this may lead to a greater chance of developing cavities in adult teeth.  In other words, healthy baby teeth are very important! 

My child’s permanent tooth is knocked out, what should I do?

This is very different from dealing with a baby tooth.  You need to find the tooth and rinse it gently with water and only water!  There is no need to clean it with soap and do not scrub the tooth.  If possible, though it’s not for the faint of heart, replace the tooth in the socket/gums immediately.  You can hold the tooth in place with clean gauze or a washcloth.  If putting the tooth back in the socket is not an option, place the tooth in a clean container with cold milk or saliva (preferably the patient’s saliva).  Call your pediatric dental office immediately.  These steps, if acted upon instantly, will increase the chances of saving the tooth. 

I think my child chipped or fractured their tooth?

Again, contacting your pediatric dentist immediately is step one.  The faster you act the better chance of saving the tooth, preventing infection and/or reducing the need for extensive dental treatment.  If you can find the broken tooth fragment, place it in cold milk and bring it in with you to your pediatric dental office.  If the lip, or any other part of the mouth is injured, rinse the mouth with water and apply cold compresses to reduce swelling.  

What do I do if my child has a toothache from their injury?

Check in with your pediatric dentist and visit the office if the pain persists.  Your pediatric dentist will more than likely recommend over-the-counter children’s pain medication to ease symptoms.  You may also want to apply a cold compress or ice wrapped in a cloth directly on the site of pain.   It is not advised to put heat or aspirin on the sore area.  Aspirin is not recommended with kids and heat may increase, not decrease, swelling or inflammation.

Children will be children and there is no way to prevent them from falling or foreseeing an accident.  But there are ways to reduce risk for severe oral injury in sports by wearing protective gear such as a mouthguard.  Taking your child to regular dental check-ups provides your pediatric dentist the opportunity to discuss additional age-appropriate preventive strategies like always using a car seat for young children, child-proofing your home to prevent falls, and the use of mouthguards and helmets.  The head must be protected as much as possible.  Whether your child is going skiing, playing their favorite sport, or going for a quick bike ride, helmets are always recommended.  One of my first questions when my patient’s parent tells me their child hit their head or jaw is “were they responsive soon after impact?  Do they seem like themselves?  Do you think they suffered a concussion?”  A severe head injury can be life threatening and if you think this happened to your child they will need immediate medical attention.  This would be the time when you don’t call me, or your pediatric dentist, first but 911.  

This is a lot to take in!  I hope you are reading this as a preventive measure, in a calm state, rather than you quickly googled, “what to do when your kid hits their mouth?”  Either way I hope this helps alleviate some of your parenting stress and gives you a plan of action. 

Until next time, keep your kids smiling!

Dr. Nick