Can You Handle A Dental Emergency?
Pediatric dentist and AAPD national spokesperson Dr. Bruce Weiner weighs in on oral injuries during the toddling years and beyond
The toddling years: a thrilling time for the child and the parent, although in vastly different ways. For toddlers, it’s all about exploration; learning to crawl and walk and being on the move as much as possible. For parents, though, it’s often a fine line between celebrating their child’s accomplishments one minute, and fretting over their safety the next.
As children begin to walk, they become more susceptible to accidents. It’s all part of the process of growing up, of course, but falling or bumping into hard objects can damage their new little teeth. If left untreated, dental injuries that result from these “misadventures” can lead to infection – in both the mouth and other places like the ears, sinuses and brain – loss of teeth and, ultimately, costly dental restorative treatment. That’s why it’s so important to have a plan in place and a Dental Home – or home base – established for your child’s dental needs. Plus, children who have already visited a pediatric dentist will perceive the dental office as a friendly place, and they might be calmer and less afraid in the event of a dental emergency.
What is a dental emergency – and what should you do?
A dental emergency can be any traumatic injury to the mouth that results in significant bleeding. The first thing I tell parents is that in the event of any dental issue, emergency or not, they can always call their pediatric dentist. If there is bleeding, significant pain, swelling or fever – or simply doubt about whether or not their child needs immediate treatment – just pick up the phone.
In today’s smartphone-enabled world, we’ll often ask parents to take a picture of the injury and text it to us. That way, we can determine the extent of the damage and answer any questions they might have prior to their visit.
I also recommend printing out this checklist and posting it somewhere visible – like on the fridge or pinned to a bulletin board. That way, you or anyone else who might be taking care of your child can make a quick, informed decision about what to do.
As a pediatric dentist, I’ve seen all kinds of dental injuries – but most involve a child chipping his or her teeth or entirely knocking out a tooth. In these situations, there are different protocols to follow depending on whether or not the affected tooth is a baby tooth or a permanent tooth.
For an injury that has resulted in a chipped front tooth – baby or permanent – rinse the child’s mouth with water if there is bleeding and apply a cold compress to the lip to minimize bleeding and reduce swelling. Save any tooth fragments you’re able to find and bring them with you to the pediatric dentist. If the chipped tooth was a permanent front tooth, the broken fragment (which should be kept in water) might be bonded in place for the most ideal cosmetic repair. If the tooth fragment can’t be found, there are many other cosmetic bonding options.
If toddlers displace, or knock out, one or more of their baby four front teeth, the dentist may be able to reposition those teeth to minimize the chances of premature tooth loss. Displaced teeth will need to be monitored periodically for signs of infection that might affect the developing permanent teeth.
In the case of a knocked out permanent tooth, the best alternative is to replant the tooth immediately back into the socket – the less time the tooth is out of place, the better. Hold the tooth by the crown (the white part) and, if it is dirty, wash it briefly in cold water (close the drain in the sink!). Then, put the tooth into the socket and have your child hold it in place by biting on a piece of gauze. If you’re unable to replant the tooth, store it in cold milk on the way to the pediatric dentist. This will help give the tooth the best opportunity for reattachment.
If your child experiences any kind of dental emergency, remain as calm as possible to lessen his or her anxiety. Children take their emotional cues from the adults around them – so a calm demeanor is always helpful. The primary concern in these cases is to control the bleeding, which can be done with clean, wet gauze or a washcloth.
Act fast – and remember, your pediatric dentist is a phone call away!
Dental emergencies can be scary, but acting quickly can potentially save a tooth, prevent infection and reduce the need for extensive dental treatment down the road – so never hesitate to call your pediatric dentist if you don’t know what to do. Remember: a child with a healthy mouth will have an easier time eating, speaking, sleeping, playing, going to school, paying attention in class and all the other things that make growing up such a wonderful time.
Bruce H. Weiner, D.D.S., AAPD National Spokesperson
Dr. Bruce H. Weiner is a pediatric dentist at Fort Worth Pediatric Dentistry in Fort Worth, Texas. He graduated from the Virginia Military Institute in 1967 and the University of Maryland School of Dentistry in 1971. Dr. Weiner served as an Air Force dental officer in Germany from 1971 to 1975 before completing a two-year Pediatric Dental Residency at the University of Maryland and Johns Hopkins University. Dr. Weiner is a Board Certified Diplomate of the American Board of Pediatric Dentistry and serves on the Continuing Education Committee and the Board of Directors for the AAPD. He has taught at Baylor College of Dentistry and has given local, national and international presentations for dental and medical groups.