What to Do If Your Child Chips a Tooth
Children are active, energetic and wonderfully fearless, which means dental injuries are a fairly regular occurrence in family life. A fall in the playground, a collision during sport or simply an unfortunate tumble at home can all result in a chipped, broken or knocked-out tooth. When it happens, parents often feel a rush of panic, unsure whether what they are looking at constitutes an emergency or something that can wait. Knowing what to do in those first crucial minutes can make a significant difference to the outcome, particularly for injuries involving adult teeth.
At Gorgie Road Dental Practice, our children’s dentist team sees dental trauma injuries regularly and is experienced in providing prompt, effective care for young patients following accidents. The most important thing to remember is that if you are in any doubt about the severity of an injury, call us straight away. We would always rather reassure a parent that all is well than have a significant injury go unaddressed.
Types of Dental Trauma in Children
Not all dental injuries are the same, and the appropriate response depends on the type and severity of the damage. The main types of dental trauma seen in children include:
- Chipped or fractured tooth: A piece of the tooth has broken off, ranging from a small cosmetic chip to a more significant fracture that exposes the inner layers of the tooth.
- Cracked tooth: A crack runs through part of the tooth. Cracks can range from surface crazing that requires no treatment to deep fractures that affect the root or pulp of the tooth.
- Luxated tooth: The tooth has been displaced in its socket, either pushed inward, pushed outward, tilted or partially out of position, but is still attached.
- Avulsed tooth: The tooth has been completely knocked out of the socket. This is the most time-sensitive dental emergency.
- Intrusion: The tooth has been pushed up into the jawbone, which can look as though the tooth has disappeared or become shorter.
- Root fracture: The root of the tooth is fractured, which may not be visible without an X-ray.
Immediate Steps to Take When Your Child Chips a Tooth
NHS Inform Scotland provides clear guidance on managing dental injuries: if a tooth is chipped, contact your dentist to arrange an appointment. A small chip is not usually a dental emergency, but it should be seen within a day or two to assess whether any treatment is needed and to smooth any sharp edges that might irritate the tongue, lips or cheeks.
If a larger piece of tooth has broken off, try to find the fragment. Put it in milk or a small container of saliva and bring it with you to the dental appointment. In some cases, the dentist may be able to bond the original fragment back onto the tooth, which produces the best possible cosmetic result. Even if reattachment is not possible, having the fragment can be helpful for matching the colour and shape of any restoration.
Rinse your child’s mouth gently with water to clean the area. If there is any pain, appropriate children’s pain relief, such as paracetamol or ibuprofen given according to the manufacturer’s instructions, can help manage discomfort until the appointment. Applying a cold compress to the outside of the face can also help reduce swelling if the injury involved impact to the lips or cheeks as well as the tooth.
What to Do If a Tooth Is Knocked Out Completely
A completely knocked-out permanent tooth is a dental emergency. The speed with which you act has a direct bearing on whether the tooth can be successfully reimplanted. Follow these steps immediately:
- Find the tooth and pick it up by the crown (the white part), not the root.
- If the tooth is dirty, rinse it gently with milk or clean water for no more than ten seconds. Do not scrub it or use soap.
- If possible, place the tooth back into the socket immediately. Hold it gently in position and ask your child to bite down on a clean cloth to keep it in place. Do not force it if it does not go back easily.
- If you cannot reinsert the tooth, place it in a small container of cold milk. Milk is the best short-term storage medium for an avulsed tooth. If milk is not available, ask your child to hold the tooth inside their cheek (only if they are old enough not to swallow it), or use the patient’s own saliva in a container.
- Get to a dentist immediately. Time is critical; ideally the tooth should be reimplanted within 30 minutes for the best chance of survival.
It is important to note that this guidance applies only to permanent adult teeth. A knocked-out baby tooth should never be reimplanted, as doing so can damage the developing adult tooth underneath. If your young child loses a baby tooth due to trauma, call your dentist for advice, but do not attempt to put the tooth back.
Quick Reference Guide: Dental Trauma in Children
| Type of Injury | Baby Tooth | Adult Tooth | Urgency |
|---|---|---|---|
| Small chip, no pain | Dental appointment within a few days | Dental appointment within a few days | Non-urgent |
| Large chip or fracture | Same-day or next-day dental appointment | Same-day dental appointment | Urgent |
| Tooth displaced (still in socket) | Same-day dental appointment | Same-day dental appointment | Urgent |
| Tooth knocked out completely | Do not reimplant; call dentist for advice | Emergency – aim to reimplant and see dentist within 30 minutes | Emergency |
| Tooth pushed into gum (intrusion) | Same-day dental appointment | Same-day dental appointment | Urgent |
After the Initial Treatment: What to Expect
Following dental trauma, there will usually be a period of monitoring to assess how the tooth responds over the coming days, weeks and months. Some traumatised teeth remain perfectly healthy; others may show signs of complications over time, including discolouration, infection or changes to the root. NHS guidance for children who have had dental injuries advises eating soft foods for approximately one week following the incident and brushing very gently with a soft toothbrush to keep the area clean.
Your dentist may take X-rays at follow-up appointments to check the root and surrounding bone are healing well. In baby teeth, the main concern following trauma is whether the injury affects the developing adult tooth beneath. Sometimes a traumatised baby tooth will discolour, which can be alarming but is not always a sign of a problem. Your dentist will keep a close eye on any discoloured tooth and advise you if any treatment is needed.
For older children with adult teeth, the monitoring period is particularly important. If the nerve of a traumatised tooth dies, root canal treatment may be needed to prevent infection from spreading. Catching this early through regular monitoring appointments is much better than waiting for symptoms to develop.
Preventing Dental Injuries in Active Children
While accidents cannot always be avoided, some dental injuries are preventable with the right protective measures. Custom-fitted mouthguards, made by your dentist, offer significantly better protection than over-the-counter versions and are comfortable enough for children to wear consistently. Any child who participates in contact sports, martial arts, rugby, hockey or similar activities should be wearing a mouthguard, and ideally one that has been professionally fitted.
Helmets with face guards, where appropriate to the sport, also provide vital protection. For cycling, skateboarding and similar activities, a well-fitted helmet reduces the risk of facial injuries. Teaching children about the importance of this protective equipment, rather than simply insisting they wear it, makes them more likely to comply as they get older and more independent.
We Are Here When You Need Us
If your child has had a dental injury or you have questions about how to protect their teeth during sport and play, our team is ready to help. We deal with dental trauma in children regularly and understand both the clinical and emotional aspects of managing these situations. We also provide custom mouthguards to help prevent injuries in the first place. Please do not hesitate to call us if you are unsure whether your child’s injury needs to be seen urgently. Contact Gorgie Road Dental Practice on 0131 337 3936 and we will do everything we can to help.