Around a quarter of school children have suffered trauma to their permanent teeth. One of the most severe injuries is when a child’s tooth is knocked out or avulsed.
Would you know what to do if your child’s tooth is knocked out?
I’m guessing that you probably wouldn’t know what to do if your child’s tooth is knocked out. If you did have an idea you might not be confident to put the plan into action and I don’t blame you. If no one has taught you, how would you be expected to know?
Prevention is better than cure
No post on dental trauma would be complete without a plea to make sure your child has a well fitting mouthguard and that they wear it for all contact sports. Mouthguards can’t work in pockets. You can buy over the counter mouthguards which you heat and then bite into shape and these are adequate. However, if your child is playing lots of sports, especially those with high contact, then I would definitely recommend a custom made mouthguard which should cost in the region of £40. That said, I have treated patients who have avulsed teeth in playground collisions, in car accidents, at swimming pools, by falling off bikes and skidding on ice. We can’t always prevent dental trauma so here’s what to do if your child’s tooth is knocked out.
Time is of the essence
The sooner the tooth is back in the mouth the better. This is because the root of the tooth is covered in cells which we need to keep alive in order for the tooth to be able to reintegrate back into the mouth. Ideally an avulsed tooth should be replanted within 15 minutes of trauma. Now you see why I am writing this post! How many people could get to their dentist in that time?
How to replant an avulsed tooth
- Explain to your child gently, but firmly that the tooth needs to be put back into their mouth. Try to give them as much privacy as the situation allows.
- Pick up the tooth by the crown (this is the white bit that you would normally see in the mouth – not the pointy bit!).
- Do not touch the root of the tooth.
- Do not scrape or scrub the tooth.
- If there is obvious debris on the root, please gently rinse it quickly (10 seconds) with saline (salt water) or milk or if neither of the above are available, with cold water.
- Do not clean the tooth with alcohol.
- Firmly reposition the tooth into the socket. Use the adjacent teeth as a guide to work out which way round it goes. Try to get it as close to the level of the other teeth as possible.
- Ask your child to bite down on some damp gauze or a damp clean flannel or handkerchief to keep the tooth in place. A wet tea bag also works well.
- Give them a big hug 🙂
What to do if you cannot replant the tooth
If you cannot replant the tooth, ideally ask your child to keep it between their cheek and gum until you get to the dentist. If your child is too upset to do this, place the tooth in a clean container and cover with milk.
Get to your dentist
Ring your dentist to tell them that you are on your way and that your child’s tooth is knocked out. This way they can be ready for you on arrival. They might suggest that you go straight to your local hospital instead. If so, make sure you get a direct phone number. Ideally you should be aiming to access dental care within the hour.
When should a tooth not be replanted?
- Baby teeth are not usually replanted as this can cause damage to the permanent tooth underneath the gum.
- When the child has other injuries which are more severe and need treating first.
- When the child has a significant medical history which would put them at risk. This would include children receiving active chemotherapy, children with a transplanted organ and children with significant heart problems – if in doubt, please seek expert advice.
The International Association of Dental Traumatology has produced this poster which you can also download in different languages from their website.