By Dr. Cindy Weideman
Edited by Amy Crelly

When a baby tooth falls out, you know what to do—the Tooth Fairy takes care of it, and all is well. But what do you do when your little super-hero comes screaming into the kitchen, makeshift cape streaming behind him, with blood gushing down his chin and a permanent tooth outstretched in his gory little palm? Even Wonder Woman might panic! Trauma to the teeth or mouth can be scary stuff, but knowing how to handle the situation makes coming to his rescue a whole lot easier.

When a tooth is knocked out, the American Association of Endodontists recommends the following steps:
Get treatment—FAST! Getting treatment from an endodontist (a root-canal specialist) within 30 minutes of the injury dramatically improves your chances of saving the tooth. The sooner your child is treated, the better.
Pick up the tooth by the chewing surface, not the root. Avoid handling the root to minimize injury to the tooth.
If the tooth is dirty, gently rinse it with water. Do not use soap or chemicals or scrub the tooth, and do not dry it by wrapping it in cloth or a tissue.
Reposition the tooth in the socket, if possible. Carefully push the tooth into the socket and hold it in place.
Keep the tooth moist. If the tooth cannot be replaced in the socket, place it in a glass of milk or in the mouth next to the cheek. If these options are not practical, use water with a pinch of salt.

The most common causes of injury to teeth include bicycle and scooter accidents, trampoline mishaps and slipping in the bathtub. I can’t stand trampolines! I have seen countless patients after trampoline accidents: a tooth gets pushed into the knee while jumping, or knocked loose by another child’s head; a tooth gets stuck in the net while a child is jumping or the child falls off the edge and hits his teeth on the side of the trampoline. (Did I mention I really don’t like trampolines?)
If your child falls and you see blood oozing from around a tooth or it has loosened, you should gently clean the area then put an ice pack on any swollen areas of the mouth or face. If it is a permanent tooth, you need to get to the dentist right away so she can reposition or stabilize it in the mouth as soon as possible. If the injury is to a baby tooth, do not attempt to reposition it as you may damage the developing permanent tooth growing under it. Have your child eat very soft foods or liquids until you can get to the dentist.
When your child fractures a tooth, it can be repaired using a composite bonding technique to make it look natural again. But the broken tooth will need to be monitored by the dentist. Badly injured teeth have reduced blood supply to them and sometimes become infected. These teeth often need root canals to be kept healthy.
When a permanent tooth is lost, contact the dentist immediately. Time is a critical factor in saving a permanent tooth. Find the tooth and gently rinse off any dirt with room temperature water. Hold the tooth with the crown, not the root, and do not scrub it. Place the tooth in the socket if you can and have the child hold the tooth in place. If you are not able to reinsert the tooth, put it in a cup with milk or water and bring it to the dentist. If you do not have milk or water, have the person hold the tooth under their tongue to keep it moist.

Here’s a tip!
If you have a toddler in your house and want to prevent coffee table collisions, consider swapping your coffee table for a soft round fabric foot stool.

About The Author
Dr. Cindy Weideman is a board certified Pediatric Dentist and First 5 Sacramento Commissioner. She has practiced in the Sacramento area for 19 years. She has advanced training in child psychology, developmental disabilities and infant oral health.
Dr. Weideman’s office is located in Citrus Heights, and she has just recently opened a new office in the Rocklin/Roseville area. For more great advice, visit her online: www.sacchildrensdentist.com