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Emergency Dental Care for Urgent Needs
Dental injuries and emergencies are common and can be distressing for children and parents. Approximately one-third of children will experience some form of dental trauma, with many more facing a dental emergency. The risk of dental trauma is highest during toddlerhood (18-40 months) and the preadolescent/adolescent years, when sports-related injuries are more common. Below is a summary of common dental emergencies in children and tips on how to manage them.
Toothache
Toothaches are a frequent issue for children of all ages and are typically caused by various factors. For younger children, discomfort can be caused by food particles stuck between teeth, which can usually be alleviated by using a toothbrush, clean finger, or dental floss. If the pain persists, it is crucial to seek help from a pediatric dentist. Toothaches can be caused by tooth fractures, cavities, dental injuries, and the emergence of wisdom teeth during adolescence.
How you can assist:
- Rinse the affected area with warm water. Avoid using medication or heat on the affected tooth or surrounding gums.
- Check for any trapped food and remove it if necessary.
- Apply a cold compress to the affected area to help decrease swelling.
- Contact the pediatric dentist for additional guidance.
Dental Avulsion (Knocked-out Tooth)
In the event that a child's tooth is completely knocked out, it is important to contact the pediatric dentist immediately. While pediatric dentists typically do not reimplant avulsed primary (baby) teeth due to the risk of damaging the tooth bud and impacting the development of the permanent tooth, they will make every effort to reimplant avulsed permanent teeth unless irreversible damage has occurred. Reimplantation is most successful when done within one hour of the avulsion, so quick action is essential!
How you can assist:
- Retrieve the tooth. Avoid touching the tooth roots! Handle only the crown.
- Rinse off any dirt or debris with water, without scrubbing or scraping the tooth.
- For older children, gently insert the tooth back into its original socket or have the child place it in their cheek pouch. For younger children, immerse the tooth in a glass of milk or saliva (do not attempt to reinsert it to prevent the risk of swallowing).
- Ensure the tooth does not dry out during transport. Moisture is crucial for the success of reimplantation.
- Visit the pediatric dentist as soon as possible or take the child to the Emergency Room immediately – time is critical to saving the tooth.
Dental Intrusion (Tooth Pushed Into Jawbone)
In some instances, dental trauma can cause a tooth (or multiple teeth) to be pushed upwards into the jawbone. The prognosis is generally better for teeth that have been displaced by less than 3mm, but each situation is unique. The force of the trauma can often be strong enough to harm the tooth's ligament and result in a fracture in its socket.
If there is a suspicion of dental intrusion in primary or permanent teeth, it is crucial to contact a pediatric dentist right away. Depending on the seriousness and depth of the intrusion, the dentist may choose to either let the tooth naturally move back into place or perform root canal therapy to help preserve the tooth's integrity.
How you can assist:
- Cleanse the child's mouth with cold water.
- Apply ice packs to the affected areas to help reduce swelling.
- Give Tylenol for pain relief.
- Contact the pediatric dentist if possible, or go to the Emergency Room.
Tooth Luxation/extrusion/lateral Displacement (Tooth Displacement)
Tooth displacement can be classified as luxation, extrusion, or lateral displacement depending on the tooth's position after injury. A luxated tooth may stay in its socket with the pulp intact half of the time, but it is often at an abnormal angle and may cause fractures in the jawbone. Extrusion occurs when a tooth is partially dislodged from its socket, and while primary tooth extrusions in children may heal on their own, permanent teeth require dental treatment to prevent infection and preserve the tooth. If tooth displacement is suspected, it is important to seek immediate care from a pediatric dentist.
How you can assist:
- Apply a cold, damp compress to the affected area.
- Provide pain relief (such as Children’s Tylenol).
- Reach out to the pediatric dentist right away.
Crown Fracture
The crown of the tooth is the largest and most visible part, making it susceptible to trauma. From minor enamel cracks to exposed pulp, crown fractures can vary in severity. It is crucial to seek immediate attention if the pulp is exposed.
A pediatric dentist can determine the extent of the fracture through dental X-rays. Changes in the tooth's color, like pink or yellow hues, are warning signs of a serious issue. Minor fractures may be treated with a dental sealant, while more severe cases may require pulp treatments. Contacting the pediatric dentist is essential in the event of a crown fracture to prevent irritation and inflammation of the soft tissues in the mouth, which could lead to infection.
How you can assist:
- Rinse the child's mouth with warm water.
- Apply a cold, damp compress to the affected area.
- Administer strong pain relief (such as Children’s Tylenol).
- Pack the tooth with a biocompatible material.
- Visit the pediatric dentist or Emergency Room based on availability and the severity of the injury.
Root Fracture
If a root fracture is suspected, dental X-rays are necessary for diagnosis as it is not visible to the naked eye. The tooth may be monitored, treated, or extracted depending on the location of the fracture and the child's discomfort resulting from direct trauma.
How you can assist:
- Apply a cold, damp compress to the affected area.
- Provide pain relief (such as Children’s Tylenol).
- Reach out to the pediatric dentist.
Dental Concussion
When a tooth has been impacted but not dislodged or fractured, it is known as being "concussed." This is most frequently seen in toddlers and can result in temporary or permanent discoloration of the tooth. Emergency treatment is typically not necessary unless the tooth turns black or dark, which may indicate the need for root canal therapy.
Injured Cheek, Lip or Tongue
In case of a child's cheek, lip, or tongue bleeding from a cut or bite, apply firm pressure with a clean cloth or gauze. Use ice to reduce swelling. If bleeding persists, seek immediate medical attention at the Emergency Room or contact a healthcare professional.
Fractured Jaw
If you suspect a broken or fractured jaw, please seek immediate medical attention at the Emergency Room. In the meantime, instruct the child to refrain from moving their jaw. For a young child, carefully secure a scarf around their head and jaw to restrict movement.
Head Injury/head Trauma
If a child has experienced head trauma, it is important to go to the Emergency Room right away. Even if they have not lost consciousness, it is essential for pediatric doctors to evaluate for possible delayed concussion or internal bleeding.
