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Emergency Dental Care for Urgent Needs
Dental injuries and emergencies are frequent occurrences that can be upsetting for both children and parents. Around one-third of children will encounter some type of dental trauma, with even more experiencing a dental emergency. The likelihood of dental trauma is greatest during toddlerhood (18-40 months) and the preadolescent/adolescent years, particularly during sports-related activities. Here is an overview of common dental emergencies in children and advice on how to handle them.
Toothache
Toothaches are common for children of all ages and can be caused by a variety of factors. For younger children, discomfort may be due to food particles stuck between teeth, which can often be relieved by brushing, using a clean finger, or flossing. If the pain continues, it is important to see a pediatric dentist. Toothaches can also be caused by tooth fractures, cavities, dental injuries, and the eruption 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 immediately get in touch with the pediatric dentist. Although pediatric dentists typically do not reimplant avulsed primary (baby) teeth to prevent harm to the tooth bud and impact on the permanent tooth's development, they will attempt to reimplant avulsed permanent teeth unless irreversible damage has taken place. Reimplantation is most successful when performed within one hour of the avulsion, so prompt action is crucial!
How you can assist:
- Remove the tooth carefully, avoiding contact with the roots. Only touch the crown of the tooth.
- Clean the tooth with water to remove any dirt or debris, without scrubbing or scraping.
- For older children, gently place the tooth back in its socket or have them hold it in their cheek. For younger children, store the tooth in milk or saliva to prevent swallowing.
- Keep the tooth moist during transportation, as moisture is essential for successful reimplantation.
- Seek immediate dental or medical attention to save the tooth, as time is of the essence.
Dental Intrusion (Tooth Pushed Into Jawbone)
Dental trauma can sometimes cause a tooth to be pushed upwards into the jawbone. The prognosis is typically better for teeth displaced by less than 3mm, but each case is unique. The force of the trauma can damage the tooth's ligament and cause a fracture in its socket.
If there is a concern about dental intrusion in primary or permanent teeth, it is important to contact a pediatric dentist immediately. Depending on the severity and depth of the intrusion, the dentist may opt to allow the tooth to naturally reposition itself or perform root canal therapy to protect the tooth's integrity.
How you can assist:
- Rinse the child's mouth with cold water.
- Use ice packs on the affected areas to reduce swelling.
- Administer Tylenol for pain relief.
- If possible, reach out to the pediatric dentist or head to the Emergency Room.
Tooth Luxation/extrusion/lateral Displacement (Tooth Displacement)
Tooth displacement can be categorized as luxation, extrusion, or lateral displacement based on the tooth's position following an injury. A luxated tooth may remain in its socket with the pulp intact half of the time, but it is typically at an abnormal angle and can lead to jawbone fractures. Extrusion happens when a tooth is partially knocked out of its socket, and while primary tooth extrusions in children may heal naturally, permanent teeth need dental intervention to avoid infection and save the tooth. If tooth displacement is suspected, it is crucial to promptly seek 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 a tooth is the largest and most visible part, making it vulnerable to injury. From small cracks in the enamel to exposed pulp, crown fractures can vary in seriousness. It is important to seek immediate attention if the pulp is exposed.
A pediatric dentist can assess the extent of the fracture using dental X-rays. Changes in the color of the tooth, such as pink or yellow hues, are signs of a potentially serious problem. Minor fractures may be treated with a dental sealant, while more severe cases may require pulp treatments. It is crucial to contact the pediatric dentist if a crown fracture occurs 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 there is suspicion of a root fracture, dental X-rays are required for diagnosis since it cannot be seen with the naked eye. Depending on the location of the fracture and the child's discomfort from direct trauma, the tooth may be monitored, treated, or extracted.
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
If a tooth is impacted but not dislodged or fractured, it is referred to as being "concussed." This is commonly seen in young children and can lead to temporary or permanent discoloration of the tooth. Emergency treatment is usually not needed unless the tooth changes color to black or dark, which may suggest the need for root canal therapy.
Injured Cheek, Lip or Tongue
If a child's cheek, lip, or tongue is bleeding from a cut or bite, apply firm pressure with a clean cloth or gauze. Use ice to reduce swelling. If bleeding continues, seek immediate medical attention at the Emergency Room or contact a healthcare professional.
Fractured Jaw
If you think a jaw is broken or fractured, please go to the Emergency Room right away. In the meantime, tell the child not to move their jaw. For a young child, gently tie a scarf around their head and jaw to limit movement.
Head Injury/head Trauma
Taking a child to the Emergency Room right away is essential if they have experienced head trauma, even if they have not lost consciousness. Pediatric doctors must evaluate for possible delayed concussion or internal bleeding.
