Child Dental Emergency: What Parents Should Do

If your child hurts a tooth, first check for a head injury, then stop any bleeding with gentle pressure on a clean cloth. Never put a knocked-out baby tooth back in, but do try to replant a knocked-out adult tooth right away, or keep it in milk. Go to the ER for a head injury, heavy bleeding, or facial swelling with fever; call a dentist for everything else.

Dental injuries are common in children, especially toddlers learning to walk and school-age kids playing sports. What to do depends on one key question: is it a baby tooth or an adult tooth?

Is it a Baby Tooth or an Adult Tooth?

As a rough guide, the front teeth of a child under 6 are almost always baby (primary) teeth. Adult front teeth usually come in between about ages 6 and 8. Adult teeth are larger and often have slightly ridged edges when new. If you're not sure, treat it as an adult tooth and call a dentist right away.

What to Do for Common Child Dental Emergencies

Why You Should Never Put a Baby Tooth Back In

The adult tooth is developing right under the baby tooth. Pushing a baby tooth back into the socket can damage that adult tooth. Dental trauma experts, including the International Association of Dental Traumatology, advise against replanting baby teeth. Keep the tooth anyway so the dentist can confirm it came out whole.

When to Go to the ER

Go to the ER, or call 911, if your child has:

• A head injury, especially with vomiting, drowsiness, confusion, or loss of consciousness
• Bleeding that doesn't stop after 10–15 minutes of firm pressure
• Facial swelling with fever, or swelling near the eye or under the jaw
• Trouble breathing or swallowing
• A possible broken jaw: the teeth don't meet normally, or the mouth won't open or close

Safe Pain Relief for Children

• Use children's acetaminophen or ibuprofen dosed for your child's age and weight, following the label or your pediatrician's advice.
• Never give aspirin to children or teenagers. It's linked to Reye's syndrome, a rare but serious illness.
• Don't use numbing gels containing benzocaine in children under 2. The FDA warns they can cause a rare but dangerous blood condition called methemoglobinemia.
• A cold compress on the outside of the face for 15–20 minutes can ease swelling after an injury.

Watch for Changes After a Tooth Injury

Even if a tooth seems fine, call a dentist if, in the following days or weeks, it turns gray or dark, the gum near it develops a bump or pimple, or your child has new pain or swelling. These can be signs the nerve has been damaged, or an infection is developing.

How a Virtual Dentist Can Help

When your child is hurt at night or on a weekend, it's hard to know if it can wait. A licensed dentist from Teledentistry.com can look at the injury over video and help you decide whether you need the ER, an urgent in-person dentist, or a regular appointment. They can also walk you through first aid, including how to store an adult tooth. Talk to a dentist now.