A fall or a knock to the mouth can be frightening for any parent. Knowing which baby teeth injuries need prompt attention, and which can wait for a routine visit, helps you act calmly and get your child the right care.

What to do straight after a knock to a baby tooth

Check your child before you look at the tooth. If they have lost consciousness, are vomiting, seem unusually drowsy, have trouble breathing, have uncontrolled bleeding from the mouth, or you suspect a head injury, call 000 immediately. A baby tooth is never worth delaying emergency medical care.

If your child is alert and behaving normally, turn your attention to the mouth. For a kids dental emergency in Box Hill, the general rule is to call the dentist the same day if a baby tooth has been knocked out completely, pushed up into the gum, is very loose, is broken, or your child is in pain. A small chip with no pain and no bleeding can usually wait for a prompt appointment in the next few days.

Young children often cannot explain what hurts. Watch for refusal to eat, crying when drinking cold water, or repeatedly touching the mouth. These are reasons to call Bright Start Dental on (03) 9003 0608 during opening hours, Monday to Saturday 8:30am to 5:00pm.

Knocked-out baby tooth: never put it back

If a baby tooth has come all the way out, do not try to reinsert it. Pushing a baby tooth back into the socket can injure the developing adult tooth underneath. That adult tooth may not appear for several years, so damage now can cause problems later.

Instead, pick the tooth up by the crown, not the root, and rinse it gently under cold water. Keep it in a clean container and bring it to the appointment so the dentist can see which tooth was lost and check the surrounding gum.

Control any bleeding by having your child bite on a piece of clean gauze or a clean cloth until it stops. A cold compress wrapped in a tea towel against the lip or cheek can ease swelling. Ask a pharmacist about pain relief suitable for your child’s age.

• Do not replant a baby tooth — it can harm the adult tooth beneath.
• Keep the tooth and bring it to the dentist.
• Use gentle pressure with gauze for bleeding.

Tooth pushed up into the gum or moved sideways

Sometimes a baby tooth is driven upwards into the gum so it looks shorter or disappears. Other times it is pushed sideways or backwards. Do not try to pull it down or straighten it yourself. This is one of the situations where you should call the dentist the same day.

The dentist will assess whether the tooth has damaged the gum or the adult tooth bud. In some cases the tooth is left to settle. In others it may need to be removed. An X-ray may be needed to see the position of the adult tooth underneath.

If the tooth is very loose but still in place, avoid wiggling it. Give soft foods and keep the area clean with a warm salt water rinse if your child is old enough to spit it out without swallowing.

Chipped, broken or grey baby teeth

A small chip with no pain can often wait for an appointment in the next few days. Save any broken pieces and bring them with you. Rinse the mouth with warm salt water if your child can do so safely. A cold compress on the outside of the lip or cheek helps with swelling.

A larger break, a piece of tooth that cuts the tongue or lip, or pain when eating or drinking means you should call the dentist the same day. The dentist may smooth the sharp edge or place a temporary repair to protect the tooth until it can be properly restored.

Weeks or months after a knock, a baby tooth may turn grey or dark. This happens when blood collects inside the tooth. It does not always mean the tooth is dead, but it should be checked. Tell your dentist at the next visit so the tooth can be monitored. Sometimes a grey baby tooth is fine and simply needs watching. Other times it becomes infected and needs treatment or removal.

• Save broken pieces and bring them to the appointment.
• Use warm salt water rinses if your child can spit.
• A cold compress helps swelling.
• Report any colour change at the next check-up.

Cut lip, gum or tongue

Cuts inside the mouth bleed heavily because the area has a rich blood supply. Stay calm. Press clean gauze or a clean cloth gently on the cut. If bleeding doesn’t stop with steady pressure, or if the cut is deep and gaping, seek medical help at an emergency department.

For a minor cut, offer cold foods like yoghurt or ice blocks to soothe the area. Avoid salty or spicy foods for a day or two. Keep the mouth clean with warm salt water rinses after meals if your child is able to use them.

If a baby tooth is broken and the sharp edge is cutting the lip or tongue, call the dentist. A smooth edge can be applied to stop further injury.

When to call the dentist: a quick guide

Use this table as a guide. It does not replace a proper examination. When in doubt, call Bright Start Dental on (03) 9003 0608. The clinic offers children’s dentistry and emergency dental care, and eligible children may be covered under the Child Dental Benefits Schedule.

Preventing baby tooth injuries in Box Hill toddlers

Many knocks happen at home. Toddlers are top-heavy and unsteady. Supervise them on furniture, especially when they are climbing or jumping. Use safety gates on stairs. Keep coffee tables and other hard edges clear of toys that encourage climbing.

For older children playing sport, a mouthguard protects both baby and adult teeth. A custom-fitted mouthguard from your dentist fits better than a boil-and-bite type from a shop. Bright Start Dental can discuss mouthguards at a routine check-up.

Regular dental visits help your child become comfortable with the dentist, so if an injury does happen they are more likely to cooperate. Bright Start Dental is at Suite 2.02, 9 Prospect St, Box Hill VIC 3128, open Monday to Saturday 8:30am to 5:00pm and closed Sunday. Online booking is available.

This article by Bright Start Dental is general information only and not a substitute for personalised dental advice. Please book a consultation for advice specific to you.