Teeth - What to do if a child knocks out their adult front tooth

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

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How can it happen?

Even a gentle knock can make a tooth fall out. Front teeth often take the full impact of a knock or bump. The upper front permanent (adult) teeth are the most likely of all teeth in children to be knocked right out. This is usually due to accidents.

Is it common?

A quarter of all 15 year olds have had some type of injury to their front teeth. Not all accidents result in complete loss of the tooth, but still a significant number do.

Can the tooth be saved?

If it is a baby tooth (if your child is under the age of five) then it usually won't be replanted. If it is a second (permanent) tooth, then saving it is very important.

What should I do when it happens?

  •  First, check that your child does not have any other injuries.

  •  If your child seems seriously hurt , call an ambulance.

  • Find the tooth/teeth and if dirty, gently rinse in milk or saline (or water as a last resort), holding the crown of the tooth. Do not scrub the root.
  • Put the tooth straight back into place in the mouth.
  •  If you cannot put the tooth in place in the mouth, put the tooth straight into a glass of milk, not water. 
  • See a dentist or go to the nearest hospital as soon as possible - even if you cannot find the tooth.

What will the dentist do?

The dentist will take a full medical history - including your child's tetanus status. The dentist will clean your child's mouth and try to put the tooth back in to the right place in the mouth. The dentist will have to place a "splint" on to the tooth (like a plaster on a broken arm) to keep the tooth in place. This will usually stay on for two weeks and its placement is a simple procedure. Your child may be given antibiotics (and a tetanus booster if needed).

What do I do then?

You need to make sure that your child keeps their mouth very clean by gently brushing the teeth and using a mouthwash (warm salt water will do, 

or a commercial brand recommended by your dentist). Within two weeks, you should return to your dentist and they will decide whether to take the splint off.

What are the possible problems with putting a tooth back in?

Your child's body may fail to recognise its own tooth when it is put back and so it may "reject" it. This rejection means that the body dissolves the root. This is more likely for a tooth that stays longer out of the mouth before being replanted. Rejection can be minimised by some forms of "root canal treatment", which your dentist will explain to you. It is important to continue to see your dentist very regularly to check the health of the replanted tooth.

Can I prevent this happening?

Every child should wear a mouth guard for all contact sports. Mouthguards should also be considered for riding scooters, bikes and skateboards, just as helmets are needed for these activities.

If your child has front teeth that stick out, you may consider seeing an orthodontist, as these teeth are more often damaged in accidents. 

Remember:

Always try to save a front tooth that has been knocked out.

  • After rinsing carefully, put the tooth straight back in place in the mouth.
  • If you cannot place the tooth back in the mouth, put the tooth in a glass of milk.
  • Your child should wear a mouth guard for all contact sports. 
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The Children's Hospital at Westmead
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Sydney Children's Hospital, Randwick
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Hunter New England Kids Health
www.hnekidshealth.nsw.gov.au

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