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?

Surprisingly, 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 this is still a very high number of injuries.

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 re-planted. 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 he/she seems seriously hurt call an ambulance.
  • Find the tooth/teeth and if dirty gently rinse in milk, 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 teeth (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 tetanus if necessary).

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). A week to ten days later 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?

The 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 will be worse the longer the tooth is out of the mouth. It 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 in order to check the health of the root.

Can I prevent this happening?

Every child should wear a mouth guard for all contact sports just like children need to wear a helmet when on a bicycle. If your child has front teeth that stick out, you may consider seeing an orthodontist as such teeth are more often damaged in accidents.

Remember

  • An attempt should always be made to try to save a front tooth that is 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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