What should you do when your child comes to you crying with a bloody mouth and a tooth in their hand? A normal reaction to this scenario is panic. However, if you know what steps to take, you could prevent permanent damage to your child’s teeth.
The American Dental Association estimates that by the time kids graduate from high school, one in three boys and one in four girls will have suffered some sort of traumatic injury to their teeth. Also, baby teeth are a lot easier to knock out than permanent teeth because their crowns (the top part of the tooth that is visible in the mouth) are a lot longer than their roots (the bottom part of the tooth that’s hidden under the gums.)
Most caring parents wonder what they should do when their child knocks out a tooth. It is critical that parents are informed so they do not inadvertently damage the permanent tooth that is developing underneath the baby tooth in their child’s mouth.
A couple of days ago, I wrote about the steps you should take when a permanent tooth gets knocked out. With permanent teeth, you want to put them back in the socket as soon as possible. However, when you are dealing with a baby tooth you may not want to put it back in because you could end up damaging the permanent tooth that is still developing below your child’s gum-line.
What to Do When Your Child’s Baby Tooth Gets Knocked Out
First of all, when a tooth gets knocked out you need to find it. You need to make sure that the baby tooth was not accidentally breathed into the child’s airway. In my pediatric dentistry textbook, Pediatric Dentistry: Infancy Through Adolescence by Pinkham it states the following:
Primary teeth [that are knocked out] should be accounted for to rule out potential aspiration. If the tooth cannot be found, the child should be referred for further evaluation by a pediatrician
If you can’t find the tooth anywhere it is important to make sure that your child didn’t accidentally breathe it in. Since children are still developing their reflexes, it may be easier for a child to breathe a tooth and get it lodged in their throat. This can cause difficulty breathing and even an infection in the lung if not promptly dealt with.
Next, you have two options:
1 – You can decide to simply get rid of the tooth and welcome an early visit from the tooth fairy. If your child’s tooth was already loose because the permanent tooth below it is about to come in, then this may be the best option as the permanent tooth should erupt normally as long as the trauma wasn’t severe. You should visit your dentist just to make sure everything is alright.
2 – You can try to save the tooth by having it re-implanted. If your child is only three years old and knocks out a tooth, it may be beneficial to try to re-implant it, however this is something that only your dentist and you can determine after talking about the risks and benefits. It is normally recommended to not re-implant primary teeth due to the damage that can be done to the permanent teeth that are developing underneath. However, there are many exceptions to this recommendation.
How to Proceed If You Want to Re-Implant the Knocked Out Baby Tooth
If you do want to have the dentist re-implant the tooth, there are reports that if the dentist can shorten the roots of the baby teeth, then damage may not be done to the developing permanent tooth. If the child is very young and would have to wait a few years for the permanent tooth to come in, then re-implantation of the knocked out tooth may be an excellent option.
In addition to the successful replantation of avulsed permanent teeth, the replantation of primary anterior teeth may also be indicated. The decision is based on age and stage of tooth development, development of dentition, storage of the avulsed tooth and the way it is transported to the treatment site, the appropriate in vitro treatment of the tooth before reinsertion, and the willingness of the child to cooperate…As [with] any surgical intervention, the attending dentist in this case has to weigh the benefits against the risks.
Your dentist will be able to explain the risks and benefits to the parents.
If you want to try to save the tooth and have it re-implanted, the safest way to proceed is to simply deposit the tooth in an appropriate solution. A balanced salt solution is the absolute best way to keep the cells on the outside of the tooth alive. You can find a balanced salt solution, branded as Save-a-Tooth on Amazon and at many drugstores. It is also available at many schools, athletic facilities, and other places where teeth are frequently knocked out.
In order to try to have tooth re-implanted, you should call your dentist and get an appointment as soon as possible — within hours. Studies have shown that if you wait more than two hours, the tooth will not be able to be re-implanted.
If your dentist is not available, he or she probably has a way to reach them in emergencies. Try to get in contact with them, or find another dentist that can re-implant the tooth as soon as possible. Time is of the essence since after more than a few hours, the cells on the tooth’s root may die and re-implantation will no longer be an option.
Facts to Consider About a Knocked Out Baby Tooth
Here are some factors that will affect your child if they have a tooth knocked out:
- If their baby canines (the third tooth from the mid line on both sides) haven’t come in yet, a tooth loss could make their jaw smaller, thus making it harder for the permanent teeth to eventually erupt into the mouth.
- If the baby incisors (the front four teeth) are lost before the child has mastered speech, his speech development may be affected temporarily until the permanent incisors come in.
- A study has shown that in 75% of the cases involving a knocked out baby incisor, the developing permanent tooth gets damaged. But this number depends a lot on the age of the child. If the tooth was knocked out before the kid is two years old, then there is a 95% chance that it will affect the developing permanent tooth. If it happens after age 5, then there is only an 18% chance that it will affect the developing permanent tooth.
In many dental emergencies, the parents want to get their child dental care as soon as possible and may go to the closest dentist, rather than their usual dentist. Be aware that when you take your child to a dentist who is not their primary dentist that you need to let the dentist know of any health problems or allergies that the child may have so that you can avoid complications to their treatment.
Have you ever experienced having a baby tooth knocked out? If so, please share your story in the comments so we all can learn from it. Thanks for reading!