Clinical Reference Systems: Pediatric Advisor 10.0
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DESCRIPTION

This guideline covers injuries to the teeth. Often, the only noticeable injury is bleeding from the gums. The tooth has been jarred and perhaps slightly loosened. These minor injuries heal in 3 days. The next most common injury is tooth displacement (usually pushed inward). These may need repositioning and stabilizing. Chipped (or fractured) teeth need to be seen by a dentist. Permanent teeth that are knocked out constitute an emergency. Baby teeth that are knocked out can't be reimplanted but the underlying teeth need to be checked for damage.

FIRST AID FOR REPLACING A PERMANENT TOOTH

Primary (baby) teeth can't be reimplanted. Permanent (second) teeth need to be returned to their sockets and the gumline as soon as possible. Best results occur if a permanent tooth is reimplanted within 15 minutes; after 2 hours it can't be reimplanted. Ideally the tooth should be returned to the socket at the scene of the accident.

• Rinse off the tooth with saliva or water.
• Replace it in the socket facing the correct way.
• Press down on the tooth with your thumb until the crown is level with the adjacent tooth.
• Have your child bite down on a wad of cloth to keep the tooth in position until you can reach your dentist.

HOME CARE

Put a piece of ice or a Popsicle on the injured gum area unless it increases the pain. If it still hurts, give your child some acetaminophen or ibuprofen. If any teeth are loose, put your child on a soft diet for 3 days.

CALL YOUR CHILD'S DENTIST IMMEDIATELY IF:

• A large piece of tooth has been chipped off.
• A red dot is visible inside a fracture.
• A tooth is severely pushed out of its normal position.

CALL YOUR CHILD'S DENTIST DURING OFFICE HOURS IF:

• A small piece of tooth has been chipped off.
• A tooth is slightly pushed out of its normal position.
• The tooth is sensitive to cold fluids.
• You have other concerns or questions.