Dental injuries are common and are a normal part of childhood. Most cases are easily resolved, but some require immediate care to avoid future complications.

What is important to assess?

Intra-oral and extra-oral damage

Try to calm the child and give medication to control the pain. Applying ice helps a great deal in any facial injury.
Assess whether hospital care is needed, depending on the severity of the situation.
Rinse the child's mouth with running water to try to identify any broken, intruded, tilted or avulsed teeth.
If a tooth has been fractured or avulsed, try to find it and store the tooth or fragment, in order of preference, in: cold milk, saliva (keeping the tooth in the vestibular sulcus, at the back of the mouth), saline solution, or water.

As soon as possible, contact a dentist or dental clinic for guidance.

My child fell but has only minor injuries. They report no significant symptoms, only slight pain, perhaps some redness and slight bleeding where they hit themselves. The teeth are intact and in their normal position. What should I do?

The child should still be assessed by a dentist as soon as possible.
Do not touch or try to wiggle the teeth to see whether they are firm.
Try to keep the whole area as clean and disinfected as possible, without causing hurt. In the days following the accident, a surgical toothbrush (available from pharmacies) can be used, together with a chlorhexidine-based gel. Mouthwashes with chlorhexidine-based products can also be used 3-4 times a day, especially when the child finds it harder to let you brush because it hurts. Another alternative is to use sterile gauze pads.
Soft diet for at least 15 days.
Anti-inflammatory medication, if necessary and prescribed.

My child fell. They report no significant symptoms, but has broken a tooth or teeth. What should I do?

If you have found a fragment at the scene, it should be stored, in order of preference, in: cold milk, saliva (keeping the tooth in the vestibular sulcus, at the back of the mouth), saline solution, or water.
The child should be assessed by a dentist as soon as possible.

What will the dentist do?

The dentist will try to gather as much information as possible in order to make the best decision about treatment.

Parents should not underestimate the consequences, visible or not, of an injury to the face and/or teeth. The teeth may appear to be in good condition, with no fractures or infection, yet show signs and symptoms later on. Often the child does not complain at the time and everything seems normal, but over time one of the teeth begins to darken. This may indicate, for example, that the tooth has died because its blood supply was interrupted after the accident. Any damage to the baby teeth can also affect the permanent teeth later on. Certain types of accident can also affect the temporomandibular joint. Pain in the ear area, headaches, and changes in or limited movement of the jaw should be identified and monitored after the accident.

Parents should therefore ALWAYS seek help and advice from a dental professional, in order to minimise the damage that may arise from an injury, so that treatment can be planned in the best possible way.

Dr. Ana Cepêda, OMD 9003