Fractured Teeth, Knocked Out Teeth, and other Dental Accidents

Tooth Knocked Loose: Sometimes the gums will bleed along the gumline and the tooth seems loose, but is in the same position as before. Usually needs no treatment whether it is a baby tooth or a permanent tooth. Sometimes, if it is quite loose, we might place a splint to hold it in place while it heals. This looks kind of like braces that are worn for a few weeks. The outcome is usually good. Sometimes a baby tooth will turn dark.

Tooth Knocked Out of Position: This is more serious. Usually, repositioning the tooth is desirable, preferably the day of the accident with finger pressure. Sometimes, with a permanent tooth, you can't easily reposition the tooth with finger pressure. Short term orthodontic repositioning is best for these cases. Sometimes a tooth (usually a baby tooth) is pushed up into the gum. This is called an intruded tooth. If the baby tooth is intruded less than 50% of the crown length (the part you normally can see), then it will very likely re-erupt back into position with no problem. This takes a few months. If it is pushed up where you can't even see it, then it may or may not reerupt and may need some additional treatment even if it does. If it does not come back down, it may need to be removed.

Knocked Out Tooth: Well, if it is a baby tooth, just leave it out and place it under the child's pillow for the tooth fairy. It is not worth the risk to the developing permanent tooth to replant it. Now, if it is a permanent tooth, you really need to follow these instructions carefully because you do want to save the tooth. First, find the tooth. Do NOT scrub it clean, just put it in a moist environment like milk. Call the dentist right away. Try to place the tooth back in the socket. Most people don't like the idea of doing that, so your dentist can replant the tooth. It's fairly easy to do. The problem is that even though it is back in, you probably need a splint to keep the tooth in position while it heals. It is best to get the tooth back in as soon as possible. After several days the tooth will need a root canal to remove the now dead nerve inside the tooth.

Broken or Chipped Tooth: Quite common, especially in older kids. The little chips I often see in baby teeth are usually not much to worry about and can be smoothed out or left alone. Larger fractures might need a white filling to restore the lost tooth structure. If the fracture is into the pulp (nerve), the tooth will need a root canal.