Dental Emergency Procedures

It is the unusual child who does not suffer some kind of injury during his childhood. These injuries are always unexpected and often more serious than they appear. Calm and prompt action can help minimize the damaging effects of injury and lessen your child's pain and fear.

Injuries to the mouth, face, and teeth happen frequently, and go from the simple to the complex. Most injuries to the young permanent teeth happen from falls. Contact sports account for many more. Some injuries can be treated properly by a parent; others require the services of a dentist. Severe injuries to the head, neck, and face may need the services available in the emergency room of a hospital. Such injuries are often the result of automobile accidents.

All injuries should be treated as soon as possible, to save your child from unnecessary pain and in some cases to save a tooth. Whenever the face, lips, cheeks, or tongue are cut and bleeding, pieces of dirt, debris or fragments of fractured teeth may be imbedded in the cut.

  Toothache

This is by far the most common cause of dental pain in a child. It is usually caused by untreated tooth decay. Have your child rinse his mouth with warm water and carefully remove food from between teeth in the area of the pain with dental floss. If swelling is present, apply cold compresses to the cheek made by wrapping a small towel around a plastic bag filled with ice. Lacking ice use a cold wet towel. Never use heat or aspirin placed on the gum or aching tooth.

• Rinse the mouth with warm water to clean it out.
• Use dental floss to remove any food that might be trapped between the teeth.
• Do not place aspirin on the aching tooth or gum tissues.
• See your dentist as soon as possible.

  Problems with braces and retainers

If an end of the brace is loose, you can make your child comfortable by covering the end of the wire with cotton, gauze, wax, or chewing gum. If the entire brace is loose, try gently to remove it from his mouth. Do not use force.

If successful, place the appliance in a small container and see your orthodontist immediately.

If the appliance is embedded in the gum, tongue, or cheek, do not try to remove it. See your orthodontist immediately.

• If a wire is causing irritation, cover the end with a small cotton ball, beeswax, a piece of gauze, or chewing gum, until you can get to the orthodontist.
• If the entire brace is loose, try gently to remove it from his mouth. Do not use force.
• If a wire is stuck in the cheek, tongue or gums tissue, do not attempt to remove it. Go to your orthodontist immediately.
• If an appliance becomes loose or a piece of it breaks, take the appliance and the piece to your orthodontist.

  Knocked-out tooth

Never scrub the tooth or immerse it in a cleaning or sterilizing liquid. Rinse the tooth gently in tap water and attempt to replace it in the socket. If successful, hold the tooth in place or have the child bite against a gauze pack to hold it in place. If you cannot replace it, put the tooth in a container of cool water or milk and see a dentist immediately.

The tooth should be replaced in the socket within an hour of the accident, if it is to have a chance for survival.

• If the tooth is dirty, rinse it gently in running water.
• Do not scrub it or remove any attached tissue fragments.
• Gently insert and hold the tooth in the socket.
• If this is not possible, place tooth in a cup of milk, or when milk is not available, in a cup of cool water.
• Go immediately to your dentist! Don't forget to bring the tooth!

  Broken tooth

The mouth should be rinsed with warm water to remove dirt and other debris from the area of the broken tooth. Apply cold compresses to the lip and face in the area of the injured tooth to control swelling.

• Gently clean dirt from the injured area with warm water.
• Place cold compresses on the face, in the area of the injured tooth, to decrease swelling.
• Go to the dentist immediately.

  Bitten tongue or lip

Apply pressure to the cut with clean gauze or cloth. Apply ice directly to the wound or cold compresses to the face in the area of the wound, to control swelling.

If bleeding cannot be stopped within a few minutes, take your child to a hospital emergency room immediately.

Children, particularly small children, can easily severely damage a lip, cheek, or tongue that is anesthetized, by biting it. Children who have received a local dental anesthetic should be carefully observed until the numbness of the tissue is gone.

If damage does occur, see your dentist immediately.

• Apply direct pressure to the bleeding area with a clean cloth.
• If swelling is present, apply cold compresses.
• If bleeding does not stop go to the emergency room.

  Objects caught between teeth

Try removing a wedged object with dental floss. Guide the floss carefully, to avoid cutting the gum. Do not use tooth picks or other sharp instruments.

If you fail to remove the object, call your dentist for advice.

• Try to remove the object with floss.
• Guide the floss carefully to avoid cutting the gums.
• If you're not successful in removing the object, go to the dentist.
• Do not try to remove the object with a sharp or pointed instrument.

  Possible broken jaw

If a jaw fracture is suspected, it should be treated as a fracture: Movement of the jaws should be prevented by wrapping a towel or cloth under the lower jaw and across the top of the head and holding it tight.

Cold compresses will keep swelling down while the child is taken to a hospital emergency room immediately.

• Do not move the jaw.
• Secure the jaw in place by tying a handkerchief, necktie, or towel around the jaw and over the top of the head.
• If swelling is present, apply cold compresses.
• Go immediately to a hospital emergency room, or call your dentist.

  If a dental emergency happens while you are traveling

• Look in the yellow pages under "dentist" to find the state or local dental society phone number to get a referral.
• Ask a hospital emergency room to recommend a dentist.
• If you are out of the country, contact the US Embassy or ask hotel personnel to refer you to a dentist.

  Be prepared

Being prepared for a dental emergency is no accident. It takes a little time and thought, but by knowing what to do before an accident happens, you may someday save a tooth - yours or someone else's.

• As in all matters of health, prevention of disease and injury are the best policy. Some injuries can be prevented by taking certain precautions.
• Children in contact sports should wear mouthguards.
• Children and infants when riding in a car should be firmly held in their seats by seat belts. Never allow an exception.
• Keep loose objects off the floor where children can trip over them.
• Keep bureau drawers and doors closed.
• Keep electrical outlets covered and electrical cords disconnected.