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What to Do in a Dental Emergency

Experts share how to be prepared.


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While we all have a pediatrician or urgent care center we can call in case of an emergency, what do we do when our kid has a sudden dental problem? “The best way to cope with any unexpected dental issue is to establish a relationship with a pediatric dentist early on,” says Elisa Velazquez, DMD, who has a private practice in Toms River and is vice president of the New Jersey Academy of Pediatric Dentistry.

“That means your child should see a dentist for the first time no later than his or her first birthday. That way, you’ll have a dental home in case of an emergency.” From a chipped tooth to a debilitating toothache, countless unexpected issues can crop up. Here’s how to deal with them:

KNOCKED-OUT TOOTH

Obviously, your child should always wear a mouth guard during contact activities. But dental injuries can occur off the sports field, too. “Whether it’s toddlers falling as they learn to walk or kids horsing around, accidents happen,” says pediatric dentist Mary Hayes, DDS, a spokesperson for the American Dental Association (ADA). “Because all dental emergencies involve a concussion risk, make sure your child is okay first.” If your child injures her face or head or loses consciousness, go to the ER. Otherwise, call your dentist immediately. Pick up the tooth by the crown, and place it in a cup of milk (or water, if that’s all that’s available). Don’t reinsert it or clean it off; let your dentist handle that so you don’t do further damage. And don’t delay. “The success rate is best when you can get the tooth placed within 30 minutes of the accident,” says Hayes. The good news: Baby teeth don’t need to be re-implanted because they could disturb underlying permanent tooth buds. However, your dentist should still do an exam to make sure no fragments remain.

CHIPPED OR CRACKED TOOTH

If you notice a chip or crack in your child’s tooth, call your dentist right away. There’s nothing you can do, but you do need to have your child seen as soon as possible. “There’s a risk that the nerve has been exposed,” says Hayes. “And some kids are stoic and may not complain of pain.” The tooth may or may not be repaired. For instance, a toddler with a small chip may not need a restoration since the tooth will be replaced by a permanent one eventually. Each case should be evaluated individually, says Hayes.

TOOTHACHE

Kids have toothaches for many different reasons including a cavity (you may see a brown spot on the tooth), swelling gums (an abscess) or new teeth erupting. “One of the most painful incidences is when a baby tooth is retained and the new tooth is coming through,” says Velazquez. With any toothache, call your dentist immediately to schedule an exam. In the meantime, consider giving an age-appropriate dose of ibuprofen. If it’s a new tooth erupting, dab a topical anesthetic on the gum.

BURNED LIP OR PALATE

If your child bites into a slice of hot pizza or gulps hot cocoa, he could burn his lip or palate (the roof of the mouth). “There’s not much you can do except avoid crunchy foods and anything acidic, like citrus or tomatoes, for the next few days,” says Velazquez. “The upside is that the mouth is amazing [in terms of] how quickly it heals.” Offer an ice pop to soothe discomfort, or if he’s old enough, have him rinse it himself with cool water. But if there’s blistering in or around the mouth, he should be seen by his dentist or pediatrician ASAP.

BITING THE TONGUE OR LIP

It’s easy to bite the tongue or lip, especially after dental procedures when the mouth is numbed. Most of the time it’s nothing to worry about, and the pain subsides quickly. But if the tongue is bleeding profusely, use gauze to apply pressure. If the bleeding doesn’t stop after ten minutes of direct pressure, go to the ER, says Hayes. The same goes if your child bites through her lip.

MOUTH SORES

Painful canker sores may erupt due to stress or a minor mouth injury, such as accidentally biting the inside of the cheek. Kids also sometimes get them right before or after a virus. Other lesions look similar, but are viral in origin. “Call your dentist, especially if it’s the first time your child has experienced mouth sores,” says Velazquez. “It’s especially important to treat young children who aren’t eating or drinking due to the pain because it’s easy for them to get dehydrated.” To aid healing, stick with a soft diet, avoid acidic foods and use topical anesthetics. Your dentist may be able to perform an in-office laser treatment or offer a prescription mouthwash for kids who are old enough to swish and spit.

LOOSE WIRE ON BRACES

Orthodontic discomfort is not an emergency, but it’s miserable. Your child needs to be seen as soon as possible. In the meantime, a poking wire can be pushed flat against the tooth with a cotton swab or pencil eraser. If that’s unsuccessful, pinch off some dental wax, roll it into a pea-sized ball, then flatten and place over the wire tip, says Velazquez. If an expander is lost, have your child eat soft foods—nothing crunchy or sticky, which may have caused the damage in the first place—until he’s seen by the dentist.

Arricca Elin SanSone is a New York-based health and lifestyle writer.

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