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Pediatric Dental Emergencies
Orthodontic Emergencies

Overview

If you experience a dental emergency, be sure to call our practice as soon as possible at (301) 881-6170.

We are here to help you, any time, any day. When your dental health is at risk, we will do everything we can to make sure that you’re treated as soon as possible. While dental emergencies are rare, they can happen, and it’s important to know how to take care of your teeth no matter what. Common dental emergencies include:

Broken or cracked tooth/teeth
Broken jaw
Permanent tooth that has been knocked out
Object caught between teeth
Severe toothache

Pediatric Dental Emergencies
Please see references below for tips on managing these dental situations for your family.

Bitten Lip or Tongue
If your child has bitten his lip or tongue severely enough to cause bleeding, clean the bite gently with water and use a cold compress (a cold, wet towel or washcloth pressed firmly against the area) to reduce or avoid swelling. Give us a call to help determine how serious the bite is.

Object Caught In Teeth
If your child has something caught between his teeth, use dental floss to gently remove it. Never use a metal, plastic, or sharp tool to remove a stuck object. If you are unable to remove the item with dental floss, give us a call.

Broken, Chipped, or Fractured Tooth
If your child has chipped or broken a piece off of his tooth, have him rinse his mouth with warm water, then use a cold compress to reduce swelling. Try to locate and save the tooth fragment that broke off. Call us immediately.

Knocked Out Tooth
If your child’s tooth has been knocked out of his mouth, find the tooth and rinse it with water (no soap), taking care to only touch the crown of the tooth (the part you can see when it’s in place). If you can, place the tooth back in its socket and hold it in place with a clean towel or cloth. If you can’t return the tooth to its socket, place it in a clean container with milk. In either case, call us immediately and/or go to the hospital. If you act quickly, it’s possible to save a permanent, or adult tooth. Unfortunately, primary teeth are generally not re-implanted. If one of your child’s primary teeth has been knocked out, you will want to schedule a visit to our practice as soon as possible so that your dentist can ensure that there are no fragments of tooth remaining.

Loose Tooth
If your child has a very loose tooth, it should be removed to avoid being swallowed or inhaled.

Toothache
If your child complains of a toothache, rinse his mouth with warm water and inspect his teeth to be sure there is nothing caught between them. If pain continues, use a cold compress to ease the pain. Do not apply heat or any kind of aspirin or topical pain reliever directly to the affected area, as this can cause damage to the gums. Children’s pain relievers may be taken orally. Schedule an appointment immediately.

Broken Jaw
If you know or suspect your child has sustained a broken jaw, use a cold compress to reduce swelling. Call our emergency number and/or go to the hospital immediately. In many cases a broken jaw is the result of a blow to the head. Severe blows to the head can be dangerous and even life-threatening.

Avoiding Injury
You can help your child avoid dental emergencies. Child-proof your house to avoid falls. Don’t let your child chew on ice, popcorn kernels, or other hard foods. Always use car seats for young children and require seatbelts for older children. And if your child plays contact sports, have him wear a mouthguard. Ask us about creating a custom-fitted mouthguard for your child. Finally, prevent toothaches with regular brushing, flossing, and visits to our office.

Common dental injuries in sports include:

Tooth Knocked Out:

Time is the most important factor when trying to save a tooth, so get to your dentist as soon as possible.
In general, there is a 30-minute window of opportunity to re-implant the tooth in the socket.
Do not try to re-implant the tooth yourself.
The best liquid to transport tooth in is cold milk. If milk is not available, use saliva (if possible), saline, or water if nothing else is available.
Don’t let the tooth dry out and don’t wrap it in anything.
Don’t touch the tooth root if you can avoid it.
Primary teeth, often called “baby-teeth,” are generally not re-implanted.

Tooth Chipped/Cracked:

Save the fractured portion of your tooth if you can locate it, and store it in saliva or milk until you’re able to reach our office. Your dentist may be able to save the tooth by bonding the fractured portion back on to your tooth.
Your dentist will likely use an X-ray of the tooth to determine the treatment necessary based on the severity of the injury.
For a serious chip that exposes the pulp of the tooth, get to your dentist as soon as possible.
If a tooth is chipped or cracked, sometimes the tooth can be fixed with just a filling or bonding alone.
Sometimes, a tooth is cracked or chipped in a way that the nerve of the tooth is affected, and a more complicated treatment may be needed.

Tooth Displaced:

If a tooth is moved due to trauma, see your dentist as soon as possible.
Do not try to move the tooth back on your own.
For any mouth discomfort before you get to the dentist, apply ice.

Preventing Injury
One of the best and most convenient ways to prevent injury to your teeth and mouth while playing sports is to wear a mouthguard. There are several types of mouthguards to choose from, and your doctor can help you choose the best one for your particular needs.

Orthodontic Emergencies

True orthodontic emergencies are rare, but when they occur we are available to you. As a general rule, you should call our office when you experience severe pain or have a painful appliance problem you can’t take care of yourself. We’ll be able to schedule an appointment to resolve the problem.

You might be surprised to learn that you may be able to solve many problems yourself temporarily until you can get to our office. If there is a loose piece that you can remove, put it in a plastic bag or envelope and bring it with you to your next appointment. If your braces are poking you, put soft wax on the piece that’s sticking out. If the wire has slid to one side, you can pull it back to the other side with needle-nosed pliers, replacing it in the tube on the back tooth.

After alleviating your discomfort, it is very important that you still call our office as soon as possible to schedule a time to repair the problem. Allowing your appliance to remain damaged for an extended period of time may result in disruptions to your treatment plan.

General soreness
general soreness in teeth
When you get your braces on, you may feel general soreness in your mouth, and teeth may be tender to biting pressures for three to five days. Stick to a soft diet until your teeth do not hurt to chewing. Irritated gums and other sore spots can be relieved by rinsing your mouth with a warm salt-water mouthwash. Dissolve one teaspoonful of salt in eight ounces of warm water, and rinse your mouth vigorously. An alternative (better tasting) mouthwash is the Healthy Gums Rinse by The Natural Dentist. Placing Orabase on the affected area may also help relieve discomfort; Orabase can be found in a pharmacy. If the tenderness is severe, take Acetaminophen (Tylenol) or whatever you normally take for headache or similar pain. Aspirin, Ibuprofen (Motrin, Advil) and Naproxen Sodium (Naprosyn, Anaprox) actually slow the tooth movement, so it is not advisable to use them frequently while wearing braces.

The lips, cheeks, and tongue may become irritated for one to two weeks as they learn a new posture and become accustomed to the surface of the braces. You can put wax on the braces to lessen this. We’ll show you how!

Loose appliance
loose wire
If your appliance is poking you, place wax on the offending part.

Loose bracket

If your bracket or band is still attached to the wire, you should leave it in place and put wax on it if needed for comfort. If the bracket or band can be removed easily, place it in an envelope and save it to bring to your next appointment.

Loose wire

Using a pair of tweezers or needle nose pliers, try to put your wire back into place. It is ok to use a piece of floss to tie the wire into place: tie the floss around the bracket in place of the missing colored o-ring. If you cannot put the wire into a comfortable position, and covering the end with wax doesn’t help, as a last resort use a small fingernail clipper to clip the wire behind the last tooth to which it is securely fastened. If the end of the wire is still sharp place wax on it.