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Scrapes, bruises, cuts, and injuries are a part of childhood. Some of these injuries can be more serious than others though like when a child knocks a tooth out. There are some simple steps that must be followed if this happens to your child. Read on.

Children often take part in a number of sporting activities, tend to play rough, and fall quite often. This normal and healthy part of growing up also means, mind you, that injuries tend to follow children around. The teeth are not spared, either.

Chipping a tooth, breaking it, or knocking it out completely are all common in children. As a parent, the sight of blood, tears, a knocked-out tooth or two, and people panicking can be very disconcerting. However, this is the time to remain calm and follow some recommended practices before you can get to the dentist.

Would should you do if your child completely knocks out a tooth?

1. Try and determine if missing tooth is a milk tooth or a permanent tooth

Baby teeth being knocked out is not an emergency, although some dental care will definitely be in order. If, however, the tooth that is knocked out is a permanent tooth, that kind of situation should be treated as a dental emergency.

  • Children under the age of six are unlikely to have any permanent teeth yet, so any tooth that gets knocked out is most likely a milk tooth.
  • Children between the ages of six and 13 usually have both baby teeth and permanent teeth in the mouth.
  • Kids over 13 are unlikely to have any milk teeth in the mouth whatsoever.

If you are unsure whether the tooth that was knocked out is permanent or not, err on the side of caution and get to a dentist as soon as possible.

2. Calm your child down and try to control the bleeding

A fall or a hit that knocks out a tooth is also likely to have done some damage to the lips or gums. Have your child rinse out their mouth with water and apply a wet cloth or cotton ball to try and stop the bleeding from the lips. Any head injury or a potential fracture has to be ruled out since those are much more serious and take precedence while administering treatment. If there's any doubt as to whether you need to see a dentist or go to the ER because there are signs of a head injury, in other words, choose the emergency room every time.

3. Store the knocked-out tooth carefully

Water is the worst option to try and store the tooth. Ideally, the knocked-out tooth should be kept in milk, saline, or something called Hanks balanced salt solution (available at chemists). The dry time of the knocked-out tooth should be kept to a minimum. The longer a tooth is dry outside the mouth, the lower its chance of its survival.

The inside of the cheek is also a good place to store a knocked-out tooth, although this may not always be possible in younger children who are crying or unable to follow instructions.

It can be difficult to know the difference, but try and pick the tooth up by its crown (the part you see in the mouth) and avoid touching the root at all.

4. Time is everything

The chances of replanting a knocked-out tooth are at their maximum when done within the first thirty minutes. This is why getting to the dentist must be a priority. Inform the dental office in advance and they will make the necessary preparations before you get there.

5. Do not try and replant the tooth in the socket yourself

In the dental office, we have seen far too many cases where parents try to put back knocked-out teeth by themselves — and it just ends up complicating the case. The age of the tooth and whether its development has been completed, the time it spent outside the mouth, and whether the tooth has any structural damage all determine what kind of treatment has to be provided to the tooth before it can be replanted.

The simple act of orienting the tooth correctly can be difficult when the socket is bleeding profusely. Also, too much pressure or not enough of it can also make successful replanting of the tooth difficult.

Let the dentist make these decisions.

After your child sees a dentist: How to care for a replanted tooth

In most cases, the dentist is going to replant the tooth and then use a splint to keep it in position. It is important that the child not apply any excessive pressure during this time. Maintaining good oral hygiene is also essential — more so during this time — to minimize the risk of infection. As a parent, you can help brush your child's teeth gently so that they are not in any pain.

The use of analgesics to control the pain and antibiotics to control systemic infection is also very likely. Dentists will expect parents to administer these medicines as instructed, so be sure to ask any questions you may have.

Once the initial healing has taken place, the dentist may advise further root canal treatment or apexification procedures to help increase the chance that the replanted tooth will survive in the long term.   

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