Dental emergencies: what to do first

First: call us, or 911 if it is bigger than a tooth

During office hours, Monday to Friday 8 AM to 5 PM, call and we will get your child in the same day. After hours, leave a message and we will call back when we open.

After hours with a child in real pain, or a permanent tooth knocked out? Do not wait for morning. Urgent care or the ER can help with pain and swelling tonight, and we will see you first thing.

Knocked-out tooth

Baby tooth

Do not put it back in. Reimplanting a baby tooth can damage the adult tooth growing behind it. Press a clean cloth on the spot to stop the bleeding, keep the tooth in a bag so we can see it, and call us.

Permanent tooth

1. Move fast The best odds are within 30 to 60 minutes.
2. Hold it by the crown The chewing part, never the root.
3. Rinse only if dirty A few seconds in milk or saline. Do not scrub it and do not let it dry out.
4. Try to put it back Slide it gently into the socket and have your child bite softly on gauze or a clean cloth to hold it there.
5. If that will not work, keep it wet A cup of cold milk, not water. Bring it with you.

Chipped or broken tooth

• Rinse the mouth with warm water.
• Cold compress on the cheek if there is swelling.
• Find and save any pieces in milk or water.
• Cover a sharp edge with orthodontic wax or sugar-free gum so it does not cut the tongue.
• Call us. Even a small chip needs a look, because a crack can reach the nerve.

Toothache

• Rinse with warm salt water.
• Floss gently on both sides of the tooth in case something is wedged.
• Cold compress on the outside of the cheek for swelling.
• Children’s acetaminophen or ibuprofen as the package directs, if your pediatrician has okayed them. Never put aspirin or any painkiller directly on the gum. It burns.
• Call us. A toothache that wakes a child up, or comes with facial swelling, is a same-day visit.

Bitten lip, tongue or cheek

Mouths bleed a lot, so it usually looks worse than it is. Clean gently with water, press a clean cloth or gauze on the spot for 10 to 15 minutes without peeking, and use ice wrapped in a cloth for swelling. A deep or gaping cut, or bleeding that will not stop, means urgent care or the ER for stitches. If a tooth was involved, call us afterward.

Tooth pushed in, loose, or out of place after a fall

Check your child first, then the tooth. Dazed, vomiting, or knocked out cold means a medical emergency before a dental one. If your child is fine, do not wiggle the tooth or push it back into place. Soft foods, a cold compress, and call us the same day.

Something stuck between teeth

Floss gently. Tying a small knot in the floss can help drag it out. Never use a pin or anything sharp. Call us if it will not come out or the gum starts to swell.

Lost filling, crown or spacer

Keep the crown or spacer if you have it. Cover a rough edge with orthodontic wax or sugar-free gum. Call us; this is usually a quick fix and not a same-day emergency unless it hurts. Soreness or a little bleeding after recent treatment? Our After your visit page covers what is normal.

Preventing the next one

• A mouthguard for sports. Any game with a ball, a bat, a stick or a mat. Ask us which kind fits your child.
• No ice, hard candy or pen caps. Most chipped teeth we see were not from a fall.
• Keep up the checkups. A small cavity caught early never becomes a midnight toothache. How preventive care works.