What Should I Do After My Child Experiences a Tooth Fracture?

 

As many precautions as you take with your kids, a chipped or broken tooth is quite common, especially among toddlers just learning to walk or preschool children engaged in vigorous play or sports. It might not even be rough play, but just a chewed piece of ice or biting into a piece of hard candy can ultimately cause some damage. There are many kinds of injuries to the tooth that can occur, from a minor chip to a fracture (a cracked or broken tooth). It might happen to one of their baby teeth or to a permanent adult tooth.

A Child’s Tooth Fracture? Get to Your Pediatric Dentist!

If your child’s tooth gets chipped or broken, whether it’s a baby tooth or a permanent tooth, it is very important to call their pediatric dentist right away and schedule an emergency appointment. If it’s after business hours and it’s more than a very minor chipped tooth, go to your nearest hospital’s emergency room.

What to Do Immediately After a Tooth Fracture

According to the American Dental Association and the American Academy of Pediatrics, here’s what you should do after a child’s tooth fracture to minimize the damage and temporarily treat any pain:

• Rinse their mouth with warm water to gently clean the area.
• Save any pieces of the tooth that you find, as they may be able to be reattached.
• Place the tooth fragments in a container of milk, saliva or water. Keep them moist.
• Remove any objects in the mouth with floss. Do not use a pointed or sharp instrument.
• If there is bleeding, have the child bite down on a wet piece of gauze, or hold it to the injured tooth. Keep this pressure applied until the bleeding stops.
• Place a cold compress on their face to minimize swelling.
• For pain, use an age-appropriate children’s pain medication. Do not apply heat or aspirin directly to the mouth.

Calm, quick action after a tooth fracture can help to save the tooth, prevent infection, and minimize the need for extensive dental treatment.  

Tooth Fractures in Primary (Baby) Teeth Versus Tooth Fractures in a Child’s Permanent (Adult) Teeth

Pediatric Dentistry and the American Association of Endodontists explain the differences between primary teeth and permanent teeth in children when it comes to treating fractures.

Baby teeth are often chipped on the edges just from normal use. These smaller chips are often left alone or a dentist can smooth them out for a nicer appearance. For a larger fracture, your pediatric dentist can put a white filling in to restore the tooth’s lost structure. At times, the original piece(s) can be replaced. In some cases, a crown may be required. The type of treatment your dentist recommends will depend upon the age of the patient and the extent of the fracture. When treating fractures in baby teeth, the main purpose is to prevent damage to the underlying permanent tooth. For this reason, a baby tooth that has been knocked out completely would not be replanted.

A child’s permanent teeth are not fully developed, so any tooth fracture to a permanent tooth needs immediate attention. The classifications of tooth fractures and common types of treatment are as follows:

• Class 1 – Fractures or chips in outer enamel layer – For smaller chips, edges are simply smoothed over. For larger chips, they might do a composite filling (bonding).
• Class 2 – Larger fractures into the dentin layer – A common type of fracture; often sensitive to cold air and liquids. To protect the dentin, composite will be used to restore the tooth. A large fracture may require a crown or porcelain veneer, though with young children, it may be advised to wait for further tooth development and an orthodontic visit.
• Class 3 – Fractures into the tooth’s pulp – Special attention is required, since there’s the danger of bacteria entering into the pulp. For adults, this often indicates the need for a root canal. Children with still-developing permanent teeth have healthier pulps with a better supply of blood, so they can often recover on their own. If a large portion of the tooth’s crown is missing, they may need a root canal to hold a dental crown in place.
• Class 4 – Fractures onto the root of the tooth – Though this isn’t common, it is very serious and may need complete removal. If your dentist is able to save the tooth, treatment might be orthodontic extrusion, a root canal, a post-and-core technique and a dental crown.