what should i do if my child knocks out a tooth

Falls in the park, a collision at school, a slip in the bathroom or a two-wheeler accident: knocked-out front teeth are among the most common childhood injuries. What you do in the first half hour can decide whether an adult tooth survives. Here is the order to think in.

Step 1: check the child, not the tooth

Go to a hospital emergency department first if your child lost consciousness even briefly, is vomiting, seems confused or unusually drowsy, has a cut that will not stop bleeding with firm pressure, or has pain or difficulty opening and closing the jaw. A head or jaw injury matters more than any tooth.

Step 2: milk tooth or adult tooth?

A child under about six almost certainly has milk front teeth. Between six and eight, the front teeth may be either. Adult front teeth are larger, and when new they have a slightly wavy biting edge. If you are not sure, treat it as an adult tooth and call us.

If it is a milk tooth

• Do not try to put it back. Replanting a milk tooth can damage the adult tooth developing just above it.
• Press a clean, damp cloth or gauze on the socket for 10 to 15 minutes to stop the bleeding.
• Keep the tooth and bring it along, so the dentist can confirm the whole tooth came out and nothing is left in the gum.
• Give soft, cool foods and the pain relief your paediatrician advises for your child's weight.
• Book a dental check within a day or two. The dentist will check the neighbouring teeth and the gum, and may take an X-ray.

If it is an adult tooth: act fast

1. Find the tooth and hold it only by the crown, the white part you normally see in the mouth. Do not touch the root.
2. If it is dirty, rinse it briefly in milk or clean water for a few seconds. Do not scrub it, wipe it or wrap it in tissue; the living cells on the root need to stay intact.
3. Try to put it back in the socket, facing the right way round, and have your child bite gently on a clean handkerchief to hold it.
4. If you cannot put it back, keep it in a small container of cold milk. Saliva works too: an older child can spit into a cup and the tooth can sit in that. Do not ask a young child to hold it in the mouth, as they may swallow it. Do not store it in water or let it dry out.
5. See a dentist within 30 to 60 minutes. The sooner the tooth is back in place, the better its chances.

What the dentist will do

The dentist will clean and reposition the tooth if needed, take an X-ray, and usually fix it to the neighbouring teeth with a thin flexible splint for a couple of weeks. Your child will need several follow-up visits over the following months, because a replanted tooth may need root canal treatment later, and young teeth with unfinished roots need special care. Ask your family doctor whether a tetanus booster is due if the tooth fell on soil or the road.

Where to go in Pune

Our Kharadi clinic is open from 8 AM to 11 PM, seven days a week. Call 8484 990 678 on the way so we can be ready, and we will tell you whether to come straight to Kharadi. After 11 PM, or if your child has a jaw injury, swelling spreading towards the eye or neck, difficulty breathing or swallowing, or bleeding that will not stop, go to a hospital emergency department. For more, see our emergency dentist page and our page on broken and knocked-out teeth.

Prevention is simple: a helmet for every child on a two-wheeler or bicycle, and a mouthguard for cricket, hockey, skating and martial arts.