Overview

When it comes to children's health, dental emergencies can be particularly distressing for both the child and their parents. A dental emergency refers to any dental problem or complication that requires immediate attention.¹ Understanding the common dental emergencies that can occur in children is crucial for parents and caregivers. By being prepared and knowing how to handle these situations, you can provide immediate care and prevent further complications.

Being prepared and knowing what steps to take can help you stay calm and take appropriate action. 

It is important to note that children may have a combination of baby teeth and adult teeth in their mouth and that treatment options may vary depending on which kind of tooth it is.

Common dental emergencies in children

The following are examples of common dental emergencies and the necessary actions required:

Knocked-out tooth

A tooth is avulsed when it is completely knocked out of its socket.^2,3 Avulsed teeth need urgent care as they are dental emergencies. Teeth are typically dislodged from the mouth due to a significant application of force. This can occur due to accidents or sports injuries. If your child's tooth gets knocked out, seek immediate treatment to improve the chances of saving it. Contact your dentist or nearest dental clinic for emergency services. Address the avulsed tooth at the scene of the accident by following these steps: 

• Find the tooth and handle it with caution, holding it by the top part and avoiding contact with the root
• Gently rinse the tooth with water to eliminate dirt or debris, do not scrub it or use soap
• Try to reinsert the tooth back into the socket if possible, and hold it in place by gently biting on a clean cloth
• If it is not possible to reinsert the tooth, you should place it in a container filled with milk or saliva to keep it moist
• Immediately seek dental care to increase the chances of saving the tooth²

Broken tooth

Broken teeth can usually be saved. Contact your dentist, explain the situation, and request an immediate appointment if available.⁵

This can happen due to falls, accidents, or biting down on hard objects. If your child breaks a tooth:

• Clean the area and rinse the mouth with warm water 
• Use a cold pack to decrease swelling and ease pain
• In case of bleeding, use a clean cloth or gauze to apply gentle pressure 
• Gather all the fractured tooth fragments and bring them to the dentist 
• It's important to seek professional dental care as soon as possible to prevent further damage and infection¹

If the crack is minor, the dentist can repair the tooth with a white filling. However, if the crack is severe, a root canal might be necessary. Additionally, the tooth may require a crown.⁵

Toothache or tooth sensitivity

Tooth pain occurs when the nerve in the tooth is irritated. Dental pain is common. Contact your dentist, describe your symptoms, and request an appointment as soon as possible.⁵

Toothaches can be caused by tooth decay, cavities, or infection. If your child complains of a toothache:

• Rinse their mouth with warm salt water to help alleviate pain and reduce inflammation 
• Use a cold compress on the outside of the cheek if there is swelling. Avoid giving your child aspirin or applying any pain medication directly to the tooth or gums
• Provide pain relief with normal over-the-counter painkillers 
• Schedule an appointment with the dentist to determine the cause of the toothache and receive appropriate treatment^1,5

Extruded (partially dislodged) tooth

An extended tooth is longer than the adjacent healthy teeth. It is more sensitive and moves more easily when tapped. Bleeding from the gums can occur soon after the injury. If the tooth continues to move out of place, there is a greater risk of blood flow being cut off and the tooth nerve dying.

Go to the dentist right away. If your child experiences pain before reaching the dentist's office, you can alleviate it by placing a cold compress on the outside of your child's mouth or cheek in the affected area. If necessary, you can also take an over-the-counter pain relief like acetaminophen, or ibuprofen.¹

Dental abscess

Abscesses are infections that occur around the root of a tooth or in the space between teeth and gums. They can cause swelling and damage to tissue and nearby teeth. If left untreated, the infection can spread to the surrounding areas and cause swelling of the face or jaw.

It is important to see a dentist as soon as possible if your child has a dental abscess. In the meantime, you can try rinsing the child's mouth with a mild salt-water solution (1/2 teaspoon of table salt in 8 ounces of water) multiple times a day to alleviate pain and draw out pus.¹

Once the dentist has examined the child, they will determine if the infection can be treated at the surgery or if the child needs to be referred to a Maxillofacial and Oral Surgeon for further management. 

Severe soft tissue injury

If your child has injuries to the soft tissues such as her/his tongue, cheeks, gums, and lips, it can cause bleeding. To manage the bleeding, follow these steps:

• Cleanse her/his mouth by gargling with a gentle saltwater mixture
• Apply pressure to the bleeding site using a damp gauze or a tea bag and keep it in place for 15 to 20 minutes(The tannic acid in tea can shrink blood vessels and lessen bleeding)
• To stop bleeding and alleviate pain, apply a cold compress to the outer part of her/his mouth or cheek in the affected region for a duration of five to ten minutes
• If the bleeding persists, it is important to seek immediate dental attention or go to the emergency room. Keep applying pressure to the bleeding area with the gauze until you can see your dentist^1,4

Possible broken jaw

Go to your dentist or a hospital emergency room immediately. While you are on your way, make sure to apply ice to her/his jaw to help reduce the swelling and provide pain relief.⁵ Once you get to the emergency room X-rays will be taken to determine if there is a fracture. If a fracture is noted, the child will be referred to a Maxillofacial and Oral Surgeon for further management and possible surgical intervention.

Objects caught between teeth

If you are unable to remove the object gently with dental floss, it is recommended to visit the dentist. Avoid using sharp or pointed instruments as they can cause cuts on your child’s gums or scratches on the teeth' surface.⁴ Objects that are stuck between teeth can cause a lot of discomfort and even simulate toothache.

Steps to take during a Dental Emergency

During a dental emergency, it's crucial to stay calm and take immediate action. Here are a few basic instructions to adhere to:

• Assess the dental emergency to determine its severity
• Determine if it requires immediate professional attention or if it can be managed at home temporarily
• Children may feel scared or anxious during a dental emergency. Offer them comfort and reassurance to help them stay calm
• Control bleeding by applying gentle pressure with a clean cloth or gauze
• Clean the area by rinsing the mouth with warm salt water
• Contact the dentist and explain the situation. Follow the instructions for immediate care or schedule an emergency appointment
• Preserve knocked-out teeth or broken tooth fragments: Handle them carefully by the crown, avoid touching the root, and keep them moist in milk or saliva
• Seek professional help: If the dental emergency is severe or involves intense pain, swelling, or infection, seek immediate professional help

Remember, every dental emergency is unique, and the steps to take may vary depending on the situation. It's essential to consult with your child's dentist for specific guidance.

Tips for preventing dental emergencies in children

While it's not always possible to prevent dental emergencies, there are several measures parents can take to minimise the risk. Here are some tips for preventing dental emergencies in children:

• Encourage regular dental check-ups: Regular dental visits can help identify and address any potential dental issues before they become emergencies
• Promote good oral hygiene: Teach your child good oral hygiene habits, like brushing twice a day with fluoride toothpaste and flossing daily
• Use protective gear during sports: If your child participates in contact sports or activities with a risk of dental injuries, ensure they wear a mouthguard
• Avoid chewing on hard objects: Discourage your child from chewing on hard objects like ice, pens, or pencils, as this can lead to tooth damage
• Practice safe habits: Teach your child to avoid using their teeth to open packages or bottles and to be cautious when eating hard or sticky foods
• Maintain a healthy diet: Provide a balanced diet rich in fruits, vegetables, and calcium to promote strong teeth and gums⁵

By following these preventive measures, you can significantly reduce the chances of your child experiencing a dental emergency.

Knowing when to seek professional help for dental emergencies

While some dental emergencies can be managed temporarily at home, it's important to know when to seek professional help. Here are some signs that indicate the need for immediate dental care:

• Severe tooth pain or swelling that persists or worsens
• Unstoppable or excessive bleeding
• A tooth that has been dislodged or a tooth that is fractured with jagged edges
• Signs of infection such as fever, facial swelling, or a foul taste in the mouth
• Trauma to the face or mouth resulting in severe pain or difficulty opening or closing the mouth

If your child experiences any of these symptoms, do not hesitate to seek professional help. Prompt dental care can prevent further complications and ensure the best possible outcome for your child's oral health.¹

Conclusion

As a parent, being prepared and knowing how to handle dental emergencies in children is crucial. By understanding common dental emergencies, taking immediate action, and following preventive measures, you can effectively manage dental emergencies and protect your child's oral health.

Remember to stay calm, provide comfort to your child, and seek professional help when necessary. By mastering dental emergencies, you can ensure the best possible care for your child's teeth and promote a lifetime of healthy smiles. Call your child's dentist today and schedule an appointment to discuss dental emergencies and create an emergency action plan. 

Summary

Parents have a significant impact on maintaining their children's oral health. By promoting good dietary habits and practising daily oral hygiene, they can effectively prevent cavities. Dental emergencies vary in urgency and can be treated at the dental office or an emergency department if more serious in nature.