A Guide to Dental Injuries in Children

When a child damages a tooth, it can be just as traumatising for the anxious parents as for the child involved. Dental injuries tend to bleed a lot and they often look a lot worse than they really are.

The problem is that children tend to damage their teeth a lot. In the UK, toothache is one of the most common reasons why people call the NHS Direct hotline. In 2009, children with rotten teeth became the 3rd highest number of hospital admissions in the UK. That shows how serious the need for emergency dental treatment can be.

Research suggests that around 30% of children have suffered a dental injury. Most tend to occur when the child is a ‘toddler’, as the fall over regularly and the milk teeth are easily dislodged. However, problems can occur later for some children too. Statistically, boys in school are far more likely to lose a tooth than girls, mainly due to playground fights and more competitive sports.

Is a lost tooth serious?

When a young child loses a tooth, there can be a tendency to dismiss it as ‘just a milk tooth’. The consensus is that the tooth was going to fall out anyway, so losing it a little earlier does not matter too much. It is an understandable reaction from parents, who are eager to make their child feel better and to allay their own worries after a fall or similar sort of accident.

However, the fact is that milk teeth do serve a number of important purposes. For example, the milk teeth help with speech and learning to form words properly at an early age. Losing teeth early can therefore slow down or disrupt this learning curve. Similarly, the milk teeth help the jaw to grow properly and ensure that there is enough space for the adult teeth to grow into.

Therefore, contrary to popular perception, losing a milk tooth does matter. Losing an adult tooth is also problematic for older children. Losing an adult tooth as they are growing can affect the ‘bite’ and cause a malocclusion. This may result in a need for orthodontic work and for the child to wear braces in the future.

What action should you take?

If you have a toddler, your first action should be to make your home as child-friendly as possible. Low table edges and other types of hard furniture are usually an accident waiting to happen. A trip, bump or fall (and there will be plenty of those) are likely to knock a tooth out, simply because toddlers are so uncoordinated that they cannot break their fall effectively.

If a milk tooth is lost, however, the dentist will advise against trying to reimplant it. Milk tooth are important to your child’s dental development. However, trying to reimplant a milk tooth may damage the adult tooth below the surface. As an anxious parent, therefore, do not try to replace a lost milk tooth before taking your child to the dentist. Once a milk tooth is gone, put it under the pillow and wait for the tooth fairy to collect it!

You should also make sure that you have a telephone number for an emergency dentist somewhere close by and accessible. It can also help to prepare a dental repair kit to keep at home, including items to staunch blood flow and soothe pain if required.

What about older children?

With older children whose adult teeth have already emerged, the strategy is slightly different. Those adult teeth, if looked after, could last a lifetime. Therefore, if a tooth is knocked out or dislodged, you need to do everything you can to get the patient (and the tooth) to an emergency dentist as soon as possible. Even if an adult tooth is knocked completely out of its socket, there is still a chance that it can be replaced and saved, once the gums have grown back around it.

Ideally, if your child loses a tooth, you should try to get them to a dentist within the space of an hour. This will give the dentist the most chance possible of replacing the tooth successfully. If you can, keep the tooth in a cup of milk while transporting it and try to avoid touching the sensitive root structure – make sure you pick the tooth up by its crown.

What should you watch out for?

Sometimes, with a dental injury, it can be difficult for a parent to know whether to call the dentist or not. Here’s a few of the key indicators that you might want to watch out for:

Is there severe pain in a particular tooth? This can be an indicator of underlying decay which needs immediate treatment to stop it from deteriorating.

Does the flow of bleeding continue even after you have applied pressure to the affected area? If the bleeding continues after 10 minutes, you should contact your emergency dentist.

Is your child having trouble with breathing and swallowing? Is there any aching or pain in the jaw area?

If you child has had a blow to the face, are they slightly concussed? Do they feel dizzy, look confused and have trouble forming sentences. In this case, contact your doctor.

Does your child have a serious or deep cut on the inside of their mouth? Alternatively, does the cut puncture right through the lip? Because of eating, drinking and talking, these types of wounds may not heal naturally – therefore you may need to consult your dentist.

Finally, is there any sign of an infection forming in the mouth, tooth or the surrounding area? If you child has a high temperature or feels feverish, this could be because the dental injury has become infected. This infection can often happen after the injury, so you should monitor your child’s health for a period of time. Infection can easily spread to adjacent teeth, gums and around the mouth, although it can usually be controlled with a course of anti-biotics.

Mouth guards

There is more detailed information elsewhere on this site about mouth guards. However, it is worth reiterating that they should be an essential part of kit for any teenager playing competitive, physical contact sports. It should also be the parent’s responsibility to ensure that their child has a suitable mouth guard.

There are several different types of mouthguard available. They all provide some degree of vital protection, not just against damage to your teeth but also against damage to your jaw. In moments of strong contact, they can also help to ensure that you do not accidentally bite your tongue.

What about chipped or fractured teeth?

We’ve focused primarily on what happens if your child loses a tooth. However, there are other types of dental injury which may require emergency treatment. For example, a tooth can become split or fractured.

On these occasions, your child will probably experience fairly severe toothache – if not immediately, then certainly after a few days the tooth will become very sensitive to hot and cold.

The danger with a damaged tooth is that the inner pulp of the tooth can decay and become infected. This can mean eventually that root canal treatment is required. If the tooth is treated early enough, however, then the dentist may be able to crown the tooth and save it from infection and further decay.

What can a parent do to prevent emergencies?

Unfortunately, there will always be accident – especially when there are children involved! However, it is important to remember that many dental emergencies stem from dental decay progressing unchecked. Decay undermines the health of your teeth and makes them weaker. If decay is not treated and your teeth are not looked after, it can often cause the teeth to split, chip or become infected.

The best way to avoid dental emergencies, therefore, is to ensure that you teach your child how to look after their teeth from an early age. You should teeth them the appropriate technique for brushing and ensure that they brush their teeth twice every day for at least two minutes. This brushing is a good habit to get into – it helps to remove the plaque that causes decay.

As well as brushing their teeth, you should also ensure that your child visits a dentist regularly to have their teeth checked. After all, it is much more preferable to be visiting a dentist regularly for an all-clear than to visit them once in a blue moon for a full-blown dental emergency!


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