My child hurt a tooth, what do I do? Published March 21, 2013 By Capt. Aaron Wulff 22nd Aerospace Medicine Squadron MCCONNELL AIR FORCE BASE, Kan. -- Accidents involving a child's mouth are unavoidable. Teeth can be chipped, broken, loosened or completely knocked out. Dental injuries can occur at any point in a child's life. As toddlers, the primary cause of damage to baby teeth is falling and hitting their mouth, while in the teen years, sports injuries are the primary cause of damaged permanent teeth. In order to have the best possible chance of saving a damaged tooth, it is important to know a few simple steps that could mean the difference between losing a tooth or saving that beautiful smile. The 30 minutes immediately following an incident are critical in determining if a tooth can be repaired or saved. Due to the type of injury sustained, steps to take can vary. If a tooth has been chipped or broken, try to locate any fragments, gently wash them with water, and go to the dentist as soon as possible. It may be possible for the dentist to bond or cement the pieces back in place. If it appears that the center of the tooth is bleeding, the nerve or pulp may be damaged. This is considered a dental emergency and needs to be treated by a dentist as quickly as possible. If a tooth has been knocked out of position but is still in the socket, wash your hands and apply firm pressure with your fingers to pop it back into place. The teeth on either side will typically guide the tooth back in place. Apply a cold compress to reduce swelling and head to the dentist as soon as possible. The dentist will adjust the positioning of the tooth and monitor the health of the tooth for a few weeks or months and provide care as needed. If a baby tooth is completely knocked out, or avulsed, clean the child's mouth out with water and apply a cold compress to reduce swelling. Do not attempt to replace the baby tooth in the mouth as damage may occur to the developing permanent tooth under the gums. Make an appointment to see the child's dentist as soon as possible to determine the severity of the injury. If a permanent tooth is knocked out, or avulsed, time is of the essence. If possible, replace the tooth in the socket within 20 minutes. If the tooth has been dropped in the dirt, hold the tooth by the crown (the part visible above the gums) and very gently rinse it under water just long enough to remove the debris. Do not rub or touch the root as it is composed of very delicate cells that are very easily damaged. If the tooth is unable to go back in the socket, place the tooth in milk or saline, which are gentler to the delicate structures of the root than plain water. An immediate call to your dentist is recommended, as the best long term results occur when the dental treatment is initiated within the first 30 minutes. Parents play a key role in helping their child develop a beautiful smile. To help your child keep a healthy smile, survey their living area and pad sharp edges of tables to avoid tooth-surface encounters and place gates across stairs. As your child grows and begins playing sports, a mouth guard is essential in preventing potential dental trauma that could cause lifelong complications. Dental injuries are a part of growing up. While many can be prevented, it is important to remember the proper action to take following an incident. A relationship formed between a patient and a dentist, beginning at an early age, is also important for maintaining a lifelong healthy smile.