05/07/2016  |  
First Aid for Common Tooth Injuries

Playing sports without a mouthguard, biting down on something hard, grinding your teeth…these are common ways you can chip, crack, loosen or lose a tooth. The steps you take following such a dental injury will depend on the type and extent of the damage, but it’s generally important to see a dentist as soon as possible.

Completely Knocked Out (Avulsed) Tooth


Permanent Tooth

Replanting an avulsed adult tooth within 5 minutes ensures the best outcome, as the body will still recognize the tooth as its own, rather than a “graft,” and ligaments that attach the tooth to the surrounding bone are present on the root surface and can reattach. Factors such as the injured person’s age can also affect the outcome.

What to do:
  1. Carefully remove debris from the tooth root by rinsing it in cold tap or bottled water. Avoid touching the root surface itself. Hold the tooth by the crown — the white enamel portion.
  2. Replant the tooth by grasping the crown between the thumb and first finger with the smooth, flat surface facing forward and pushing the tooth firmly into the socket.
  3. Apply sustained pressure so tooth is not pushed back out.
  4. If immediate replantation is not possible, control the bleeding with pressure, place the tooth in the patient’s own saliva (for example between the cheek and gums if the patient is old enough to be trusted not to swallow the tooth) or cold milk or water to keep it from drying out.
  5. See a dentist as soon as possible.

Primary Tooth

Do NOT attempt to replant a baby tooth as it could interfere with the health of the underlying permanent tooth. Control bleeding with direct pressure and see a dentist as soon as possible.

Displaced Tooth


Permanent or Primary Tooth

If a tooth is moved out of place or pushed deeper into the jaw, do NOT try to reposition it yourself. See a dentist as soon as possible. The longer the tooth is left out of alignment, the harder it will be to move it back to its original position. The dentist may “splint” it to non-affected teeth to brace it. Depending on the extent of damage, the tooth may need to be moved back into position via orthodontics or extracted.

Chipped/Broken Tooth


Permanent or Primary Tooth

Locate the tooth fragment if you can, as it may be possible to reattach it using tooth-colored bonding materials. Do not try to file or smooth the tooth yourself. Note that the tooth may be sensitive to hot and cold due to exposure of nerves in the pulp at their center.

Cracked/Fractured Tooth


Permanent or Primary Tooth

This type of injury is similar to a chip/break but generally more extensive damage has occurred. Do not wiggle the tooth or try to remove any portion of it, and avoid biting on it. It may be sensitive to pressure and temperature changes if the pulp has been exposed. If the crack or fracture extends below the gum tissue, it may not possible to save the tooth. A dentist examination is very important to determine your options.

You can learn more about this subject by reading the Dear Doctor magazine articles “Children's Dental Concerns and Injuries” and “What to Do When Dental Injuries Occur.”

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