Baby tooth knocked loose, What should I do?

Baby tooth subluxation

In continuation of our dental trauma series, I’d like to talk about dental “concussion” and “subluxation”. These two types of dental trauma are the most common dental injuries I see in the office. Basically, the individual falls forward and “bangs” the tooth (or teeth) on some type of surface (coffee table, cement, monkey bar, another kid’s head, you get the idea).

Is the tooth loose?

What separates the two different diagnosis is if the tooth has been loosen or not. In both scenarios, you can expect the tooth to be tender to touch. A “concussed” tooth is tender to touch without mobility and a “subluxated” tooth is also tender to touch but loosened.

Let’s talk about an action plan for your child’s tooth knocked loose.

Don’t panic. Your first instinct is probably to pick up your kid.
First things first. Make sure your child does not have any other serious injuries. Loss of consciousness? Not acting like himself or herself? anything broken? If everything checks out initially, look around the mouth and check for anything missing or looking different. If a tooth is missing, we will follow steps as outlined from the dental avulsion post. If something looks different like a tooth pushed back or forward, your instinct may to move it back to where it was or maybe even leave it and let the dentist do that part. If not, likely the tooth (or teeth) was just banged up and everything else is ok.

Call your pediatric dentist

Please call your child’s dentist. This is urgent but not an emergency. You and your dentist will find the soonest appointment, same day if possible and if not, hopefully within 1-2 days.

If that is the case (as in dentist appointment not at this moment), here’s what I suggest doing. Observe your child as he/she go on a normal day. Questions I will ask you include any recent changes in eating habits? For example only eating soft foods or won’t eat at all. Have you had to give any OTC pain medication like Tylenol or Motrin? When and how did the trauma happen?
During the exam and from the dental radiographs for children, I will be checking for any dental trauma and that includes the tooth itself, like a fracture line , damage to the supporting tissues like the gums, other areas of the mouth. From there I will make an initial diagnosis with a treatment and follow up plan. Part of being a pediatric dental specialist, we spend a good portion of our training knowing how to assess and treat such situations. I encourage you, if you haven’t already, establish a dental home for your child with a pediatric dentist. As I said earlier, emergencies are by definition not something we expect to happen. However, when it does happen, you want someone who is experienced and educated in these situations to guide you and your child most appropriately.

In the last 2 weeks, I have seen at least 4 toddlers with the types of dental trauma mentioned above. I hope nothing ever happens but if it does, keep us at Anchorage Pediatric Dentistry in mind !

Dr. Christy Jen received her undergraduate and dental degree from the University of Washington, and completed her pediatric dental training at Children’s Hospital of Pittsburgh. She practiced in Michigan and Louisiana while her husband finished his surgery training before finally making Alaska their home.

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