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My Child Knocked Out a Baby Tooth! Now What?

Baby teeth. They’re the set of teeth that are meant to be lost. The set that if your child loses accidentally, you don’t panic over, or worry about saving or replacing. But did you know that in some cases you actually can save baby teeth that are lost accidentally? Dr. Michele Simpson of Wilmington, NC explains.

Picture this: Your son is running on uneven pavement, and his shoe catches a raised tile, sending him flying through the air. He lands, taking the impact on his top, central incisor- knocking the tooth clean out. Now, what? At this moment, you have a few options. You can consider the tooth a lost cause and introduce your son to the tooth fairy a little early, or according to Dr. Michele Simpson, there may be hope of saving the tooth and having a dentist re-implant it. But time is of the essence!

"The first thing you want to do if your child loses a tooth is to stop any bleeding by having your child bite down on a piece of sterile gauze." Says Simpson. "Then, once your child is safe, you should look for the tooth if you don’t already know where it is. It is important that you rule out your child swallowing the tooth because this can cause aspiration. If you cannot locate the tooth and suspect it was inhaled, bring your child to a pediatrician or urgent care immediately." Another potential problem if you cannot locate the tooth is that it may have been pushed up into the gum and will need to be repaired by a dentist. A dentist can either pull the tooth back down and re-set it if possible or pull the tooth if necessary. Either way, it is important that the baby tooth is found, because it could damage the permanent tooth growing in behind it- or cause crowding and more pain down the road.

If the tooth has fallen completely out, and you do have the tooth, Simpson says the first thing you’ll want to do is keep the tooth wet. "It is imperative that you not let the lost tooth dry out. Submerge the lost tooth in a container of salt water, milk, or even the child’s saliva. If the tooth is dirty, rinse it in whatever solution you are using to soak it, but do not try scrubbing the tooth or removing any tissue that’s still attached." According to Simpson, some pharmacies, and sporting goods stores even sell a product specifically made for preserving fallen teeth. She suggests you keep a box on hand, especially if you have children who play rough sports, or who are accident prone. If you don’t already have it, use one of the methods mentioned above- don’t rush out looking for a product and risk the tooth drying out in the meantime.

Once you have preserved the tooth, according to Simpson, the next step should be finding a dentist- but act quickly. Says Simpson "You have about two hours from the time the tooth falls out to get it re-implanted. If you go beyond two hours, chances are the tooth will not re-implant." If the accident occurs after regular business hours, first try calling your regular dentist. Most dentists have a recording with an emergency number or an answering service who can page them after hours. If your dentist does not have an after-hours number, don’t worry about patient loyalty- just keep calling until you find someone who will see you immediately. Should you end up needing to visit a different dentist than usual, make sure you inform him or her if your child has any medical or dental issues they should be aware of.

Once the tooth has been successfully re-implanted, the next few weeks are critical. "Make sure you are following the aftercare instructions to the letter," she cautions. "Once the tooth is in place, you’re not out of the woods. You want to give that tooth every chance possible to re-implant." Furthermore, says Simpson "Even if you do follow the instructions perfectly, there is still a chance the tooth won’t take." If that happens, follow up with your dentist and discuss other treatment options. "Sometimes," says Simpson "the best course of action is to do nothing at all, and just wait for the permanent tooth to grow in. In some situations, there may be a risk of crowding, and the dentist may want to put in a spacer, so the adult teeth grow in straight. It all depends on the individual mouth and situation."

Ultimately, Simpson advises "Don’t go this alone." If your child loses a baby tooth, seek help from a dental professional immediately- "Even if you think it’s a lost cause, have a dentist check it out as soon as possible."

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Michele Simpson DDS

Wilmington Dental Office

3317 Masonboro Loop Rd • Suite 140 • Wilmington, NC 28409

(910) 550-3959