Children fall. It is a normal part of childhood — but when a fall involves a tooth, the next few minutes and hours can make a significant difference to the outcome. Dental trauma in children is common: studies cited by the International Association of Dental Traumatology (IADT) estimate that up to 30% of children experience some form of dental injury before age 6.
Here is what the evidence says to do — and what to expect when you bring your child in.
First: check the child, then the tooth
Before focusing on the tooth, check your child. If they lost consciousness, even briefly, or you are concerned about a head injury, seek medical attention first. Dental injuries and head injuries can occur together in a fall.
Once you are confident your child is otherwise okay, assess the tooth.
If the tooth is chipped or cracked
A chipped tooth — where a piece of enamel has broken off — may look alarming but is often straightforward to treat. The urgency depends on how deep the chip goes:
- Enamel only (smooth edge, no sensitivity, no visible yellow-cream layer beneath): see us within 24–48 hours. The sharp edge can usually be smoothed or built back up.
- Into the dentine (the sensitive yellow-cream layer beneath the enamel is visible, or the child has sensitivity to air or cold): same-day or next-day appointment. The exposed dentine needs to be covered promptly to prevent bacteria reaching the pulp.
- Into the pulp (a pink or red dot is visible at the centre of the broken surface, or there is bleeding from the tooth itself): contact us the same day. The pulp is exposed and will need treatment promptly.
Keep the broken tooth fragment if you can find it — bring it to the appointment in a small container of water or milk.
If the tooth is pushed in, tilted or moved
Luxation injuries — where the tooth is still in the mouth but has moved from its original position — need to be seen the same day. Do not try to push the tooth back into position yourself.
The types range from concussion (tooth in place but tender to touch) to intrusion (tooth pushed up into the gum) and lateral displacement. The IADT guidelines distinguish between these because the treatment and monitoring protocols differ significantly.
If a tooth is completely knocked out
A knocked-out permanent tooth is a dental emergency. Time matters significantly.
1. Pick the tooth up by the crown (the white part you can see), not the root. 2. If it is dirty, rinse it very briefly in milk or clean water — do not scrub it. 3. Store it in milk, or wrap it in cling film to keep it moist. Do not let it dry out. 4. Get to us or the nearest dental facility immediately — ideally within 30–60 minutes.
For baby teeth: a knocked-out primary tooth is generally not replanted (doing so can damage the developing permanent tooth underneath). However, it still needs to be seen, and we will advise on what to watch for.
For permanent teeth: the sooner the tooth is replanted and stabilised, the better the long-term outcome.
What to expect at the appointment
We will take a clinical history, examine the tooth and surrounding tissues, and take an X-ray to check the root and the developing teeth beneath. Treatment depends on the type and severity of the injury — it may be smoothing a chip, placing a protective coating, splinting a displaced tooth, or pulp treatment.
Following dental trauma, the tooth needs to be monitored at intervals for months or even years, because some complications (including nerve death and root resorption) develop slowly and are only visible on X-ray. We will advise you on the follow-up schedule.
Sources: International Association of Dental Traumatology, Guidelines for Management of Traumatic Dental Injuries, 2020; American Academy of Pediatric Dentistry, Guideline on Management of Traumatic Dental Injuries, 2019.