Tooth Injury

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DEFINITION

• Injuries to the teeth

Types of Teeth Injuries

• Chipped or Fractured Tooth: All need to seen by a dentist. A fracture that enters into the pulp (center) of a tooth is referred to as complicated; the tooth is usually painful or sensitive to hot and cold. You may be able to identify a complicated tooth fracture by noticing a small red dot or pink blush (the pulp) in the fractured area. To prevent permanent tooth damage, fractures into the pulp need to be treated within 3-4 hours.
• Loosened Tooth: If mild, it usually tightens up on its own (may bleed a little from the gums).
• Displaced Tooth: Any tooth that has been pushed out of normal position (displaced) needs to be seen by a dentist to assess the damage. Displaced teeth that interfere with biting, chewing, or closing of the mouth need to be repositioned within 4 hours for reasons of comfort and function. Mild displacement can wait for 24 hours for assessment.
• Knocked-out Tooth: This is a dental emergency. The knocked-out tooth needs to be placed back in its socket at soon as possible, ideally within one hour.

FIRST AID Advice for Knocked-out Tooth

• To save the tooth, it must be put back in its socket as soon as possible (2 hours is the outer limit for survival). Use the following technique:
  • Rinse off the tooth with saliva or water. Do not scrub the tooth.
  • Replace it in the socket facing the correct way.
  • Press down on the tooth with your thumb until the crown is level with the adjacent tooth.
  • Lastly, bite down on a wad of cloth to stabilize the tooth until you can be seen by a dentist.

Transporting a Knocked-out Tooth

• Follow these instructions if you are not able to put the tooth back in its socket.
  • It is very important to keep the tooth moist. Do not let it dry out.
  • Transport the tooth in saliva or milk.

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WHEN TO CALL YOUR DOCTOR

Call 911 Now (you may need an ambulance) If

• Knocked out (unconscious)
• Major bleeding that can't be stopped

Call Your Dentist or Doctor Now (night or day) If:

• You think you have a serious injury
• Knocked-out tooth (see First Aid)
• Tooth is almost falling out
• Tooth is greatly pushed out of its normal position
• Tooth that's pushed out of its normal position interferes with normal bite
• Chipped tooth is missing a large piece, or a red dot is visible inside the chipped area
• Bleeding won't stop after 10 minutes of direct pressure
• Severe pain

Call Your Dentist Within 24 Hours (between 9 am and 4 pm) If:

• You think you need to be seen
• Tooth is slightly pushed out of its normal position
• Can see a chip or fracture line in the tooth
• Tooth sensitive to cold fluids  
• Tooth feels very loose when you try to move it

Call Your Dentist During Weekday Office Hours If:

• You have other questions or concerns

Self Care at Home If

• Minor tooth injury and you don't think you need to be seen

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HOME CARE ADVICE FOR MINOR TOOTH INJURIES

1. Local Cold: For pain, apply a piece of ice or a Popsicle to the injured gum area for 20 minutes.
2. Pain Medication: For pain relief, take acetaminophen every 4-6 hours (e.g. Tylenol; adult dosage 650 mg) OR ibuprofen every 6-8 hours (e.g. Advil, Motrin; adult dosage 400 mg).
   • Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
   • Do not take acetaminophen if you have liver disease.
   • Read the package instructions thoroughly on all medications that you take.
3. Soft Diet: If you have any loose teeth, eat a soft diet for 3 days. After 3 days, they should be tightening up.
4. Call Your Dentist If:
   • Pain becomes severe
   • Tooth becomes sensitive to hot or cold fluids
   • Tooth becomes a darker color
   • You become worse 

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.