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Tooth Troubles

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New walkers are very likely to take a few falls and bang a few teeth. About one-third of all toddlers have some kind of trauma to their pearly whites. The risk peaks between 18 and 40 months, so learn what to do now just in case.


If a baby tooth is knocked out completely, chances are the dentist won't be able to re-implant it -- so the tooth fairy wins. Permanent teeth, on the other hand, can be re-implanted within one to two hours after being injured. If your child loses a permanent tooth when he's older, put it in a clean container with a sample of his saliva, and take it to the dentist or the emergency room right away.


In all missing-teeth cases, apply pressure to the hole to stop the bleeding. If bleeding doesn't stop after 10 minutes of constant, firm pressure, see the dentist or go to the emergency room. Once the bleeding has stopped, give your child acetaminophen (Tylenol) to relieve his pain.


If your child's tooth breaks off and is partly in and partly out of the gum -- or there is a break line running up the tooth, or a glob of reddish flesh (the dental pulp) sticking out -- see the dentist right away. If the tooth has just shifted a bit, it doesn't need attention. Your child will probably push the tooth back into place with his tongue over the next few days. If a tooth has been pushed up into the gum (intruded) but isn't broken off or bleeding, wait for a next-day visit to the dentist. But be sure to check in with the dentist at some point, since further care may be necessary now or in the future.


After any dental trauma, baby teeth are likely to turn color over a period of several weeks. If you notice that happening, it means that the inside of the tooth has died, and the tooth may need to be pulled. But don't worry -- extraction is a quick, painless procedure these days.


If your child's teeth are okay, but he's cut or bruised his gums or lips, apply cold and pressure. A small bag of ice or a frozen fruit bar should work well. If the cut is larger than 1/4 inch or goes across the lip border, take your little one to see his health care provider. The provider can make sure everything will heal properly.


Don't panic if your child cuts his tongue and you see a lot of blood. The tongue has a good blood supply, so it puts on quite a show. But except in the case of very large cuts, the tongue will heal itself.


Remember, even though they're not permanent, injured baby teeth still need attention. Trauma to them can harm the permanent teeth developing underneath the gum, possibly delaying the time they come in. And decay in a baby tooth can affect general gum and tooth health, too. So keep an eye on the pearly whites.


FYI: It's a good idea to make a dental appointment before your baby is really off and running, so you'll know who to call in a pinch. Pediatricians and dentists recommend that the first visit take place by age 1. And the dentist and your child will already be friends.


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