June 26, 2019 Tri Le Your child comes running into your home with what seems like a bloody lip. You quickly learn that he or she has a chip missing out of their tooth. What do you do when this happens? Many parents will encounter this from time-to-time. Accidents happen, but chipped teeth, especially those in a child, can be very painful and need proper care to minimize pain and reduce the risk of infection. What to Do Immediately When your son or daughter has a chipped tooth, your first step is to calm the child. In some cases, the child will be in a significant amount of pain. In others, they are afraid and worried. In all situations, it is up to you to stay calm. This is a common injury. All dentists who, like us at Bunker Hill Dentistry, offer pediatric services will have experience with chipped teeth in children and will be able to fix it. Once you calm your child and stop any crying, you can then assess the situation. If there’s bleeding, apply pressure to the area to stop it. Try to keep the child from swallowing blood. Once this stops, you can then assess the problem more thoroughly. Is It a Baby or a Permanent Tooth? You’ll need to identify if the tooth is a permanent or a baby tooth. Youngsters start to lose primary teeth from ages 5-7 so if your child is significantly younger you can be quite sure it’s a baby tooth that has been chipped. A child will typically lose all baby teeth by the age of 12, although front incisor teeth – by far the most likely to be chipped – commonly fall out by the time a child is 8. Therefore, if your child is between 5 and 8 then you will likely need to work out if it’s a baby or permanent tooth if you don’t know already. Read on to learn how to identify the difference. If the tooth is a baby tooth, don’t assume no action is necessary. In some cases, the chip can be sharp, causing the potential for pain and oral tissue damage. Also, the chipped tooth may also involve a fracture, or a deep chip can result in an infection. In all cases, you need to consider treatment options. If It Is a Baby Tooth You can tell if it is a baby tooth, primarily, by whether the tooth is small and if your son or daughter has lost that tooth previously. Baby teeth are whiter than permanent teeth (if they have permanent teeth to compare against) and the bottom edge of a baby tooth is smooth. Here are some tips for handling a chipped baby tooth. How Does It Look? Examine the tooth as closely as possible. How much of the tooth has been chipped off? Is the tooth moving? Is there any damage along the gumline, such as the tooth pulling away from the gum? What Steps Should You Take? Rinse your child’s mouth with cool water. Encourage them to spit it out. Then, place a cold compress on the child’s face near the tooth. This can help to minimize any tissue swelling in the area. Do this for 20 to 30 minutes. If possible, keep the fragment. Don’t worry if your child has swallowed it or if the child doesn’t know where it is. If your child is in inconsolable pain, especially if he or she is very small, it may be necessary to take the child to the emergency room. This may only be necessary if there is extensive pain due to an exposed nerve. You may be able to call a nurse line or your child’s dentist for immediate help if it is during office hours. What Repair Options Are Available? In some situations, the dentist may recommend extraction of the baby tooth if the chip is significant or if there is any type of nerve damage. It may be possible to repair the baby tooth, but this is not always necessary since most children will lose front teeth (those likely to be chipped) by the time they are eight. If It Is a Permanent Tooth A permanent tooth chip is one that you need to care for with a bit more attention. A permanent tooth will be a darker shade than a baby tooth and its bottom edge will be rougher and more jagged. Because it is larger, it may hurt a bit more. Your child is older, too, which means he or she may be more self-conscious about the loss of the tooth or the chip. Here are a few tips for managing this situation. How Does It Look? With a permanent tooth, you also need to examine the injury closely. Look at the size and location of the chip. How deep is it? Did it cause the tooth to move at all in the gumline? What Steps Should You Take? Rinse the child’s mouth with cool water and encourage them to spit it out. Once the child has calmed down, apply a cold press to the area for at least 20 minutes. If there is any significant bleeding, apply pressure until it stops. Encourage the child not to touch the chipped area, including with their tongue. Then, seek out care from your dentist as soon as possible. Try to understand what happened and talk to your child about the incident. More information may help the dentist when it comes to treatment. What Repair Options Are Available? For permanent teeth, there are more options for chipped tooth repair. This includes filing down the area where the chip is missing. This is best for minor chips, such as corners or the very tip of the tooth. It helps to smooth it down, so it isn’t uncomfortable. For larger ones, dentists may apply dental bonding. Bonding uses a specific material to fill in the open area, creating a very natural-looking tooth. In some situations, bonding isn’t ideal, such as if the chip is significant. Using a veneer in this situation may be an option. It’s up to your dentist to determine the best possible care option. What Type of Aftercare Can You Expect? Once the treatment is completed, your dentist will provide specific insight into how to care for it. Most people are able to eat and drink within 24 hours. And, it is important to consider long term care, including proper dental hygiene to keep the tooth in good overall health. Don’t forget to give your child an extra bit of attention when an event like this happens. The process is a hard one to go through, especially when there’s significant pain involved. The good news is that treatment can help get your child’s smile back to what it once was in nearly all situations. Tri LeA practicing dentist since 1987, Dr. Le has been running successful dental practices in Texas with his wife Ann since 1990. A member of the ADA, AACD and AADSM, Dr. Le has also contributed to several leading dental journals.