What Parents Need to Know About Pediatric Dental Emergencies

Even when your child has preventive and routine care at our Upper East Side Pediatric Dentistry practice, dental emergencies can happen. In many cases, the difference between saving and losing a tooth depends on taking the proper action in the immediate aftermath of an injury. 

 You should contact Dr Sara for emergency care ASAP in the case of:



  • A knocked-out (avulsed) tooth

  • A chipped or broken tooth

  • A cut or bitten tongue, lip, cheek that requires suturing

  • A toothache with facial swelling

The primary goals when treating a traumatic dental or oral injury are to:

  • Save teeth at risk of being lost

  • Prevent or treat infection

  • Restore function in the best possible way 

What To Do If a Baby Tooth is Knocked Out

In general, a knocked out baby tooth is not as serious as a knocked out permanent tooth. But your child should still come to the office for an exam.

  1. First, comfort your child and stem the bleeding by applying light pressure with a sterile gauze pad. 

  2. Try to find the knocked out tooth to be sure the child has not swallowed it. It’s important to try to find the tooth because it could possibly be knocked into the gums, or part of the tooth may still remain in the bone. 

  3. Don’t try to put a baby tooth back into the socket because you could inadvertently damage the permanent tooth.

  4. Make an appointment at our pediatric dental office. 

We’ll examine your child’s mouth thoroughly and possibly take x-rays to check the surrounding teeth and unerupted permanent teeth for damage. It’s sometimes necessary to insert a space maintainer to keep surrounding teeth from shifting and assure that permanent teeth erupt properly.

Even preschool age children are aware of their appearance. If the knocked out tooth is a front tooth, a gap may last for several years until the adult teeth erupt. If necessary, we can make a temporary bridge called a “pedo-partial” that only stays in place until permanent teeth come in. Every consideration is given to the individual child’s situation and treatment plan.

What To Do If a Permanent Tooth Is Knocked Out


Time and fast action are crucial when a permanent tooth is knocked out. For the best outcome, your child should see Dr Sara within one hour of the incident. Follow these steps immediately:

Call our office immediately. If it’s after hours, our voicemail will give you the phone number to reach Dr. Sara.

  • Take a photo. Zoom in to the tooth. Have the child point the nose up to the ceiling. Pull back the lip. This is not diagnostic, but it will give us a sense of the severity.

  • Try to find the tooth. Gently place the tooth back into the socket. 

    • Gently press down on the tooth with your thumb until the crown is level with the adjacent tooth.

    • Have the child bite down on a wad of gauze or cloth to stabilize the tooth until arrival at our Upper East Side dental office.

  • If you can’t reinsert the tooth, keep the tooth moist by putting it in a plastic bag filled with milk.

  • If you have Save-a-Tooth, you can insert the tooth in it and bring it to our office. It’s inexpensive and you can buy it online. It’s a good thing to have on hand when you have children - especially if they play sports. Ask our office how to order it.

Chipped or Broken Tooth

Children can chip or break teeth because of falls or sports injuries, or even biting down on hard foods like ice or candy. 

If your child chips or breaks a tooth, immediately rinse the mouth with warm water to clean the area. You can use sterile gauze to stop bleeding. If there is facial swelling, apply ice. Most importantly, he or she needs a dental exam and x-rays as soon as possible. 

If there is a history of loss of consciousness, nausea or vomiting, or if the incident is not witnessed, it is wise to go directly to a local hospital for evaluation. Then call Dr. Sara as soon as possible to follow up.

There are four classes of dental fractures:

Class 1 – Fractures in the outer enamel layer

Class 2 – Fractures into the dentin layer

Class 3 – Fractures into the pulp

Class 4 – Fractures of the root

Treatment options will depend on the class of the fracture and whether or not it’s a permanent or primary tooth.

A Cut or Bitten Tongue, Cheek or Lip

If you child bites his/her lip, tongue or cheek, clean the area gently with warm water and apply a cold compress. If there is uncontrolled bleeding, call 911.

If bleeding can be controlled, call or come to our office or an emergency room to determine if the cut needs sutures. It is important to have Dr. Sara evaluate whether there is dental involvement or if a segment of a chipped tooth got embedded in the child’s lip or tongue. 

A Toothache With Facial Swelling

A toothache can occur from a deep cavity, an oral ulcer, dental trauma, an absess, a gum problem, a loose baby tooth or even from something stuck between the teeth. 

Toothaches become an emergency when they involve severe pain and/or facial swelling. These can be symptoms of an abscess. Without treatment, infection from an abscess can spread to other areas of the body and even become life-threatening

If your child has a toothache, call our pediatric dental office for an appointment for your child to be seen ASAP. Do not wait for an abscess to form.

How to Prevent Dental Emergencies

There are a number of simple precautions to take to avoid an accident and injury to the teeth:

  • Visit the pediatric dentist every six months to make sure your child's teeth are healthy and strong.

  • Establish a routine of oral care from infancy on.

  • Dr. Sara can make your child a sport-specific mouthguard and suggest an appropriate helmet for sports or recreational activities.

  • Supervise young children. Don’t let them run around with pencils or toys in their mouths.

  • Reduce trip hazards in your home and use gates to block stairways and dangerous areas from young children.