If you or someone you’re with has a dental injury, it's important to get the right help.
If the accident causes you or someone you know to be knocked out (lose consciousness) or if there is a lot of bleeding, it's important to call for emergency help. Otherwise, contact a dentist straight away. If it's outside usual opening hours, contact an out-of-hours dentist or go to the accident and emergency department at the nearest hospital.
Try to do the following if your tooth has been knocked out.
- Try not to touch the tooth's root – it's best if you handle it by the crown (the white bit at the top).
- If possible, put the tooth back into its socket in your mouth. This is called reimplanting. If the tooth is dirty, gently rinse it with milk or saline solution (for example contact lens solution) for a few seconds, but don't scrub the tooth. Try to put it in the right way round, but don't worry too much as your dentist can fix this. The important thing is to put it back in as quickly as possible. Don't put children’s milk teeth back in the socket as this can damage the developing adult teeth.
- Bite down gently on a clean handkerchief or a piece of gauze to keep your tooth back in place in its socket.
- If you can't reimplant your tooth, store it in milk or saliva (by spitting into a container) or place it inside your mouth between your cheek and gum until you can get to a dentist. However, this isn't recommended for young children as they could swallow or inhale the tooth.
- If you haven't got the whole tooth, don't try to put a broken tooth back in your mouth. Store it in a pot of saliva or milk as your dentist may be able to reattach it.
Even if you don't think your tooth is broken, it's important to see your dentist as soon as possible. There may be an injury below the gumline that you can't see.
If your tooth has been loosened or knocked out
Your dentist will look inside your mouth to see if your tooth has been reimplanted properly. If not, and depending on your injury, he or she may try to reimplant it as soon as possible. However, this may not always be appropriate or possible.
You may need to have your tooth splinted (joined to your neighbouring teeth) to hold it in place as it heals. There are different types of splint – the most common is made of clear plastic. Another type is a thin piece of wire that attaches your loose tooth to those on either side of it. How long you need to keep the splint on will depend on how severe your injury was.
Your dentist may take some X-rays to see how serious your injury is and if there are any pieces of broken tooth stuck in your lip, gum or tongue. It’s rare, but if there is a possibility that you have inhaled a piece of tooth and it’s stuck in your airway, your dentist may refer you to hospital for a chest X-ray.
If your tooth has been chipped
Treatment for a chipped tooth will depend on where your tooth has broken. Teeth have a core of blood vessels and nerves at their centre called the pulp. If your tooth is injured, the pulp can be damaged and the blood vessels may die.
If a piece of your tooth has chipped off but the pulp isn't damaged, your dentist will smooth the uneven edge and replace the corner with a tooth-coloured filling. If the pulp is damaged, you may need to have root canal treatment to remove the damaged blood vessels and nerves from your tooth.
Your dentist may also check whether the chipped tooth has caused any further damage to your mouth. For example you may need to have an X-ray to check that a piece of your tooth isn’t stuck in your lip.
If your tooth has broken roots
Your teeth have roots that are set in your jawbones. If a root fractures, it's possible that your tooth won't look any different because the fracture is hidden by bone and gum. However, your dentist may be able to see a fractured root on X-rays.
If your tooth is quite firm, you may only need to go back for regular X-rays and tests to make sure that the pulp stays healthy. However, if your tooth is loose, it will need to be splinted for a few weeks to help the fracture heal.
If your dentist finds that the pulp has been damaged and isn't likely to recover in the weeks and months after the root fracture, he or she may recommend that you have root canal treatment to save your tooth.
Some fractures are unlikely to heal, particularly if they are near your gum or the tooth has broken lengthways. Your dentist may recommend that you have your tooth taken out.
After your treatment
If at any stage you feel pain or notice any change in colour to your damaged tooth, it's important to see your dentist. This is because the tooth pulp can die a long time after a dental injury. If you have had your tooth reimplanted, continue to get it checked as you may need treatment in the future.
Young children who injure their milk teeth may need different treatment to adults or teenagers. For example, if a milk tooth gets knocked out, the dentist is unlikely to try to reimplant it. This is because it could damage the permanent tooth when it develops or if it’s already developing.
See our frequently asked questions for more information about dental injuries in children.
If you regularly play a sport that puts you at any risk of dental injury (for example rugby, boxing, cricket, hockey), you may wish to consider getting a mouthguard. This will offer some protection and can reduce the likelihood of you getting an injury. Mouthguards are usually made of rubber and form a cover that goes over your teeth and gums.
You can buy mouthguards in some sports shops but it's better to ask your dentist to make one that has been individually made to fit you. This will protect your teeth more effectively. Your dentist will take a mould of your teeth using a putty-like material. This is then sent to a laboratory where your mouthguard is made. Children will need to have their mouthguards replaced as new teeth develop and their mouths grow.
I lost a tooth in a hockey match but I don't like wearing the false tooth that my dentist made. Are there any alternatives?
You may be able to have a bridge or implants to fill the space. Alternatively your dentist may recommend that you have orthodontic treatment to move your teeth inwards to fill the gap. However, everyone is different so you will need to speak to your dentist to find out what alternatives are suitable for you.
You will probably be advised to have a temporary denture with a single artificial tooth to fill the gap while your gum and tooth socket heal. This can give you the time you need to discuss the long-term options with your dentist.
A bridge can be a very effective option if you don’t need many teeth replacing. This is an artificial tooth that is permanently attached to the tooth or teeth on either side of the gap. There are a number of types available – your dentist will be able to recommend the best design for you.
You may be able to have an implant to replace your missing tooth. This is a small rod made of titanium that is placed in your jawbone where your tooth used to be – a small attachment will be left poking through your gum. After three to six months your bone will fuse with the metal implant and an artificial tooth can then be screwed or clipped onto the attachment. You won't be able to remove the artificial tooth and the implant won't be visible.
Depending on the condition of your teeth, you may be able to have orthodontic treatment to hide the gap by moving adjacent teeth into the space. You will need to wear orthodontic braces and the treatment is likely to take some months or years to complete.
You can help to prevent further dental injuries by wearing a properly fitted mouthguard.
My child fell and cut the inside of his lip with his front teeth. Will this affect his developing adult teeth?
The main factors that determine whether or not your child's adult teeth will be affected include his age and how severe the injury is. Take your child to the dentist as soon as possible so that his teeth and gums can be checked for any wobbliness, swelling or discolouration.
Any potential long-term effects following a dental injury mostly depend on your child's age. Adult front teeth start to form deep inside the gums in babies. At about six to seven years old the front milk (baby) teeth fall out and the adult ones come through in their place. By the age of about eight, the crowns (the white parts that will show in your child’s adult smile) are completely formed.
The crucial time for the development of the crowns is up until the age of about eight. If the front milk tooth is injured during this time, it's possible that the enamel of the developing adult crown could be affected. This could alter the colour or shape of the adult tooth.
If the damage is more severe, the angle at which the adult tooth grows might change, or it may not come through as expected. However, this is likely to happen only if your child's injury was more serious, for example, if the tooth was pushed up into the gum.
If your child's teeth look the same as they did before the injury and the only sign of the fall is a cut lip, it's likely that his or her adult teeth won't be affected. See your dentist for more advice.
One of my front teeth was pushed into my gum in an accident so it looks shorter than the one next to it. Will it go back to how it used to be?
This is called an intrusion injury and you can have treatment to correct it. The success of your treatment will depend on the age at which you had the injury and how far your tooth has been pushed into your gum.
Adult front teeth come through to replace the milk (baby) teeth at about the age of six or seven. However, the roots of these teeth continue to develop for the next couple of years. This can affect the treatment of intrusion injuries.
If you have an intrusion injury to one of your front teeth before the root of your tooth has developed, your tooth is likely to recover. It will usually move back through your gum (re-erupt) within about three weeks. If it doesn't, you can have an orthodontic brace fitted to help pull it into the correct position.
However, if the root is fully developed, your tooth will be less able to recover. The blood supply to the pulp of your tooth may get cut off during the injury and your tooth will die. If this happens, the root of your tooth may start to dissolve – this is called root resorption. This can lead to you having a wobbly tooth that you may eventually need to have taken out. Your dentist probably won't leave your tooth to see if it re-erupts. He or she will usually recommend an orthodontic brace to move your tooth back into position and root canal treatment to remove the pulp. Your dentist will also place a dressing inside your tooth to help prevent root resorption.
- British Dental Health Foundation
0845 063 1188
- British Dental Association
020 7935 0875
- Guideline on management of acute dental trauma. American Academy of Pediatric Dentistry. www.aapd.org, published 2011
- The justification for orthodontic treatment. British Orthodontic Society. www.bos.org.uk, published 2008
- Dental injuries. Epilepsy Society. www.epilepsysociety.org.uk, published March 2012
- Information for patients. International Association of Dental Traumatology. www.iadt-dentaltrauma.org, accessed 21 June 2013
- Dental care. Better Health Channel. www.betterhealth.vic.gov.au, published October 2011
- Management of dental trauma. eMedicine. www.emedicine.medscape.com, published April 2012
- Caring for your mouth after a dental injury. British Association of Oral and Maxillofacial Surgeons. www.baoms.org.uk, accessed 22 June 2013
- Caring for teeth. British Dental Health Foundation. www.dentalhealth.org, accessed 14 August 2013
- British Dental Health Foundation
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Reviewed by Polly Kerr, Bupa Health Information Team, September 2013.
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