My Kid Bumped His Tooth…Now What?

I received an email last week from a worried mom whose cute little baby girl bumped her tooth against the crib.  The tooth became a little loose and the gum tissue looked slightly swollen.  She asked me if it was important to bring the baby to the dentist for an evaluation.  My answer of course was YES!

Dental traumas, unfortunately, are common among all children.  Toddlers who just learned how to walk bump their heads and mouths all the time while exploring the world around them.  As they enter pre and elementary school, children become more and more physical and fall easily while playing.  Even in tween and teen years, kids can injure their teeth through playing sports.


Permanent Tooth with Stained and Missing Enamel

Another Stained Tooth


For baby teeth, ultimately what we’re worried about is the possibility of an dental infection which can damage future permanent teeth.  Permanent front teeth develop at the root tip of baby teeth.  If an infection starts to fester from the baby tooth, the inflammation can cause discolored, stained, or chipped enamel.  Whatever damage that results may not be visually apparent at the time, but will show up at the age of 7 or 8 when permanent upper front teeth start to come in.  Therefore, it is very important to have the baby tooth removed as soon as an infection is present.


X-ray of upper teeth.  Note the permanent teeth that are developing right under the baby teeth


It is essential for children to be evaluated by a dentist at the time of trauma then again one month later for a re-evaluation.  At the initial visit, the dentist will likely attempt to take an x-ray for the area, take note of the degree of looseness, and tend to any soft tissue wounds on the lips and gingiva.  Since it takes approximately 3 weeks for an infection to show up on x-ray, the inital radiograph will just serve as a baseline image, something that the dentist can compare to at the re-evaluation appointment when a new x-ray is taken.  If an infection were to develop it would usually show up no later than a month later, and the dentist can remove the tooth during the re-evaluation appointment.

Having said all of that, baby teeth tend to be pretty resilient.  Some changes in color may be seen on the tooth in the few weeks/months following the traumatic event.  Any changes in color would mean that the nerve inside is dead.  However, as long as there is no infection, the tooth may very well stay in the mouth until it’s natural exfoliation time (time to fall out) with absolutely no problems.  The tooth may also stay loose for a while.  If this happens usually exfoliation will happen earlier than typically expected.  But once again, as long as there is no infection the tooth won’t have to be taken out.

If you have any questions concerning dental trauma, feel free to contact me at my Las Vegas Pediatric Dental Office at (702)242-2436.