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Emergency!
Where to look first when a tooth gets hurt or something urgent happens.
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Emergency!
A tooth has been driven up into the gum so that less of it shows, or none of it does. This page explains what has happened and what a dentist may do. Guidance for the moment itself is being written by a pediatric dentist — until it is here, contact your dentist.
Call your dentist or your local emergency number.
This section is waiting for reviewed guidance. Step-by-step advice for the first few minutes is being written by a pediatric dentist and has deliberately not been drafted here. Until it appears, contact your dentist or your local emergency services — they can tell you what to do for your child now.
This section is waiting for reviewed guidance too. Things to avoid are as important as things to do, and both belong with the dentist who is writing them rather than with this website.
An impact has pushed the tooth further into the bone rather than out of it. The tooth may look shorter than its neighbours, or may not be visible at all — which sometimes leads families to believe it has been knocked out and lost.
That confusion matters. If a tooth appears to be missing and has not been found, the AAPD states that radiographs are required to rule out aspiration or the tooth lying within surrounding tissue. A tooth driven into the gum will be found on that X-ray. Either way the answer is the same: contact your dentist.
Assessment normally begins with a clinical examination and radiographs, since the position of the tooth and its relationship to what lies above it cannot be judged by looking. In a child this includes the developing permanent tooth: the AAPD emphasises knowing the anatomy of a child’s developing jaw and avoiding injury to the developing tooth follicles, and notes that careful planning using radiographs and, where needed, three-dimensional imaging provides information about the position and development of the teeth involved.
What follows depends on that assessment. The AAPD lists a range of interventions for dental trauma including stabilisation and splinting and, where a tooth cannot be kept, extraction.
Your tooth got pushed up instead of falling out. It is still there, even if you cannot see much of it. The dentist has a special picture that shows exactly where it is.
The tooth seems to have gone — is it lost? Not necessarily. A tooth driven into the gum can look missing. Say exactly that when you ring: that the tooth cannot be seen and has not been found. The AAPD states an unaccounted tooth requires radiographs to rule out its being inhaled or lodged in tissue, so this is a reason to be seen either way.
That is a question for your dentist, who can see the position of the tooth on an X-ray and knows whether it is a baby tooth or a permanent one. This page cannot predict it, and the answer differs between the two.
Often you cannot tell from looking, which is exactly why the assessment includes radiographs. If a tooth cannot be seen and cannot be found, treat it as needing to be checked rather than assuming it is lost.
It is among the things the dentist will assess. The AAPD notes that avoiding injury to developing tooth follicles prevents longer-term dental complications in young patients, and that imaging is used to assess the position and development of the teeth involved. Whether this injury has any bearing on the permanent tooth is for your dentist to determine.
Every clinical statement on this page comes from the American Academy of Pediatric Dentistry document below. The step-by-step guidance in the sections above is being written separately by a pediatric dentist and is not drawn from this source.
This website is for education only and does not replace care from your dentist, physician, or emergency services.