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Sonoma Family Life Magazine

Is It Really a Dental Emergency?

By Malia Jacobson

Keeping kids’ smiles healthy takes more than regular dental checkups (which should begin around 18 months) and brushing twice daily. In addition to the normal loss of baby teeth and a cavity or two, many children will experience some type of tooth-related trauma, like a chipped tooth or one that suddenly turns grey, at some point. While childhood dental dramas are common, experts warn against ignoring them because problems with baby teeth can affect developing permanent teeth. Read on for help with dental problems, from minor mishaps to true emergencies, to keep baby teeth beaming and big-kid grins gleaming.

Early Years (Ages 0–5) Shades of Grey
Many parents are dismayed to discover that one of their toddler’s pearly whites isn’t white at all—think grey or light brown. A tooth that suddenly darkens is fairly common: Because baby teeth have shallower roots than permanent teeth, they can die with even a slight bump, causing them to lose their white luster. Dentists generally advise a “wait and see” approach to a greying baby tooth because it’s usually just an aesthetic issue; dying baby teeth sometimes heal, and a dead baby tooth may not create any further problems or harm adult teeth, says pediatric dentist Sabrina Magid Katz, DMD.
A greying baby tooth may become infected, which sometimes causes a tiny pustule on the gums above the tooth; a dentist can extract it and help treat the underlying infection. If the tooth has to go, take heart—it won’t affect spacing of the permanent teeth, and your little one may get to be the first of his or her pals to get a visit from the Tooth Fairy.

Elementary Years (Ages 6–12) Knockout
During the school years, kids lose most of their baby teeth and learn to care for their new adult choppers. And because children are so active during this stage, it’s not uncommon to knock out a tooth—ouch. A knocked-out tooth is a true dental emergency that warrants a call to your dentist. Dentists advise keeping the tooth damp so it doesn’t dry out; if possible, have the child hold it in place with a finger. If the tooth is a permanent one, your dentist may be able to restore it in its original position. But knocked-out baby teeth aren’t re-implanted, as that can damage the adult teeth underneath.

Another common dental dilemma: Permanent teeth coming in before baby teeth fall out, resulting in multiple “rows” of teeth. This can look odd, but it’s not a big deal, says Katz; the tongue will push the permanent teeth into alignment once the baby teeth fall out. Encourage your child to keep wiggling the baby teeth; if one is particularly stubborn, your dentist can help coax it out.

Teen Years (Ages 13–18) Chip Off the Old Block
Chomping ice, using teeth to open a bottle, or playing sports can lead to something most teens don’t want in their yearbook photo: a chipped tooth. When is a chipped tooth an emergency? While minor chips are mostly an aesthetic issue, a larger chip can expose nerve endings that make a tooth extremely temperature-sensitive and very painful, says Katz. If your child chips a tooth, try to locate the missing piece, put it in water, and call your dentist right away. A severe break may qualify as an emergency, while more minor chips can probably wait until the next business day.

If the broken piece can’t be found, your dentist can create a composite filling to restore the tooth. A composite can look natural and last for years, though your child may need to replace it at some point in her or his lifetime. To avoid chips, have teens wear mouthguards for sports. Also advise them to never use teeth as “tools”—and always model healthy dental habits by refraining from this practice yourself. 

Malia Jacobson is a health and family journalist.