Children are active, curious, and prone to the kind of tumbles and accidents that can result in dental injuries. At the same time, children can develop dental infections and toothache just as adults can, and their smaller bodies mean problems can sometimes develop more quickly. As a parent, knowing how to respond calmly and quickly when your child has a dental emergency can make a significant difference to the outcome – and in some situations, to whether a permanent tooth can be saved.
Whether you are dealing with a knocked-out tooth on a Saturday afternoon, a child in distress from a toothache, or a swollen jaw that appeared overnight, the guidance below will help you understand what to do, when you need an emergency dentist, and when to call 999 instead.
Knocked-Out Baby Teeth vs Permanent Teeth
One of the most important pieces of knowledge for any parent is understanding the critical difference between a knocked-out baby (primary) tooth and a knocked-out permanent (adult) tooth.
Knocked-Out Baby Tooth
If a young child knocks out a baby tooth, you should not attempt to put it back in the socket. Reinserting a baby tooth can damage the developing permanent tooth bud underneath the gum. Instead, keep the child calm, control any bleeding by having them bite gently on a clean cloth, and contact your dentist for an appointment to have the socket checked. The permanent tooth will eventually fill the space, but it is worth having the area assessed.
Knocked-Out Permanent Tooth
A knocked-out permanent tooth is a true dental emergency. Time is critical – the tooth has the best chance of being successfully reimplanted if it is reinserted within 30 to 60 minutes of being knocked out. Follow these steps immediately:
- Find the tooth and pick it up by the crown (the white part you can see in the mouth), not by the root
- If it is dirty, rinse it gently in milk or clean water – do not scrub it, as this damages the root surface cells needed for reimplantation
- If the child is old enough and co-operative, try to gently reinsert the tooth into the socket and have them bite on a clean cloth to hold it in position
- If reinsertion is not possible, store the tooth in a small container of milk or, if milk is unavailable, between the inside of the child’s cheek and their lower gum (if they are old enough not to swallow it)
- Get to a dentist immediately – call your own practice or, if closed, NHS 24 on 111
Do not store the tooth in water, and do not let it dry out. According to NHS Inform, dental emergencies need to be assessed and treated quickly to avoid the risk of permanent damage, and a knocked-out permanent tooth is one of the clearest examples of this.
Chipped or Fractured Teeth
A chip or fracture to a child’s tooth is common, especially in older children who play contact sports. A small chip to the corner of a front tooth with no pain may not require emergency treatment but should be assessed at a dental appointment within a day or two, as sharp edges can cut the tongue or cheek. If the fracture is large, if there is significant pain, or if you can see a pink or red area at the centre of the broken tooth (which indicates the nerve is exposed), this requires same-day emergency dental attention.
A tooth that has been pushed inwards, outwards, or sideways (rather than knocked out entirely) – known as a luxation injury – also needs urgent dental assessment. Do not try to push the tooth back into place yourself.
Toothache in Children
Toothache in children is most commonly caused by tooth decay. Scotland has ongoing public health programmes to reduce childhood tooth decay, but it remains a significant cause of dental pain in children. A child complaining of toothache should be taken to the dentist within a day or two wherever possible.
While waiting for an appointment, age-appropriate doses of paracetamol or ibuprofen (check the packaging for correct children’s doses by weight and age) can help manage pain. Salt water rinses can be helpful for older children. Never give aspirin to children under 16.
When Toothache in a Child Requires Urgent Attention
Some presentations of toothache in children need same-day or emergency care rather than a routine appointment.
| Symptom in Child | Likely Cause | Urgency |
|---|---|---|
| Swollen face or jaw | Dental abscess | Contact dentist today |
| Fever alongside dental pain | Spreading infection | Contact dentist or NHS 24 urgently |
| Difficulty swallowing or breathing | Serious spreading infection | Call 999 immediately |
| Severe uncontrolled pain | Abscess or pulpal involvement | Contact dentist today |
| Tooth visibly moving or very loose (not a baby tooth) | Trauma or bone loss | Urgent dental assessment |
| Swollen or red eye alongside toothache | Possible orbital spread | Go to A&E immediately |
Dental Injuries From Sports
Children who play contact sports – rugby, football, hockey, and martial arts in particular – face a higher risk of dental injury. A custom-fitted mouthguard from a dentist offers significantly better protection than a generic shop-bought version and can dramatically reduce the risk of knocked-out or fractured teeth. If your child regularly takes part in contact sport and does not wear a mouthguard, it is worth discussing this with your dentist.
If a sports injury results in a dental emergency, follow the guidance above for knocked-out or fractured teeth and seek dental care immediately. Even if the tooth looks intact after a blow, it is a good idea to have it checked – teeth can sustain internal damage or root fractures that are not immediately visible.
Soft Tissue Injuries in Children
Children often bite their tongues or lips during falls and accidents. The inside of the mouth is very well supplied with blood vessels, so even a relatively small cut may bleed quite dramatically. Apply gentle pressure with a clean cloth or gauze for 10 to 15 minutes. If the bleeding does not stop, or if the cut is large and gaping, seek medical or dental advice. A small cut that stops bleeding and is not deep generally does not require stitches.
Preventing Dental Emergencies in Children
While not all dental emergencies can be prevented, several practical steps can meaningfully reduce the risk.
- Register your child with an NHS dentist early – ideally when the first teeth appear – so that any decay or developmental issues are caught before they become emergencies
- Ensure children who play contact sports wear a properly fitting mouthguard
- Discourage habits such as biting hard objects, using teeth to open packaging, or chewing pencils, which increase the risk of tooth fractures
- Maintain good oral hygiene routines from an early age to reduce the risk of decay-related toothache
- Attend routine dental check-ups every six to twelve months as recommended by your dentist
Children in Scotland under the age of 26 are entitled to all NHS dental treatment free of charge, which removes the cost barrier to regular dental care entirely. Taking advantage of regular free check-ups for children is one of the most effective things a parent can do to prevent the pain and disruption of a dental emergency.
Dental Anxiety and Emergencies
A dental emergency can be frightening for a child, and the anxiety this creates can make the situation harder to manage. Try to remain calm yourself, as children take cues from their parents. Explain to the child simply and clearly what is happening and what will happen next. Avoid using frightening language about drills, needles, or pain. Most dental emergency procedures for children are straightforward and over quickly, and many modern practices are experienced in making anxious children feel as comfortable as possible.
We at Tarbert Dental Surgery have experience treating young patients and understand that dental emergencies are stressful for both children and parents. If your child has a dental emergency, please call us right away on 01880 820387 and we will do everything we can to see them promptly and put both of you at ease.