Calling All Superheroes

Author: Dr. Sarah Mischo, DMD

Before becoming a dentist, I worked as an assistant at a pediatric dental office, and the dentist who ran our office would frequently call October “Cape Season” because the number of children that came through the practice with dental trauma increased dramatically when all the costumes came out around Halloween. According to the International Association of Dental Traumatology for children, oral injuries account for 18% of all physical injuries obtained by children ages 0-6, and the mouth is the second most common area of the body to be injured in this age group. Unintentional falls, collisions, and leisure activities are the most common reasons for Traumatic Dental Injuries (TDIs), especially as children learn to crawl, walk, run, and embrace their physical environment. So, if you have a tiny superhero running around this Halloween, you may be wondering what you should do if your superhero takes a dive too quickly while chasing a bad guy. If your child suffers an injury that causes a primary tooth (also called a baby tooth) to fall out, it’s best to leave the tooth out and not try to replace it. If vou try to replace a primary tooth into its socket, there is a serious risk that you could damage the adult tooth waiting under the gums, but even more importantly, there is a risk that a younger child could accidentally inhale the tooth (called aspiration), which could cause a potentially life-threatening breathing emergency. Instead of replacing a primary tooth, you should rinse the tooth socket gently with warm water and apply firm pressure to the socket to help control any bleeding. While you don’t need to rush to an emergency department or an urgent care, you should follow up with your child’s dentist within the next one to two days.

On the other hand, if your superhero has adult teeth and loses one due to an injury, this tooth should be replaced immediately by you or another adult in order to give the tooth the best chance of survival, and you should follow up with a dentist right away (or go to an urgent care or emergency department if the accident occurs after hours or on the weekend). According to the International Association of Dental Traumatology, the following steps should be considered when a child loses a permanent tooth:

1. Find the tooth and pick it up by the crown (the white part). Avoid touching the root.

2. Attempt to place it back immediately into the socket. If the tooth is dirty, rinse it gently in milk, saline or in the patient’s saliva and replant or return it to its original position in the socket. 

3. Once the tooth has been returned to its original position in the socket, the patient should bite on gauze, a handkerchief or a napkin to hold it in place.

4. If replantation at the accident site is not possible, or for other reasons when replantation of the avulsed tooth is not feasible (eg, an unconscious patient), place the tooth, as soon as possible, in a storage or transport medium that is immediately available at the emergency site. This should be done quickly to avoid dehydration of the root surface, which starts to happen in a matter of a few minutes.