What Should You Do About a Broken Milk Tooth?

Small children fall a lot while learning to walk and run, and the front teeth are the ones that hit first. A chipped corner, a crack, a tooth pushed back into the gum, or a tooth knocked out are all common. Most do not cause lasting harm, but every one is worth a look from a dentist.

A milk tooth can also break without any fall, because decay has hollowed it out. If a tooth crumbles while eating, or the child has had a dark spot for a while, see our page on cavities in milk teeth. Decay needs treating whatever the history.

Stay calm, because the child copies you. Sit the child upright, with the head tilted slightly forward, and wipe the mouth with a clean cloth. Bleeding from the gum or lip usually looks worse than it is. Press a clean, damp cloth on the area for ten minutes, and it should stop.

Look for the broken piece, and check where it went. A fragment can be swallowed, inhaled, or pushed into the lip or gum. If the child is coughing, has trouble breathing, or the lip is swollen and a fragment may be inside it, go for medical help. Keep any piece you find in a clean container to show the dentist.

Check the rest of the mouth, the face and the neck for other injuries, and see which teeth feel loose or look out of line. A cold compress on the lip helps swelling. Paracetamol for pain only as directed on the label for the child's age and weight, and ask a doctor or pharmacist if unsure.

A blow hard enough to break a tooth can also injure the head or neck. Go to a hospital emergency department, not a dental clinic, if the child lost consciousness, even briefly, or is unusually drowsy or confused. The same goes for repeated vomiting, a seizure, a severe or worsening headache, clear fluid from the nose or ear, unequal pupils, weakness, or any change in behaviour.

Also go to hospital if the neck hurts, if the child cannot move the jaw or the bite does not close, or if swelling spreads on the face. Difficulty breathing or swallowing needs emergency care straight away. Teeth can be dealt with after the child is safe.

This is the opposite of the advice for an adult tooth, which should be put straight back in the socket. A knocked-out permanent tooth is a time emergency, as set out in our guide to what to do in a dental emergency. A milk tooth should not be replanted.

The reason is that the root of a milk tooth sits very close to the permanent tooth forming behind it. Forcing a tooth back can damage that developing tooth, and the replanted tooth is likely to get infected. Wrap the tooth in a clean cloth, take it to the dentist so they can confirm that it is whole, and do not worry if you cannot find it.

Also check whether the whole tooth came out. A piece of root left in the gum is found on an X-ray. Bring the child to the dentist the same day whenever a tooth is out, loose or pushed in.

A chipped tooth with no pain may only need smoothing or a small repair. A tooth that cracked deeply, or shows a pink or red spot in the middle where the nerve is, needs prompt care, because the nerve can become infected. Our pulpectomy page explains what is done to save such a tooth.

A tooth that turns grey, dark or yellow in the weeks or months after a knock has usually had its nerve damaged. It may not hurt. It still needs to be seen, because a dead milk tooth can form an abscess. Look for a small bump on the gum, swelling, or a tooth that hurts when biting.

The permanent tooth under a knocked tooth can be marked by the injury, with white or brown spots on the enamel or, less often, a change in shape. The risk is higher when the injury happens at a young age. The dentist will keep watch with check-ups and X-rays, and will explain when the adult tooth is due, as in when milk teeth fall out.

Same-day dental care is needed for a tooth that is knocked out, loose, pushed in or out of position, a fracture showing pink or red, bleeding that does not stop after ten minutes of pressure, a cut inside the lip or gum that is deep, and severe pain. Facial swelling that spreads, a fever, or swelling in the days after an injury also needs same-day care.

A small chip with no pain, no bleeding and a child behaving normally can wait for the next appointment, but should still be checked within a few days. Our kids dentistry page describes how children are seen. If swelling affects breathing or swallowing, go to a hospital emergency department.