Tooth Eruption Pain
- Dr. Caldwell will try to determine if the pain is a result of a loose primary tooth that is pinching the gum tissue or because of an erupting permanent tooth.
- Pain lasting for more than a week is rare, and may occur because of inflammation around an impacted or partially impacted tooth. This periodic, prolonged pain commonly occurs with the eruption of the first permanent molars. Avoid placing Aspirin directly on the tooth. Tylenol or Motrin can help relieve discomfort. Dosages should be administered based on the child’s weight or age.
- Placing a Popsicle or cold compress on the eruption site (20 minutes on, 20 minutes off) can temporarily relieve discomfort.
- Saline rinses can decrease swelling when age appropriate.
- Contact our office if your child continues to experience pain.
Broken or Displaced Teeth
- Use a clean square gauze or cotton swab with warm water or hydrogen peroxide to clean the blood, soil or other debris from the child’s face.
- To reduce swelling, apply a cold compress on the check, next to the tooth.
- To check for displacement, have the child gently bite the teeth together. If you can, carefully move the displaced tooth or teeth into the correct position. If the child cannot bite their teeth together because of the displacement, call Dr. Caldwell immediately.
- Do not attempt to move the tooth into the correct position if it has been pushed into the socket or gum.
- A broken tooth that has a sharp edge may be covered with sugarless chewing gum or paraffin (wax) to prevent injuries to the tissue.
- Tylenol or Motrin may be administered according to the child’s weight or age to relieve pain.
- Contact our office.
Knocked Out Tooth (Avulsed)
Primary Teeth (baby teeth)
Baby teeth are not re-implanted due to the potential for infection and the possibility of adversely affecting the permanent teeth.
Permanent Tooth only
- Locate the tooth.
- If found, avoid cleaning the tooth, as this could destroy the connective fibers that help anchor the tooth in the socket. Instead, gently shake the debris free.
- If you can, carefully place the tooth back into the socket. Be sure to handle it by the crown (the portion of the tooth that is visible in the mouth).
- In the event that the child is not cooperative or no one is comfortable with placing the tooth in the socket, place the tooth in a cup of water or milk, or a clean wet gauze or cloth.
- Call our office immediately or use the after-hours instructions to contact Dr. Caldwell if it is after office hours. The patient should be seen immediately. On several occasions, the tooth can be re-implanted successfully if it is done within one to two hours.
- If you cannot determine if the tooth is permanent or primary, treat it as a permanent tooth.
Lacerated lip or tongue
- Initially, your child may experience vigorous bleeding.
- Using a clean square gauze apply pressure to the wounded area for 15-20 minutes or until bleeding stops.
- Examine the mouth for fractured/broken or missing teeth.
- If swelling occurs as a result of an injury to the lip, apply a cold compress.
- Those lacerations that are deep or the tissue does not “come together” may require sutures.
- Call our office if the laceration is severe and you question the need for sutures.
Prolonged or Recurrent Bleeding after Extraction
Do not allow your child to rinse for 24 hours following an extraction, as rinsing could disrupt blood clot formation at the site. Normal drinking is okay. However, do not allow your child to use a straw for 24 hours, as this could also dislodge the clot.
If there appears to be a large amount of blood oozing from the site, do not be alarmed. The blood mixes with saliva. Therefore, it may appear a lot of blood is coming from the site. This actually may not be the case. If the bleeding is more than oozing, which is characterized by bright red blood or if it is alarming the child:
- Have the child bite a clean square gauze for 30 minutes. They should not spit or disturb the gauze during the 30-minute period.
- If the bleeding does not stop after an hour, contact our office.
Toothache - Access to Emergency Care
- Using dental floss, remove any food that is trapped in or around the affected tooth.
- Have your child rinse vigorously with warm water to remove any debris.
- To reduce swelling, apply a cold compress to the outside of the child’s cheek. (20 minutes on, 20 minutes off). Avoid using heat.
- Administer Tylenol or Motrin according to the child’s weight or age to relieve pain. Do not place Aspirin on or near the tooth.
- If the pain does not improve or your child is “up at night with pain” call our office for an appointment.
Fever Blisters and Cold Sores/Canker Sores and Mouth Ulcers
- The most common reason ulcers appear can range from trauma such as a toothbrush or a toy scraping the inside of the mouth.
- Unlike mouth ulcers, fever blisters and cold sores are herpetic lesions. When working around them, wear gloves. Instruct your child to wash their hands often and avoid touching their eyes.
- For temporary relief of mouth ulcers or canker sores, apply a moderate amount of plain Orabase or Orabase with Benzocaine. This is available as an over-the-counter medication. A common holistic approach is to apply honey to the area. All of these can be used on an as needed basis.
- Do not give your child spicy or acidic foods.
- You may give your child Tylenol or Motrin for pain or fever. Administer dosages according to their weight and age.
Orthodontic (Braces) or Ortho Appliance Problems
- If a protruding wire is irritating the tissue, use a blunt item, such as a pencil eraser to bend the wire.
- If the wire cannot be bent, cover it with a small cotton ball or paraffin (wax).
- If your child is receiving treatment by an orthodontist, should an appliance or wire loosen or break, and you cannot remove it easily, take them to see that doctor. However, if you child has had an appliance placed by Dr. Caldwell, such as an expander, call our office for assistance.
- Avoid removing any wire that is embedded in the gum, tongue or cheeks.
- Following the placement of bands and wires, your child may experience discomfort for a few days. Rinsing with a glass of warm salt water (1/2 teaspoon of salt) or holding it to the mouth can relieve the discomfort.
- Until your child can chew comfortably, we recommend a semi-soft diet.
- If your child has just had an orthodontic appliance placed in his/her mouth within the past week, it is common for them to experience slight discomfort. Generalized “aching”. This usually subsides within 2-3 days.
- Tylenol or Motrin may be given orally with water for pain in dosages according to their weight and age.
- You may also consider giving your child Tylenol or Motrin 30 minutes before the orthodontic appointment.
Inflamed or Irritated Gum Tissue
Poor oral hygiene
Poor oral hygiene can cause bleeding and inflammation. Daily brushing and flossing can remove plaque, which will restore the health of the gums. Toothpaste does not have to be used for plaque removal. A toothbrush coated with saliva has been shown to be an effective method of both removing and controlling the accumulation of plaque. Contact Dr. Caldwell if your child experiences chronic bleeding. If your child’s gums or red, sore or swollen, they should rinse with warm salt water.
Trauma
A blow or trauma to the mouth can cause swelling and bleeding. Your child’s gum and teeth should remain clean to reduce the possibility of infection. To help control swelling, apply a cold compress to the cheek (20 minutes on, 20 minutes off). To help control bleeding, apply pressure directly to the injured cheek or gum using clean gauze. If your child’s gums or red, sore or swollen, they should rinse thoroughly with warm salt water.
Eruption Dates - Primary and Permanent Teeth
Some children’s primary and permanent teeth erupt earlier or later than the average dates listed in the chart. A year on either side of the average eruption times is not unusual.
