If your child has suffered trauma to one or more of his/her teeth, you can expect some of the following reactions:

Change of color

The tooth/teeth may darken over a period of time. This discoloration ranges from a charcoal gray, to yellow to brown and is similar to a bruise on the skin.  It may lighten slightly but not return to its original color. There is no need to treat primary teeth that have discolored from trauma but this is not the case with permanent teeth.

Luxation/Displacement of teeth

Primary teeth may become displaced following a traumatic incident. Most often the tooth becomes pushed backwards; with the crown displaced towards the palate. The tooth can also be luxated or displaced laterally. The tooth will often reposition on its own as the patient swallows and the tongue presses forward against the tooth. When a tooth is displaced, the bone that supports the tooth becomes expanded by the injury which makes the tooth looser than normal. As the bone returns to normal position, the tooth should tighten up. However, if the tooth is pushed up into the bone, immediate attention is needed. If the tooth is pushed upward into the area of the developing permanent tooth, the primary tooth may need to be extracted.

Bleeding and Swelling

As with any injury, the normal reaction of the injured tissues (in the case of gum tissue and/or lips) will bleed and/or swell. A cold pack (a washcloth is good) will help decrease swelling and a warm salt water rinse will promote healing of any cuts.


Fortunately, children do not usually suffer much pain from injuries to the teeth. Occasionally there will be pain if the child tries to chew with the injured tooth. As with any injury, the area should be “babied” to avoid aggravating the injury.


An abscess appears as a localized swelling on the gum tissue associated with a tooth. It results from the nerve of the tooth dying and/or becoming infected. The body tries to get rid of the infection (bacteria) so the infection travels through the end of tooth (root), through the supporting bone and out through the gum tissue. The affected primary tooth often requires extraction while the permanent tooth requires endodontic therapy (root canal).

When to Call the Office and What to Do

If the trauma results in a fracture of the tooth, please contact our office. Depending upon the amount of the fracture, the enamel may need to be smoothed or a composite restoration placed to return the tooth to its natural contours.

If the trauma results in a PERMANENT incisor becoming completely knocked out of the mouth, gently rinse the root of the tooth under water (holding it by the crown ONLY) and REPLACE the tooth in the socket and immediately call our office.

If the trauma results in a PRIMARY tooth becoming completely knocked out of the mouth, we do NOT re-implant it. It belongs to the “tooth fairy” now.

If any of the “expected reactions” becomes worse, the area should be re-examined: Increased swelling, looseness or pain