Opinions

So your child’s tooth gets knocked out during lockdown…

Written by: Dr. Paul Cooney, BDS, MSc, FFGDP (UK), MFDS RCSGlasgow, L & H Dentalcare

Published: 19/05/2020

Paul shares advice on dental care and what to do in dental emergencies now surgeries are temporarily closed.

The call came at 2:42pm on a Tuesday afternoon during the nation’s 5th week of “lockdown” in the fight against COVID-19.  I had just finished a late lunch after a busy morning and any thoughts I’d had of a quiet afternoon were soon forgotten, as the voice at the other end of the phone informed me that her 9 year old son had fallen and knocked out his top front adult tooth at his local school.  He needed emergency dental care and as his dentist I had to think and act quickly.

The only problem was that all dental practices had been temporarily closed four weeks previously and I would not be able to provide that care myself: instead, I would need to coordinate this emergency  and it’s a dental knock out in lockdown and a concerted effort to successfully negotiate the steps required to re-implant the tooth.

If an adult tooth is knocked out, the key steps are:

  • Stay calm (take 3 deep breaths!)
  • Find the tooth ( take another 3 deep breaths!)
  • Reinsert the tooth into position ( if possible, do this immediately- don’t wait for the dentist!)
    • Hold it by the crown ( the white bit that sticks out of the gum)
    • Make sure the whole tooth is clean: you can rinse it in water if you have to (or even lick it)
    • Put it into position ( the flat side of the crown is at the front)
  • Bite on a handkerchief to hold the tooth in place
  • Seek emergency dental treatment within 2 hours.
  • Good oral hygiene is essential in the healing period.

Due to the quick thinking of the child’s teachers, the fortitude of his mother and the new COVID-19 dental emergency protocols, we were able to ensure a successful outcome. First of all, the school teachers found the tooth and placed it in a glass of milk. This is good practice as milk helps to preserve

Over the telephone, I had to establish a few key facts about his overall status: had he lost consciousness, had he vomited since in the fall, or was he experiencing any uncontrolled bleeding? Having established that he hadn’t suffered a head injury (a head injury would necessitate medical attention),  I talked the child’s mum through the steps required to place the tooth back into her son’s jaw.  She did what was required-gold medal for mum!

He was then seen by a dentist at a local Urgent Dental Centre to secure the tooth in place. These hubs have been set up to help patients with dental emergencies while dental practices are closed due to lockdown.

This was a well co-ordinated approach between the child’s teachers, his mum and the dental professionals. Please note that you NEVER try to re-implant a baby tooth that has been knocked out due to the high risk of damaging the underlying adult tooth.

So if an adult tooth is knocked out, don’t panic- all is not lost, as long as the tooth is found. Follow these steps and phone your dentist, or phone NHS 24 on 111 out of hours for professional advice- lockdown or no lockdown.

More information on dental trauma can be found here:  https://www.iadt-dentaltrauma.org/for-patients.html (this link will take you away from our website)

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