Frequently asked questions about trauma to the teeth

How do teeth get injured?

Teeth can become chipped, cracked, broken into pieces and knocked out completely. This usually happens as the result of a minor or major accident (trauma).

Children often knock their front teeth when they trip or collide during sports.

What can be done immediately?

If someone has injured their teeth, they might also have other injuries that could be more serious in the short term. It is a very good idea to get them checked out by a doctor, dentist or oral and maxillofacial team if you are worried that they might have hit their head, lost consciousness, have injured the soft tissues of the face or might have broken their jaw etc.

If the injury is only minor, you should contact your dentist for an 'emergency' appointment to assess what can be done to save the function and appearance of the teeth.

What can be done for injured teeth?

If your tooth (or teeth) have been knocked out or displaced, then it is possible for a dentist or oral and maxillofacial team to replace it and for it to retain some function in the long-term.

Teeth that are chipped, cracked or broken can often be restored to a good appearance and function - although sometimes this can entail root treatments and crowning - especially in the longer term.

What should I do immediately after the tooth has been knocked out?

The most important thing is to look after the person who has lost the tooth. Then you can worry about the tooth that has been lost.

The root of the tooth is covered in live cells that are necessary to restore good function to the replanted tooth. If you can, find the tooth and gently (with a clean finger or hanky) wipe any obvious dirt off it. Then gently place the tooth in something clean and moist (eg a clean, wet hanky). One of the healthiest ways to store teeth while they are being carried to the dentist is in a clean container filled with milk.

Why have I been given a splint?

If you have had a tooth (or teeth) knocked out and/or damaged significantly, the dentist or oral and maxillofacial team might fit a splint to stop it and the bone under it moving around.

There are several different types of splints available depending on the severity of the tooth injury. This splint usually stays on for two weeks to allow the bone to heal.

At the end of this period, the splint is removed by the dentist or oral and maxillofacial team.

Once the tooth (or teeth) are successfully implanted, your dentist will carry out root-canal treatment. This will remove the damaged nerves and blood vessels in the tooth/teeth.

My teeth still feel odd after the splint has been removed, what should I do?

Even after the splint(s) have been removed, the affected teeth might still be slightly loose.

You should avoid placing too much force on them while they are still a bit fragile. For example, continue to eat only soft foods and maybe eat elsewhere in your mouth until the affected area has healed.

Will the repaired tooth look OK, after treatment?

It is quite common for teeth that have been knocked out or damaged significantly to discolour over time. This is because blood products leak into the tooth from its inside (root canal).

Having root-canal treatment by your dentist shortly after the tooth is replaced will reduce the risk of discolouration and other complications (such as infection).

What is a successful replacement of a knocked out tooth?

In the first few weeks and months after the tooth is knocked out, dentists are happy when the tooth forms a stable join with the bony and gum tissues supporting it, doesn't get infected and doesn't give the patient significant pain.

In the longer term, the success will be judged by whether the tooth and its supporting tissues can function well and look acceptable. This often means further treatment including root treatments and crowning.

Will the tooth stay alive?

Dentists call teeth 'alive', when they have functioning tissues in their root canals, which includes blood vessels supplying the live cells in the tooth and also nerves to detect hot and cold and sweet.

Dead teeth are ones that have no functioning tissues in their root canals, although they might still have live cells between the tooth and the bone supporting it.

If a tooth has been knocked out completely, the connections to these root canal tissues from the bone underneath will have been broken and therefore the tooth will (usually) die. If this happens, the contents of the root canals of the teeth will need to be removed and blocked off with a filling.

What is more important in the long-term is whether the tooth makes a healthy connection with the bone and gums that support it.

What can I do to avoid getting/treat pain from my teeth?

Teeth signal pain from the tissues (nerves) in their root canals, from any areas of infection or inflammation in the bony or soft tissues surrounding them or when they are moved beyond healthy limits. They respond to hot, cold, sweet, pressure and movement.

There are many reasons why you can get pain in your teeth or mouth, and your dentist will be able to find out why you have pain and what can be done to avoid or treat it. Before you can visit your dentist and oral and maxillofacial team, the following might help:

  • If you have a new strong tooth pain, without swelling, you might have an infection ('hole') in a tooth - you need to have this seen to by a dentist.
    Avoiding hot and cold and biting on the tooth might help until you can be seen.

  • If you have pain only on drinking hot or cold liquids or food, you might have exposed root tissues.
    Try using a desensitising toothpaste and get your teeth checked regularly by a dentist too.

  • If you have a new strong pain and swelling/redness, you probably have an infection around a dead tooth. You should see your dentist urgently (you don't want the infection to spread to your face or jaws).
    If you don't have a dentist for any reason, do go to see your general practitioner, who might be able to give you some painkillers and antibiotics until you can find a dentist.
    If you have facial swelling caused by an infected tooth/teeth, you should see your dentist or oral and maxillofacial team urgently.

  • If you are wearing an orthodontic appliance and your teeth feel sore or hurt, do go back to see your orthodontist.

  • If you have a sore tongue, gums or other soft tissue areas of your mouth, you might have one or more sores or mouth ulcers.

    Have a look for one or more spots or 'craters', which might be white with or without a red edge to them.

    They can be caused by trauma (eg biting your cheek or tongue) or infections (eg herpes simplex/cold sores).

    These can be extremely painful or not painful at all.

    Mouth ulcers usually heal quickly or within 2-3 weeks. If you have had a sore or odd looking patch of mouth tissue for longer than three weeks, do get it checked out by your dentist. There are a number of less common reasons for odd-looking lesions of the mouth (including mouth cancer).