WHAT TO DO ABOUT CHIPPED BABY TEETH? - Dr. Steven

Young children, especially two- and three-year-old toddlers, are prone to chipping their baby teeth. This is the time of life they learn to walk, jump, and play, making them very vulnerable to accidents. Chipping a baby tooth is traumatic for the child and the parent. Rarely is this an actual dental emergency, but the parent should still call their dentist as soon as possible.

Is There a Home Remedy for Chipped Baby Teeth?

You will not be able to repair the tooth at home. However, there are steps for you to take after the accident. These steps are:

• Do not panic. If you remain calm, your child will more likely stay calm and more cooperative.
• Call your dentist and describe what happened. If possible, send a digital image by text or email to the dentist of the broken tooth.
• Inspect the gums, lips, tongue, and cheek for tooth fragments or any object that may have hit your child’s mouth. Gently remove any fragments you find.
• Gently rinse your child’s mouth with water.
• If you notice a laceration of the lip, chin, or other soft tissue, make sure the bleeding is under control. Place a wet gauze or cloth on the area and apply gentle pressure.
• Applying a cold cloth to the face will help minimize swelling.
• Allow your child to suck on a popsicle to decrease pain and swelling.

Look for a Dentist to Evaluate and Treat Your Child’s Chipped Tooth

Several options might exist for repairing a chipped baby tooth, including:

• Tooth smoothing. Many chipped baby teeth can be repaired by the dentist filing the rough edges until the tooth is smooth. If the crack doesn't involve the tooth's dentin, this may be the best and most conservative option.
• Dental bonding.For a minor chip or crack, dental bonding may restore the tooth to its original shape and functionality. This is a very safe, effective, and painless procedure. The tooth is thoroughly cleaned to ensure adequate bonding of the resin to the tooth's enamel. A gel is applied to roughen the enamel before applying the tooth-colored resin. The bonded material is then polished and is usually indistinguishable from the surrounding teeth.
• Dental crown veneer. These can restore more extensive cracks, but there are precautions in their use. Because of the very small size of baby teeth, veneers and crowns come off easily.
• Root canal treatment.Some endodontic procedures can be employed to save a baby tooth. The challenge with this treatment is the fact that a baby tooth’s roots resorb until they fall out. A root canal treatment may be necessary if the chipped tooth exposes the nerve inside the tooth. The endodontic treatment of the nerve in a baby tooth is called a pulpotomy. The steps to this treatment are:
• The tooth and the surrounding gum tissue are numbed with local anesthetic.
• The nerve in the top part of the tooth is removed with sterile instruments.
• The remaining nerve tissue in the roots of the tooth is inspected to ensure it is healthy.
• A medicine is placed on the remaining nerve tissue that helps prevent bacteria from causing an infection inside the tooth.
• A crown is placed on the top part of the tooth to protect the tooth from further damage and permit normal chewing.
• Tooth extraction.Occasionally a chipped tooth needs to be extracted to protect the underlying developing permanent tooth. If there is a high risk of the chipped tooth becoming infected, this is the preferred treatment.

What Can Happen in the Future to a Chipped Baby Tooth.

Anytime a child chips a tooth, the parent will need to watch the tooth and gum area closely as the child grows older. There are several things that can happen after a chipped baby tooth:

• Normal tooth exfoliation. Hopefully, after your child chips their tooth and sees the dentist, no other problems develop, and the tooth falls out normally. After this, the permanent tooth should erupt without any problems. The four front teeth normally fall out between 6-8 years and the canines between 9-12 years.
• The parent should watch for any discoloration of a chipped tooth. The dentist needs to be informed and follow a discolored tooth very closely. This can indicate an abscessed tooth in need of further treatment to protect the permanent tooth.
• Dental infection. The parent should regularly inspect the gum around a chipped tooth for any signs of infection. The dentist needs to be notified of any swelling or the presence of any small “pimple” area in the gum. These are signs of pus formation and this infection requires immediate attention.

Take Advantage of This Time

This is a great time to educate your child on their teeth and the importance of oral hygiene. Your dentist can emphasize the importance of oral hygiene and safety measures such as wearing a mouthguard when they are older and taking part in sports. It is also an ideal time to teach them that although baby teeth are all lost, they only get one set of permanent teeth.

Make every effort to transform the crisis of chipping a tooth into a positive learning experience for your child.

--- By Dr. Steven I Received his Doctor of Dental Medicine (DMD) from the Medical College of Georgia before practicing general dentistry in the United States Navy. He then completed a residency in endodontics at the Medical College of Georgia.