Head Start

What should Head Start staff do if a child experiences an oral injury?

Oral injuries involving the teeth, gums, tongue, lips, and back of the throat are common in young children, When a child suffers an oral injury, it is important to keep the child as calm as possible. It may be difficult to help a panicked or distraught child, and the injury may be worsened. Often, oral injuries look more serious than they are because there are so many blood vessels in the area. If possible, clean the injured area(s) with lukewarm water very carefully to make it easier to see the injury and to try to control bleeding. Keep the child's head upright and in a forward position to prevent the child from choking on blood. Keep phone numbers of the dentist and emergency medical services (EMS) in a convenient location in case of emergency. Keep children's health records up to date, and document medications, serious medical problems, immunizations, date of last tetanus inoculation, and allergies.

Following are tips for handling common oral injuries.

First, determine whether the child has suffered a non-oral injury as well as an oral injury. Symptoms of a non-oral injury may include loss of consciousness, altered orientation or mental status, bleeding from the nose or ears, uncontrolled bleeding, severe headache, nausea or vomiting, or neck pain. If the child exhibits any of these symptoms, call EMS immediately.

Tooth chipped, cracked, or fractured: If a child's tooth has been chipped, cracked, or fractured, contact the dentist immediately. Prompt action can save the tooth, prevent infection, and reduce the need for extensive dental treatment. If the injured area is dirty, clean it gently. Use a clean cloth to apply gentle, direct pressure to the injured area to control bleeding, if necessary. Apply ice, wrapped in a clean cloth, to the injured area to control swelling. If you can find the broken tooth fragment, bring it with you to the dentist.

Tooth knocked out: If a child's primary tooth has been knocked out, do not try to put it back in its socket (opening where the tooth came out) because this may damage the underlying permanent tooth. Place a clean piece of gauze, a cotton swab, or a wet tea bag over the bleeding area to control bleeding. Have the child bite on the gauze, cotton swab, or tea bag for 15 minutes. This step may be repeated once. If the bleeding persists, contact EMS or take the child to the hospital emergency room. Contact the dentist to make an appointment for appropriate follow-up care.

If a child's permanent tooth has been knocked out, it should be placed back in the socket as soon as possible. The more time that goes by before the tooth is placed back the socket, the more likely it is that the tooth will be permanently lost. After minimizing the bleeding, hold the lost tooth by the crown (top part) only, not the root. Rinse it under cold water gently if the root is dirty, but do not scrub. Reinsert it into the socket quickly, making sure that the front of the tooth is facing you. Contact the dentist to make an appointment for appropriate follow-up care.

If it is not possible to reinsert the permanent tooth, place the tooth in a container of cold milk or in a cold wet cloth and contact the dentist immediately. Take the child and the tooth to the dentist as soon as possible (preferably within 1 hour) or to the hospital emergency room, if the dentist is not available.

Tooth knocked loose, moved, or pushed into gum: If a child's tooth has been knocked loose, moved either forward or backwards, or pushed into the gum, contact the dentist immediately. If the injured area is dirty, clean it gently. Rinse the child's mouth with water. It is important for the child to be seen by a dentist right away, especially if the tooth has been moved or pushed into the gum. If the dentist is not available, take the child to the hospital emergency room.

Injury to tongue or lip: If a child's tongue or lip has been injured, it may bleed heavily because the area has many blood vessels. Rinse the injured area with water. Use a clean cloth to apply gentle, direct pressure to the injured area to control bleeding, if necessary. Apply ice, wrapped in a clean cloth, to the injured area to control swelling. If the bleeding continues 15 minutes after these steps are performed, take the child to the hospital emergency room immediately

Injury to jaw: If it is possible that a child's jaw may be broken, take the child to the hospital emergency room immediately. Apply cold compresses to the injured area to control swelling.

Toothache: If a child has a toothache, contact the dentist to make an appointment. Rinse the child's mouth with water to help relieve the pain. Apply ice, wrapped in a clean cloth, to the sore area, or have the child bite on a wet tea bag for 10 to 15 minutes to help relieve the pain. Do not put aspirin on the sore area.

Performance Standards

1304.22(a)(1)

1304.22(a)(2)

1304.22(a)(4)

References

American Academy of Pediatric Dentistry. Emergency Care.

American Dental Association. Dental Emergencies.

Casamassimo P, Holt K, eds. 2004. Bright Futures in Practice: Oral Health-Pocket Guide. Washington, DC: National Maternal and Child Health Oral Health Resource Center.

Holt K, Barzel R. 2003. A Health Professional's Guide to Pediatric Oral Health Management. Washington, DC: National Maternal and Child Health Oral Health Resource Center.

South Carolina Department of Education, South Carolina Healthy Schools 2005. Oral Health Supplemental Curriculum Resource. Columbia, SC: South Carolina Department of Education, South Carolina Healthy Schools.


	Home \| A - Z List: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z \| About Us
	Library Publications By Topic By Format Order Form Resource Highlights Knowledge Path Children with Special Health Care Needs Dental Home Dental Sealants Early Childhood Caries Fluoridated Water Fluoride Varnish Head Start Health Literacy Injury Pregnancy and Periodontal Health School Health Services MCHB-Funded Projects Grants Administration SBCOHS TOHSS Head Start Alert Newsletter Bright Futures Toolbox Links Data e-News Organizations About Us	Head Start What should Head Start staff do if a child experiences an oral injury? Oral injuries involving the teeth, gums, tongue, lips, and back of the throat are common in young children, When a child suffers an oral injury, it is important to keep the child as calm as possible. It may be difficult to help a panicked or distraught child, and the injury may be worsened. Often, oral injuries look more serious than they are because there are so many blood vessels in the area. If possible, clean the injured area(s) with lukewarm water very carefully to make it easier to see the injury and to try to control bleeding. Keep the child's head upright and in a forward position to prevent the child from choking on blood. Keep phone numbers of the dentist and emergency medical services (EMS) in a convenient location in case of emergency. Keep children's health records up to date, and document medications, serious medical problems, immunizations, date of last tetanus inoculation, and allergies. Following are tips for handling common oral injuries. First, determine whether the child has suffered a non-oral injury as well as an oral injury. Symptoms of a non-oral injury may include loss of consciousness, altered orientation or mental status, bleeding from the nose or ears, uncontrolled bleeding, severe headache, nausea or vomiting, or neck pain. If the child exhibits any of these symptoms, call EMS immediately. Tooth chipped, cracked, or fractured: If a child's tooth has been chipped, cracked, or fractured, contact the dentist immediately. Prompt action can save the tooth, prevent infection, and reduce the need for extensive dental treatment. If the injured area is dirty, clean it gently. Use a clean cloth to apply gentle, direct pressure to the injured area to control bleeding, if necessary. Apply ice, wrapped in a clean cloth, to the injured area to control swelling. If you can find the broken tooth fragment, bring it with you to the dentist. Tooth knocked out: If a child's primary tooth has been knocked out, do not try to put it back in its socket (opening where the tooth came out) because this may damage the underlying permanent tooth. Place a clean piece of gauze, a cotton swab, or a wet tea bag over the bleeding area to control bleeding. Have the child bite on the gauze, cotton swab, or tea bag for 15 minutes. This step may be repeated once. If the bleeding persists, contact EMS or take the child to the hospital emergency room. Contact the dentist to make an appointment for appropriate follow-up care. If a child's permanent tooth has been knocked out, it should be placed back in the socket as soon as possible. The more time that goes by before the tooth is placed back the socket, the more likely it is that the tooth will be permanently lost. After minimizing the bleeding, hold the lost tooth by the crown (top part) only, not the root. Rinse it under cold water gently if the root is dirty, but do not scrub. Reinsert it into the socket quickly, making sure that the front of the tooth is facing you. Contact the dentist to make an appointment for appropriate follow-up care. If it is not possible to reinsert the permanent tooth, place the tooth in a container of cold milk or in a cold wet cloth and contact the dentist immediately. Take the child and the tooth to the dentist as soon as possible (preferably within 1 hour) or to the hospital emergency room, if the dentist is not available. Tooth knocked loose, moved, or pushed into gum: If a child's tooth has been knocked loose, moved either forward or backwards, or pushed into the gum, contact the dentist immediately. If the injured area is dirty, clean it gently. Rinse the child's mouth with water. It is important for the child to be seen by a dentist right away, especially if the tooth has been moved or pushed into the gum. If the dentist is not available, take the child to the hospital emergency room. Injury to tongue or lip: If a child's tongue or lip has been injured, it may bleed heavily because the area has many blood vessels. Rinse the injured area with water. Use a clean cloth to apply gentle, direct pressure to the injured area to control bleeding, if necessary. Apply ice, wrapped in a clean cloth, to the injured area to control swelling. If the bleeding continues 15 minutes after these steps are performed, take the child to the hospital emergency room immediately Injury to jaw: If it is possible that a child's jaw may be broken, take the child to the hospital emergency room immediately. Apply cold compresses to the injured area to control swelling. Toothache: If a child has a toothache, contact the dentist to make an appointment. Rinse the child's mouth with water to help relieve the pain. Apply ice, wrapped in a clean cloth, to the sore area, or have the child bite on a wet tea bag for 10 to 15 minutes to help relieve the pain. Do not put aspirin on the sore area. Performance Standards 1304.22(a)(1) 1304.22(a)(2) 1304.22(a)(4) References American Academy of Pediatric Dentistry. Emergency Care. American Dental Association. Dental Emergencies. Casamassimo P, Holt K, eds. 2004. Bright Futures in Practice: Oral Health-Pocket Guide. Washington, DC: National Maternal and Child Health Oral Health Resource Center. Holt K, Barzel R. 2003. A Health Professional's Guide to Pediatric Oral Health Management. Washington, DC: National Maternal and Child Health Oral Health Resource Center. South Carolina Department of Education, South Carolina Healthy Schools 2005. Oral Health Supplemental Curriculum Resource. Columbia, SC: South Carolina Department of Education, South Carolina Healthy Schools.
	With funding from the Maternal and Child Health Bureau, Health Resources and Services Administration National Maternal and Child Oral Health Resource Center • Georgetown University Feedback • Accessibility • Disclaimer & Copyright • Contact Us