Paediatric Emergency

Paediatric Dental Emergencies

When something goes wrong with a child’s teeth, every minute counts — especially after trauma. Knowing what to do in the first 15 minutes can be the difference between saving and losing a tooth. At Dentistar Dental Clinic in Strovolos, Nicosia, we accommodate paediatric dental emergencies as apriority and have built clear guidance for parents on what to do at home. 

If you’re reading this during an emergency, the most important number is ours — call the clinic immediately. Below is what to do until you reach us.  

Knocked-Out Permanent Tooth (Avulsed Tooth)

  • Children become anxious about the dentist for many reasons:
  • Fear of the unknown (sounds, lights, instruments)
  • A previous unpleasant experience
  • Picking up a parent's or sibling's dental fear
  • Being told scary stories by classmates
  • Anxiety about not being in control
  • Sensory sensitivities (sounds, smells, tastes)
  • General anxiety or temperament
  • None of these means a child "can't cope." They mean we need to slow down, build trust, and use the right techniques. Anxiety isn't a defect — it's information.

Knocked-Out Baby Tooth

  • Unlike permanent teeth, we DO NOT reimplant baby teeth. The reason: reimplantation can damage the permanent tooth developing right above it
  • What to do:
  • Stop any bleeding with gentle pressure (clean gauze or tissue)
  • Calm the child and check for any other injuries
  • Save the tooth (the parents may want to keep it) but do not try to reinsert it
  • Call the clinic — we'll see your child the same day to check for damage to the developing permanent tooth, the soft tissues, and the underlying bone

Knocked-Out Permanent Tooth (Avulsed Tooth)

This is the most time-critical paediatric dental emergency. A knocked-out permanent tooth can often be saved — but only if it’s reimplanted within 30–60 minutes. 

What to do — step by step:

Find the tooth

Look on the ground, in the area of the accident, even in clothing.

Hold it by the CROWN, never the root

The crown is the white, smooth part you normally see. The root is the long part that goes into the gum. Touching the root damages the cells needed for re-implantation.

If it's dirty — rinse VERY briefly.

Use milk, saline (contact lens solution is fine), or — last resort — water. Just a quick rinse, no scrubbing, no toothpaste, no antiseptic. The goal is to remove visible dirt only.

Try to reposition it in the socket.

If you can, gently push the tooth back into its place and have the child bite gently on a clean tissue or gauze to hold it. This is the best storage medium possible.

If you can't reposition it — store it in milk.

Plain cow's milk is excellent. The next best option is saline. Avoid water if at all possible — it damages the root cells. The child can also hold it in their cheek (if old enough not to swallow it). Do NOT wrap it in a tissue.

Get to the clinic immediately.

Call us on the way. The first 30 minutes are critical; after 60 minutes the chances of saving the tooth drop significantly.

Fractured (Chipped or Broken) Tooth

  • If it's a small chip:
  • Find the broken fragment if you can
  • Rinse the child's mouth gently with warm water
  • Cold compress on the outside of the cheek if there's swelling
  • Call the clinic — small chips can often be repaired beautifully with composite bonding
  • If it's a larger fracture, or the inside (pink/red) of the tooth is visible:
  • This is more urgent — the nerve may be exposed
  • Same first-aid: rinse, cold compress, save any pieces in milk
  • Get to the clinic the same day
  • If the tooth is still in place but moves more than normal:
  • Don't push on it
  • Soft diet immediately, no biting on the affected tooth
  • Call the clinic to be seen within 24 hours

Toothache in a Child

  • Causes can include:
  • A new or growing cavity
  • Food trapped between teeth (especially under braces or after eating popcorn, meat, etc.)
  • Erupting permanent teeth (especially 6-year and 12-year molars)
  • Infection or abscess (often with swelling, bad taste, fever)
  • Sinus pressure from a cold (mimics a toothache)
  • What to do at home until you can come in::
  • Rinse the mouth with warm salt water (1 teaspoon of salt in a cup of warm water)
  • Floss gently to dislodge any trapped food
  • Cold compress on the outside of the cheek
  • Age-appropriate dose of paracetamol or ibuprofen (follow the dosing on the bottle)
  • AVOID putting aspirin, alcohol or any "folk remedy" directly on the gum or tooth — these can cause chemical burns
  • Call the clinic if pain persists more than a few hours or there's swelling, fever or trouble eating

Soft Tissue Injuries — Cuts to Lips, Tongue, Gums or Cheek

  • What to do:
  • Apply gentle pressure with clean gauze for 10–15 minutes
  • Cold compress to reduce swelling
  • Most small cuts heal on their own — the mouth heals very quickly
  • Call us if: bleeding doesn't stop after 15 minutes of pressure; the cut is deep or gaping; the cut involves the tongue or lip border; you're concerned about scarring
  • Go to A&E if there are signs of significant blood loss, the child can't breathe normally, or the injury is large

Tooth Pushed Up or Out of Position (Luxation)

  • If a tooth has been pushed into the gum, sideways or partially out::
  • Do NOT try to push it back into place yourself
  • Apply a cold compress to the outside of the face
  • Soft diet only
  • Call the clinic immediately — these injuries need same-day evaluation

Object Stuck Between the Teeth

  • Try gentle flossing first — usually this dislodges it
  • Do NOT use sharp objects (pins, knives, etc.) — these damage gums and can break off
  • If flossing doesn't work, call the clinic; we can usually remove it quickly and painlessly

Broken Braces, Wires or Space Maintainer

  • Use a pencil eraser or piece of orthodontic wax to push a poking wire flat against the tooth
  • If a bracket has come loose, leave it where it is and call us — don't try to remove it yourself
  • For a broken or loose space maintainer, call us immediately — teeth can start drifting within days

Pre-Emergency Preparation

  • The best emergency response is prepared parents. We recommend you keep:
  • Our clinic phone number in your contacts and on the fridge
  • A small "dental first aid" kit in the car: clean gauze, plain milk in a small bottle, a small container with a lid (for saving teeth or fragments)
  • Mouthguards for any contact sports your child plays — they prevent the majority of sports- related dental emergencies
  • A reasonable knowledge of who to call after hours

Everything You Need to Know

Frequently Asked Questions (FAQ)

Can a knocked-out tooth really be saved?

Yes — but only a permanent tooth, and only if you act quickly. Within 30 minutes, the success rate is very high. After 60 minutes, the chances drop significantly. The key steps: hold by the crown only, rinse briefly with milk if dirty, try to reposition in the socket — or transport in milk — and get to the clinic immediately.  

Reimplanting a baby tooth can damage the developing permanent tooth right above it. The baby tooth is also nearing the end of its life anyway. We focus instead on checking for damage to the surrounding tissues and to the permanent tooth underneath, and on planning the next steps for that area.  

If there’s a head injury, loss of consciousness, severe bleeding or any breathing concern, A&E first. Otherwise, call us first — the dental team can save the tooth faster than A&E in most cases. We accommodate emergencies as a priority. 

Often yes, especially in children. Severe or worsening pain, swelling, fever or trouble eating/sleeping all warrant a same-day call. Mild discomfort that comes and goes can usually wait for the next available appointment — but it shouldn’t be ignored.  

It may indicate the tooth’s nerve has been damaged. Bring the child in within a week or two — we’ll examine and X-ray. Sometimes the colour resolves on its own; sometimes the tooth needs treatment to remain healthy.  

Yes — for any sport with contact or fall risk (football, rugby, basketball, hockey, martial arts, skateboarding, cycling). Custom-fitted mouthguards prevent the majority of sports-related dental injuries and are far more effective than over-the-counter ones. We make custom mouthguards for children of all ages.  

A small kit makes a big difference: clean gauze, plain cow’s milk (refresh weekly), a small container with a lid (for transporting a knocked-out tooth or fragment), our clinic phone number, and age-appropriate paracetamol or ibuprofen for pain. Keep mouthguards available for sports.  

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