Little boy holding his hand over his mouth.
asierromero/stock.adobe.com

Dental Drama

Chips, knockouts and other tooth troubles
Malia Jacobson
Friday, February 8, 2019

Keeping kids’ smiles healthy takes more than brushing twice daily and regular dental checkups (which should begin around 18 months). In addition to the normal loss of baby teeth and a cavity or two, many children will experience some type of tooth-related trauma – like a chipped tooth or one that suddenly turns grey – at some point. While childhood dental issues like these are common, experts warn against ignoring them, because problems with baby teeth can affect the developing permanent teeth below. 

Shades of Gray
Many parents are dismayed to discover that one of their toddler’s pearly whites isn’t white at all – think gray or light brown. A tooth that suddenly darkens is fairly typical: Because baby teeth have shallower roots than permanent teeth, they can die with even a slight bump, causing them to lose their white luster. Dentists generally advise a “wait and see” approach to a graying baby tooth, because it’s usually just an aesthetic issue; dying baby teeth sometimes heal and a dead baby tooth may not create any further problems or harm adult teeth, says pediatric dentist Sabrina Magid Katz. 

A graying baby tooth may become infected, however, which sometimes causes a tiny pustule to form on the gums above the tooth; a dentist can extract it and help treat the underlying infection. If the tooth has to go, take heart – it won’t affect the spacing of permanent teeth, and your little one may get to be the first of their pals to get a visit from the Tooth Fairy!

Total Knockout
During the elementary school years, kids lose most of their baby teeth and learn to care for their new adult choppers. And because children are so active during this stage, it’s not uncommon to knock out a tooth.

A knocked-out tooth is a true dental emergency that warrants a call to your dentist. Dental professionals recommend keeping the tooth damp so it doesn’t dry out; if possible, have the child hold it in place with a finger. If the tooth is a permanent one, your dentist may be able to restore it in its original position. But knocked-out baby teeth aren’t re-implanted, as that can damage the adult teeth underneath. 

Another common dental dilemma: Permanent teeth coming in before baby teeth fall out, resulting in multiple “rows” of teeth. This can look odd, but it’s not a big deal, says Magid Katz; the tongue will push the permanent teeth into alignment once the baby teeth fall out. Encourage your child to keep wiggling the baby teeth, but if one is particularly stubborn, your dentist can help coax it out.

Chip Away
Chomping ice, using teeth to open a bottle or playing sports can lead to something most teens don’t want in their yearbook photo: A chipped tooth. When is a chipped tooth an emergency? While minor chips are mostly an aesthetic issue, a larger chip can expose nerve endings that make a tooth extremely temperature-sensitive and very painful, says Magid Katz. If your child chips a tooth, try to locate the missing piece, put it in water and call your dentist right away. A severe break may qualify as an emergency, while more minor chips can probably wait until the next business day. 

If the broken piece can’t be found, your dentist can create a composite filling to restore the tooth; composites look natural and can last for years, though your child may need to replace it at some point in their lifetime. To avoid chips, have teens wear mouthguards for sports and advise them to never use teeth as “tools” – and always model healthy dental habits by refraining from this practice yourself!