A dental first aid kit holds the few items needed in the first minutes after a child injures a tooth, lip or gum. Most of it costs little and fits in a zippered pouch. Its value depends on having it ready before the injury happens. Here’s what to expect.
The dental injuries children have most often at home and in sports
Toddlers who are learning to walk and run fall often, and the upper front teeth take most of the impact. Between ages 1 and 3, chipped front teeth, cut lips and baby teeth pushed out of position are the most frequent injuries. School-age children injure their teeth mostly during sports and play, including basketball, baseball, soccer, cycling and trampolines. At that age the injured tooth is often a permanent front tooth, which makes the first hour after the injury count. Other common problems are a bitten tongue or cheek, food or an object wedged between teeth, and a broken bracket or wire in children with braces.
The items that belong in the kit
Start with sterile gauze pads, which control bleeding from the gums, lips or tongue when pressed firmly in place for about 10 minutes. Add a small plastic container with a tight lid, large enough to hold a tooth covered in liquid. A tooth preservation kit with a balanced salt solution, sold in pharmacies, is the preferred way to store a knocked-out tooth; cold milk from the fridge is the standard substitute. An instant cold pack reduces lip and cheek swelling.
Complete the kit with dental floss for food stuck between teeth, orthodontic wax if the child wears braces, disposable gloves, a small flashlight, and children’s acetaminophen or ibuprofen with the dosing chart from your pediatrician. Add a card with the phone numbers of the child’s dentist and pediatrician. That card only works if the choice is made in advance, and parents who look for the best children dentist in their area often find that how a practice handles injuries is one of the clearest differences between offices. Two things stay out of the kit: aspirin, which should never be placed on the gums, and pins or toothpicks, which should never be used to dig out something stuck between teeth.
Carrying a knocked-out tooth to the dentist
A baby tooth that has been knocked out is not put back in the socket, because doing so can damage the permanent tooth developing underneath. Keep it in the container and bring it to the appointment so the dentist can confirm the whole tooth came out. A permanent tooth is different. The chance of saving it depends on how quickly a dentist replants it and how it is stored until then. Pick the tooth up by the crown, the white part, and never by the root. If it is dirty, rinse it for a few seconds with milk or saline without scrubbing. Place it in the preservation solution or cold milk. Do not wrap it in tissue and do not store it in tap water, which damages the cells on the root surface. The best results come when the tooth is replanted within an hour.
A smaller kit for the sports bag and the car
Children who play contact or ball sports need a second, smaller kit that travels with them. A zip bag with gauze, a lidded container, a tooth preservation kit, a cold pack and the dentist’s number covers most injuries on the field. Keep a spare mouthguard in the same bag, since a lost or forgotten mouthguard is a common reason children play without one. A copy of the kit in the car helps when the injury happens away from home, at the playground or on a trip.
Injuries that need a dentist rather than the kit
The kit covers the first minutes. Several injuries need a dentist the same day: a knocked-out permanent tooth, a tooth pushed up into the gum, out of position or loose, a broken tooth with a pink or red spot in the center, which means the nerve is exposed, and bleeding from the mouth that does not stop after 10 minutes of firm pressure. Swelling of the face or gums in the days after an injury also needs a visit. Pediatric practices usually follow a set protocol for a kids dental emergency, and a family that already has the office number on the kit card loses less time than one searching for it after the fall. If the child lost consciousness, is vomiting, seems confused or may have a broken jaw, go to the emergency room first.
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