Injuries to the face, mouth and teeth are common among children. We are here to help you in the time of an emergency. You may reach Dr. Warr any time, even on nights and weekends, by dialing (336) 887-9277 and choosing option #4.

Do not panic. Stay calm and determine the extent of injury. If your child has a facial or head injury, assess whether or not consciousness was lost, even for a brief moment. If so, your child should see a physician immediately. Worry about the mouth and teeth later.

• Stop any bleeding with a clean washcloth or gauze.
• If you see swelling, press a cold compress on the area.
• Check for broken and/or missing teeth.
• If there are missing teeth, look for them.
• If a permanent tooth has been knocked out, gently clean it holding the top part and not the root. Do not scrub the root. Place the tooth back in the socket, if possible. If not, place it in a glass of cold milk. Immediately transport it to a dentist.
• Baby teeth are not put back in. We will take an x-ray to make sure there are no fragments left in the gums. The area is allowed to heal. Pain medications may be prescribed. Depending on your child’s age, a space maintainer may be needed to keep space open for permanent teeth.

If any permanent tooth is avulsed, clean the tooth by handling it with the crown and not the root. Gently rinse the tooth of dirt with cold water. Do not unnecessarily scrub the root. Then place the tooth back into the socket. If you are unable to place it in the socket place it in homogenized cold milk or cold water and immediately see the dentist. Time is the determining factor for saving the tooth. If more than 30minutes has elapsed since the tooth was dislodged the prognosis is guarded.

Primary teeth are not reimplanted. An x-ray is taken to make sure all portion of the tooth is out. Pain medications are prescribed and the area is allowed to heal. Then an impression is taken to fabricate a space maintainer to maintain the space for the permanent tooth to come in.

Broken or chipped baby teeth
• If the fracture is minor, we may be able to repair it using tooth-colored filling material.
• If the fracture goes into the nerve, we may be able to save it by performing a simple baby root canal procedure. This is not as extensive as an adult root canal.
• If the fracture goes too far into the nerve or below the gums, the tooth will most likely have to be removed. A space maintainer may be put in to keep space open for permanent teeth.


Gum boil or Abscess
• A gum boil, or abscess, is caused by a severely infected tooth. The infection extends beyond the root of the tooth and into the tissue surrounding it.
• The tooth cannot be saved and must be removed to prevent further spreading of the infection.
• Your child may be put on antibiotic to help calm the infection down first, then an appointment will be made to take the tooth out about seven to ten days later.
• Make sure your child finishes all medications prescribed. Even after the tooth is out, the antibiotic treatment has to be completed or infection may return.
• If the infected tooth is not removed quickly, it can cause high fever, severe pain, facial swelling and damage to the permanent tooth underneath it. Chronically infected teeth have been know to cause death.

Toothache
• If your child is having a toothache, clean the area around the tooth gently.
• Rinse the mouth with warm salt water and use dental floss to carefully remove any trapped food between the teeth.
• DO NOT place aspirin on the tooth or gums – this will burn the tender gum tissues.
• If you see swelling, apply a cold compress to the outside of the face.
• Give acetaminophen or ibuprofen for pain.
• Call us immediately for an appointment. Toothaches can be caused by a number of problems, so we need to evaluate your child as soon as possible.

Cold sore or Canker sore
• Some patients get canker sores periodically. These sometimes painful sores can be caused by stress, vitamin deficiencies, certain foods, or viruses.
• There is nothing available to prevent canker sores, but our office may call in a prescription for a mouth rinse that will help it heal faster and relieve pain. We may also recommend an over-the-counter treatment.
• Cold sores are caused by the Herpes Simplex Virus, and may break out due to stress, illness, or exposure to sunlight.
• Treatment for cold sores is usually a topical gel or ointment applied at the site of the breakout. These ointments help the sore heal more quickly and alleviate pain.
• It is estimated that 90% of the population are carriers for the Herpes Simplex Virus, and 40% have regular breakouts. This is a common condition and you should reassure your child they have no reason to be embarrassed.
• When any sore appears in or around the mouth, set up an appointment for your child as soon as possible so we can accurately diagnose the problem and offer a comfortable solution.

We try to accommodate all emergencies on the same day, if at all possible. Please call as soon as you notice a problem, so we can give your child the best care.

Do not hesitate to contact us at (336) 887-9277 if you have any questions or concerns. Your child’s comfort and health are our priority!