Mishaps to Baby Teeth

Archived Q&A and Reviews

3-year-old's tooth was knocked loose - extract it?

August 2006

My three and a half your old son hit his mouth on a metal bench whileplaying about 3 weeks ago. His right front (top) tooth was very loose, and bled a little. We were told over the phone by his pediatrician to just let the gum/tooth heal and it would likely become firm again. It did. Today we went to the dentist, who took an x-ray of the tooth. He said that, although it was now firm, the tooth had been severed below the gumline and needed to be extracted. He has referred us to an oral surgeon in Berkeley (Klein et al). He said they would likely use ''laughing gas'' and little else, although I haven't spoken directly to the surgeon's office yet. I am looking for whatever advice (and words of comfort) anyone can give about this situation. If you have had to get your child's (baby) tooth pulled, how traumatic was it for him/her? What kind of anaesthetic was used? How long did it take to recover? Did you attempt/consider any kind of aesthetic treatment after the extraction (I understand he will not grow a permanent tooth for another 3.5 years)? Any speech problems with a missing front tooth for so long? Any words of wisdom would be much appreciated. Thanks in advance.

I would strongly recommend that you get a second opinion about your son's tooth. My daughter had a terrible fall when she was 18 months old, which broke the roots off of her two top front baby teeth, below the gum line. I went to Dr. Edward Matsuishi in El Cerrito and I have to say I am VERY happy with how everything has turned out. My daughter is now almost seven and STILL has those two front teeth!

Her teeth remain loose and are a little discolored but we have been able to save them! They turned blackish grey right after the accident but just as Dr. Ed said would happen, they eventually lightened in color to a yellow. He kept a good eye on these teeth over the years. After the inital fall we saw him monthly, I think to be sure she did not develop any infection or abscess. I felt, and he concurred, that we should save the teeth at just about all cost and take all possible precautions in order to do this: no more pacifier, no sippy cup (we immediately transitioned to a cup), cut up all food, no bagels or baguettes (no chewy foods that require you bite into them with front teeth), no hard fruits or vegetables. Everything was cut up and I also taught her how to bite into even soft foods by not using her front teeth. I DID NOT want her to loose those teeth, especially at such a young age. I felt that she may be made fun of or start to feel different without these teeth.

Other people thought that I was crazy since they were baby teeth and she would eventually lose them, (in about 5-6 YEARS!!!). I feel in my heart that we did the right thing. There was always the threat that we may need to have those teeth pulled if infection, abscess or any problems with her permenant teeth started to develop. Thankfully that has not happened and she will lose them right on schedule! A thankful mom

4-year-old knocked out his two front teeth in a fall

April 2003

My four year old son fell and knocked out two of his front teeth. Does any one have any experience with how kids react to this or how to help them cope? I understand from his dentist that there is not much to worry about in terms of his permanent teeth, I am just worried about other kids teasing him about the way he looks.

My nephew knocked out his two upper front teeth in a tricycle accident when he was around two. Like yours, my sister's dentist recommended just waiting until the adult teeth came in. They did finally come in, when he was about eight, and he has a nice-looking set of choppers now. As to teasing, the biggest problem was not other kids teasing, but rather adults incessantly asking him and his mother what happened, what the dentist said, why he didn't get transplants, when his adult teeth are ever coming in, etc. It is really hard for adults to resist asking about a 3 or 4 year old who is missing his front teeth! Ginger

Hi, My son knocked out two teeth a couple months ago and was thrilled that the tooth fairy came (he's three and has an older sister who's lost several teeth). So far, he's been very proud about it -- once the initial couple days of pain/sore gums went away. He showed the gaping hole to everyone in preschool, the grocery store, video store, pretty much everywhere we went. It probably depends on the kid but I would stress how much he looks like a ''big kid.'' ckm

I wouldn't worry about it too much. My older son lost his two front teeth at about 5 (jumping on the sofa after repeated warnings!) but since so many kids are losing teeth at about that age or just slightly older(and actually it seems to be a badge of honor)he fit right in. Adults are more likely to tease him than the kids. Karen

Our 4-year-old has a graying dead tooth

Sept. 1998

help! our not quite 4 year old son fell and apparently killed a baby tooth--we didn't even know, as there was no pain, but a few days ago my husband noticed that the tooth was gray and looked like it was dying. He took our son in to see a children's dentist (highly recommended from the UCB Parents list, I might add) and the dentist said we could either do nothing, remove the tooth to prevent potential damage to the permanent tooth, or a pulpotomy (!) which is like a mini root canal (local anesthesia only). The dentist recommended the latter.

Then we called a second (also highly recommended) children's dentist, who said they never do anything in these situations unless things look worse. has anyone had experience with this sort of situation? thanks! Corliss

My daughter fell down & knocked her two front baby teeth loose when she was 3, prompting our first visit to a dentist for her. The dentist (Dr. Matsuishi) said to watch a couple of days to see if they re-attached. They didn't, and since you can't eat with two loose front teeth, he pulled them. I think she only had gas for anasthesia, & there was no mention of pulpotomy or anything like a root canal. It was really very simple & her gums healed quickly. She didn't get her permanent front teeth for a few years, though, so she had that gap-toothed look for quite a while. Melinda

With three children, we have experienced numerous bumped teeth. Only my daughter's turned grey. The dentist (Wampler or Katsura, can't remember which, but in the same practice) said they couldn't tell if it was going to survive, but suggested waiting. It might stay as it was, get better, or show other signs of damage (pain, abcess) in which case they would do something. Do our surprise, the tooth actually turned white again after a while. Apparently teeth can get bruised. On the other hand, my niece at some early age (3 maybe) bumped and bruised and chipped a tooth. She got a gold crown for a while, but then it abcessed and she had the tooth removed when she was about 4. Her adult teeth came in about two years later, with no problem. Good luck! Cynthia

My son did the same thing as a four-year-old. The dentist (Dr. Matsuishi) mentioned the three options (do nothing, remove the tooth, or mini-root canal) but said they only do that when they are sure the tooth is dead. Usually, it's not dead. What you're seeing is in effect a bruised tooth (blood inside the tooth). His suggestion was to do nothing and watch the tooth. If it's still gray in a few months, then it's probably dead and they may pull it. My son's tooth returned to white in about two months and it's just fine. Joyce

This is in response to the mother who wrote in wondering what to do about her child's tooth.

Earlier this year, my three-year old son fell and hit one of his front teeth. It turned blue-grey a few days later. The dentist told us that he thought the tooth could be saved, but he gave us an option of having it pulled. We decided to try and save the tooth. The dentist did tell us to watch out for any abcesses that formed around the tooth.

A couple of months later we noticed that an abcess had formed above the tooth. My wife took our son back to the dentist who gave us another choice. He could either drain the abcess or pull the tooth. My wife decided to have the tooth pulled because there was no way of knowing if the abcess might return and she didn't want to subject our son to numerous dentist visits for the purpose of having an abcess drained..

After pulling the tooth, which was a dramatic experience for my son (which is one of the reasons we wanted to avoid it if possible), the dentist discovered that one of the two roots had been broken in the original fall. There was probably no way to avoid pulling the tooth under the circumstances.

I'm glad that we decided to have my son's tooth pulled. However, the drawback has been that his other front tooth has become slightly loose because of the loss of side support.

If your child is not in pain from the tooth, I would try to save it. But keep an eye out for any abcesses that form near it. Robert

Our daughter did the same thing - all of a sudden we noticed that her front tooth was brown. We saw Dr. Katsura, and even Dr. Matsuishi, (both pediatric dentists) who both said to keep an eye on it, notify them of any pain related to it (brushing, etc.) or any changes in it. It is still a bit brown (she just turned 5 - this happened when she was 3) but barely noticable unless you're looking. Neither dentist seemed concerned that it would get to the adult tooth. CC

Within 6 months of getting his _long-awaited_ front baby teeth, my (daredevil) son had a big wheel accident that completely knocked out one of his front teeth and loosened all the ones around it. I immediately got the tooth, placed it in milk (I had heard somewhere this was how to preserve them for re-insertion) and, amidst tears and totally flipping out, rushed him to a dentist that my experienced (2nd time around mommy) neighbor suggested. Imagine my shock and dissappointment when the dentist told me that they don't re-insert baby teeth. I understood the reasoning behind it - the risk for infection is too great, it may permanently damage the socket, and this would cause problems for the permanent teeth, that would come eventually (yeah, right, 4 or 5 years later). That dentist was Neil Katsura, quite possibly one of the dentists you have already seen. I inquired of my husband's dentist and my own dentist and both agreed with the prognosis.

Two days later, while jumping up and down in front of a window sill, my son slipped, hit his mouth, and knocked out the other front tooth. Experienced :-\\ at this point, I merely called the dentist, told him what happened, and said I would see him at the next (already) scheduled appointment.

That was about two and a half years ago and Sean is still missing his two front teeth. Sean and I have become professionals at the dentist, we go about every six months to check on the status of the surrounding teeth which were shocked and one that is dying(at Sean's request, he is waiting to get a prosthesis-two fake teeth on a retainer)-and we too, were given the choice of wait and see or removing the tooth (I seem to recall it would require some kind of mini-root canal). The tooth has turned slightly gray, has not absessed and is not causing Sean any kind of discomfort thus far. It has been loose for about 6 months and still shows no sign of coming out on its' own.

The most important lesson I learned from all of this is - was Sean concerned about his appearance or was I? I remember thinking that we had to get the prosthesis right away so no one would think he had gotten bottle-rot or something...but you know? Sean is not the least concerned about [this aspect] of his appearance, he is most concerned about being able to eat his favorite food - corn on the cob, and that is why, when HE was given the choice of front teeth or no, he opted for teeth. Dorothy