Playing it Safe with Dental Trauma in Children
Consultant in Paediatric Dentistry at Kings College Hospital. Safeguarding lead for Paediatric Dentistry at KCH. Board member for Dental Trauma UK
Playing it safe with dental trauma in children
Injuries to the teeth and mouth are not uncommon and can a have lasting impact on a child’s quality of life, especially when not managed safely and promptly. Thinking about ‘patient safety from the start!’, including dental trauma in these conversations is paramount and simply put, can help save a smile.
Why Dental Trauma Matters in Early Childhood
Thirty six percent of children experience dental trauma in their primary (baby) dentition, with the greatest incidence occurring between two and three years of age, when motor co-ordination is developing.
Common causes include:
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Falls (especially among toddlers)
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Playground accidents
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Sports-related injuries
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Bicycle or scooter accidents
For children under five, trauma often affects primary teeth, but even these injuries can lead to long-term complications, such as:
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Damage to developing permanent (adult) teeth
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Infection or pain
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Psychological distress or self-esteem issues
The risks increase when treatment is delayed, inadequate, or inappropriate. Early and effective action is critical in playing it safe.
First Aid for Dental Trauma
Common types of Injuries:
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Tooth knocked out (avulsion)
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Tooth loosened or displaced
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Tooth chipped or broken
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Lip or gum lacerations
When Every Minute Counts: Avulsion injuries
Immediate Response:
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For primary (baby) teeth: Never reinsert a knocked-out primary tooth. If you are unsure if it is a primary tooth versus a permanent tooth, look at the crown of the tooth (primary teeth crowns are often smaller) and the child's age (their adult front teeth often erupt from 6-7 years of age). If unsure place it in milk and seek an emergency appointment with a dentist.
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For permanent (adult) teeth:
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Pick it: Find the tooth, hold it by the crown (not the root).
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Lick it: Rinse it gently if dirty (no scrubbing).
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Stick it: Try to reinsert it in the socket if the child is cooperative.
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If not, place it in milk and get to a dentist as soon as possible- the faster it is put back in the mouth the better the long term out comes.
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Stay calm and reassure the child.
Prevention is protection
With twenty five percent of all school children set to experience dental trauma prevention is the first and most powerful layer of safety.
Many dental injuries are preventable with simple, practical steps. For infants, toddlers and pre-school children, home safety and appropriate supervision of activities can help mitigate the damage caused by falls.
‘No mouthguard, no play’
Any contact sports can result in trauma to your teeth e.g. football, boxing, hockey, cricket, rugby, American football, martial arts, wrestling, basketball, netball, cycling, gymnastics, skating, skateboarding, skiing and more. Wearing a professional mouthguard whilst playing these sports protects teeth by absorbing the forces of a traumatic impact.
Regular dental check-ups- Dental check by one, which is established national guidance in the UK has the key aim that every child should see a dentist when their first tooth comes through or at least by the age of one, to get them off to a healthy start.
A system wide responsibility: working together for safer paediatric dental care
While families are on the front line, dentists and our allied health care professionals are key in keeping young children safe from dental harm.
How can we improve what we already do?
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Mandatory dental trauma CPD for dentists
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Training accident and emergency staff and urgent care centres, to recognise and manage dental injuries
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Integrating dental trauma protocols into emergency care settings
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Having clear referral pathways for acute and long-term management of paediatric dental trauma
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Getting it right first time- collecting data on dental trauma as part of patient safety reporting
Improving the system means reducing preventable harm, increasing early intervention, and building a culture of safety from the start.
Ultimately leading to improved quality of care and outcomes for our paediatric patients that suffer dental trauma.
Every smile matters
Dental trauma may seem like a minor issue, but for a child, it can shape their future health, confidence, and comfort. With better prevention, faster response, and stronger systems, we can ensure safe care for every newborn and child, one smile at a time.
Useful resources
For more information, guidelines and campaigns on management of dental trauma- visit the International Association of Dental Traumatology and Dental Trauma UK.
https://www.dentaltrauma.co.uk/Index.aspx
CLICK HERE to visit the RCSEd Patient Safety Group Page.