Emergency Pediatric Dentist: What to Do Right Now

9 children’s dental emergencies and what to do

Most urgent first. Each one links to the guidance it’s based on, from the American Academy of Pediatric Dentistry (AAPD), the American Association of Endodontists (AAE), the American Dental Association (ADA), the American Academy of Pediatrics (AAP), the American Association of Orthodontists and children’s hospitals. When you’re unsure, call your dentist or your child’s doctor.

1. 1

   Knocked-out permanent (adult) tooth

   When

   Right now: see a dentist within 30 minutes if you can

   Good for The one dental emergency where minutes count

   Find the tooth and pick it up by the crown, never the root. If it’s dirty, rinse it gently, without scrubbing or soap: the AAP and AAPD say in milk or saline, the AAE in water. Then push it back into the socket and have your child bite on gauze or a cloth to hold it. If you can’t, keep it moist in milk, saline or your child’s saliva (spit into a cup), not tap water, and go to a dentist or the nearest ER. The AAP says the best chance is within 15 minutes; it may still be saved within the first hour.

   • Hold it by the crown, not the root
   • Don’t scrub it or use soap
   • Store it in milk, saline or saliva
   • Not in tap water

   aae.org (opens their site)

2. 2

   Knocked-out baby tooth

   When

   Call your dentist today; be seen within 24 hours

   Don’t put a baby tooth back in. The AAE and the AAPD-endorsed trauma guidelines warn that replanting it can damage the permanent tooth growing underneath, and the AAP says the adult tooth will come in on its own. If it’s bleeding, have your child bite on a piece of cold, wet gauze; an ice pop or a cold pack wrapped in a washcloth helps with swelling. Call your pediatric dentist so they can check for other injuries. Over the next weeks, watch for swollen gums, a fever, pain that doesn’t go away, or a nearby tooth turning darker.

   • Never put a baby tooth back
   • Cold, wet gauze for bleeding
   • Watch for a tooth turning dark

   healthychildren.org (opens their site)

3. 3

   Chipped or broken tooth

   When

   Same day if it bleeds or hurts badly; otherwise within 24 hours

   Rinse your child’s mouth with warm water, hold a cold compress on the cheek or lip for swelling, and look for the broken piece: keep it in a clean container of milk, saliva or saline, because the dentist may be able to bond it back on. Call your pediatric dentist. A red dot or bleeding in the middle of the break means the nerve (pulp) is exposed, which hurts and needs prompt treatment. A small chip that doesn’t hurt can wait for office hours, within a day.

   • Save the piece in milk or saliva
   • Red spot in the break: call now
   • Cold compress for a hurt lip

   mychildrensteeth.org (opens their site)

4. 4

   Tooth pushed in, pushed out or loosened after a fall

   When

   Pushed far out of place: call now. Very loose: within 24 hours

   A tooth pushed far out of place, up into the gum or partly out of its socket needs a call to the dentist now; one that’s only slightly out of line, or feels very loose, within 24 hours. A tooth that’s a little loose and still in place usually tightens on its own: serve soft foods for about 3 days and hold a cold pack on the cheek for 20 minutes. The dentist repositions and steadies a displaced tooth. Some permanent teeth need a root canal later, and the AAE suggests checking injured teeth for up to five years.

   • Pushed far out of place: call now
   • Slightly loose: soft foods for 3 days
   • Follow-up checks for years

   childrenscolorado.org (opens their site)

5. 5

   Cut or bitten lip, tongue or cheek

   When

   ER if bleeding won’t stop after 10 minutes of pressure

   For a lip, press it against the teeth for 10 minutes; for the tongue, press gauze on the cut for 5 minutes. Ice or an ice pop for 20 minutes helps the pain, and small cuts inside the mouth usually heal in 3 or 4 days. Get care now for a gaping cut of the lip, tongue or inside of the mouth that may need stitches, trouble swallowing, or a fall with a pencil or toothbrush in the mouth, which can puncture the back of the throat. Bleeding that won’t stop after 10 minutes of pressure means the ER.

   • Lip: press for 10 minutes
   • Tongue: gauze for 5 minutes
   • Gaping cut may need stitches
   • Dirty cut? Check tetanus shots

   seattlechildrens.org (opens their site)

6. 6

   Toothache

   When

   See the dentist if it lasts over a day or gets worse

   Tooth decay is the most common cause of toothaches, the Mayo Clinic says, and food stuck between teeth is another. Have your child rinse with warm water, gently floss on both sides of the sore tooth, and hold a cold pack on the cheek for 20 minutes. Children’s acetaminophen or ibuprofen, dosed for your child’s age and weight, can help; never put aspirin or heat on the sore area. A mild ache that’s gone within a day can wait for a checkup, but call your dentist if it lasts, gets worse or pain medicine doesn’t help.

   • Floss out trapped food
   • No aspirin or heat on the gums
   • Lasts over 24 hours: call the dentist

   aapd.org (opens their site)

7. 7

   Swelling or fever with tooth pain

   When

   Dentist today; ER now if swelling nears the eye or neck

   Swelling of the gum next to a tooth, the cheek or the jaw, especially with a fever, can mean an infected tooth (an abscess). Boston Children’s Hospital says to bring your child to the dentist or pediatrician at the first sign: caught early, these infections are easy to treat, but they can spread. Go to the ER now if swelling spreads toward the eye or down the neck, or your child has trouble breathing or swallowing. Don’t put heat on a swollen face. Treatment usually means draining the infection, often with antibiotics.

   • Trouble breathing or swallowing: 911
   • Swelling near the eye or neck: ER
   • No heat on a swollen face

   childrenshospital.org (opens their site)

8. 8

   Broken braces wire or loose bracket

   When

   Usually not an emergency: call the orthodontist

   A poking wire or a loose bracket hurts but is rarely an emergency, the American Association of Orthodontists says. Push a poking wire flat with a clean pencil eraser or cotton swab, or cover the end with orthodontic wax; remove a small broken piece only if you safely can, with clean tweezers. Slide a loose bracket back toward the middle of the tooth, skip hard and sticky foods, and call the orthodontist. Heavy bleeding, trouble breathing or swallowing, or a possible broken jaw needs emergency care first.

   • Pencil eraser or wax for a poking wire
   • Avoid hard, chewy and sticky foods
   • Sores: salt-water rinse

   aaoinfo.org (opens their site)

9. 9

   Something stuck between teeth

   When

   Not an emergency; call if it won’t come out

   Food or a small object wedged between teeth is uncomfortable, but the Cleveland Clinic doesn’t count it as a dental emergency. The ADA says to try to remove it gently with dental floss, and not with anything sharp or pointed. If it won’t come out, or the gum around it stays sore, call your dentist during office hours.

   • Floss gently; nothing sharp
   • Office hours are fine

   my.clevelandclinic.org (opens their site)

Kids’ dental emergencies at a glance: what to do and how soon

Check your child before the tooth. A blow hard enough to break or knock out a tooth can also hurt the head or jaw, and those come first.

Not sure if it’s a baby tooth or a permanent one? Call a dentist right away or go to the ER, as Nemours KidsHealth advises, and keep the tooth moist in milk until someone can tell you.

When to go to the ER instead of the dentist

Go to the emergency room, or call 911, before you think about a dentist if your child has:

• A possible head injury, such as a hard blow to the head or passing out, even briefly. The AAPD says a severe head injury can be life-threatening and needs immediate medical attention.
• A possible broken or dislocated jaw.
• Bleeding that won’t stop after 10 minutes of steady, direct pressure.
• Swelling that spreads toward the eye or down the neck, or trouble breathing or swallowing. Infections of upper teeth can spread around the eye, and lower ones can block the airway, Children’s Hospital of Philadelphia’s emergency guidance warns.
• A fall with something in the mouth, such as a pencil or toothbrush, that may have punctured the back of the throat.
• A knocked-out permanent tooth when you can’t reach a dentist right away. The AAP says to go to your dentist or the nearest ER, and to call ahead.

Know what an ER can do. Emergency doctors can replant a knocked-out permanent tooth, treat bleeding and cuts, and handle a broken jaw or a spreading infection. But emergency departments are seldom equipped or staffed to do dental procedures on children, notes a 2026 study of children’s ER visits for toothache in Michigan State University’s medical student research journal, so for an ordinary toothache they usually treat the pain and send you to a dentist. If you can, choose a children’s hospital: some have pediatric dentists on staff, and the AAPD lists emergency department care among a pediatric dentist’s hospital privileges.

How to find an emergency pediatric dentist after hours

1. Call your own dentist first, even at night. Many practices have an emergency number or an after-hours message that tells you what to do, the AAPD and the Cleveland Clinic say. Save it in your phone today, with your orthodontist’s.
2. No dentist, or no answer? Search the AAPD’s Find a Pediatric Dentist directory and call nearby offices. Some pediatric practices run on-call lines every night and weekend; their recorded message will say.
3. For an injured permanent tooth, try an endodontist. The AAE says endodontists specialize in traumatic dental injuries and many fit in emergencies, sometimes on weekends.
4. For lower-cost care, call a dental school clinic or a community health center and ask about urgent visits. HRSA’s guide to finding low-cost dental care explains how to find both, and many health centers charge on a sliding scale by income.
5. For the problems in the list above, go to the ER, a children’s hospital if you can.

What is a pediatric dentist, and what makes a kid-friendly one?

A pediatric dentist is a dentist with two to three years of specialty training after dental school, the AAPD says, who treats only children, from infants through teens, including children with special health care needs. Residency covers child development and psychology, behavior management, oral and facial injuries, sedation and general anesthesia, and care for children with disabilities. The ADA calls pediatric dentists the pediatricians of dentistry. Board-certified pediatric dentists have also passed the American Board of Pediatric Dentistry’s exams. Many family dentists see children too.

The AAPD says a child should first see a dentist when the first tooth appears, and no later than the first birthday, then about every six months. A dentist who already knows your child is the easiest one to reach in an emergency.

Signs of a kid-friendly dentist, and questions to ask before you need one:

• Is there an after-hours emergency line, and who answers it?
• Can you see a child with a dental injury the same day?
• Can I stay with my child during the visit?
• How do you help nervous children? (The ADA says pediatric dentists tailor behavior guidance to each child and to parents’ preferences.)
• Do you see children with special needs, and what sedation do you offer, if any? Who gives it?
• Is the office set up for kids, with a welcoming waiting room and staff used to toddlers and teens?
• Do you take our insurance or our child’s Medicaid or CHIP plan?

Looking for a pediatric dentist near Sacramento, or one for a child with special needs in LA? See our guides to pediatric dentists in the Sacramento area and special needs dentists in Los Angeles.

A dental first-aid kit for kids

Keep these together at home, and a smaller set in the sports bag:

• Your dentist’s and orthodontist’s numbers, including after hours.
• A small, clean container with a lid, for a knocked-out tooth or a broken piece.
• A tooth-saving kit with a balanced salt solution, such as Save-A-Tooth, which the AAE and the AAP both name. Milk works too.
• Clean gauze or a clean washcloth, for bleeding and to hold a replanted tooth in place.
• A cold pack, and ice pops in the freezer.
• Children’s acetaminophen or ibuprofen, with the dose for your child’s age and weight written down. No aspirin on the gums.
• Dental floss, for food stuck between teeth.
• Orthodontic wax, if your child wears braces.

Questions parents ask