Your toddler went down face first. Here is how to check.

Toddlers fall, and the face lands first

Toddlers are top heavy, in a hurry, and their hands do not yet get out in front in time. The mouth takes the hit.

Two steadying facts. Mouths bleed out of all proportion to the damage, so the red on the shirt tells you little. And most of these afternoons end with a fat lip, a rattled parent, and a child who is fine by dinner.

The order that matters: child first, mouth second, phone third.

Check the child before you check the teeth

Teeth are patient. Heads are not. Before you lift a lip, look at your toddler, and keep looking all day. Call 911 or head for the nearest emergency room, ahead of any dental question, for:

• Sleepiness the hour does not explain. Hard to rouse, or drifting off soon after the impact. A doctor, not a nap.
• Vomiting. Once can come from crying hard. More than once, or any starting later, gets checked.
• A cry you cannot bring down. You know the ordinary furious cry. Something past it, that nobody can settle, counts.
• Any loss of consciousness, even briefly, even if she seemed fine a minute later.
• Trouble breathing or swallowing, or bleeding that will not slow under steady, gentle pressure with clean gauze.
• A jaw sitting crooked, or one that will not open and close normally, which can mean a break.

A moving vehicle means a medical evaluation first

No gray area. If your child was in a car seat during a collision, or was struck by a car, a bike, or a wagon that got away from someone, a doctor sees her before anyone looks at a tooth. Full stop. Call us once she is checked.

The calm check, once the crying stops

Wait a few minutes. A screaming child will not open her mouth anyway. Then wash your hands, find good light, and gently lift the upper lip. You are not diagnosing, just collecting a description for the phone.

• Blood at the gumline. A thin red rim where a tooth meets the gum means that tooth took the impact, even if it looks fine.
• A tooth out of line, pushed back, tipped forward, or angled where its neighbors are not.
• A tooth that looks shorter. The one parents miss. A hard hit can drive a baby tooth up into the gum instead of out of it, so it looks half sunk, or gone. Compare with the matching tooth on the other side.
• A tooth that wiggles when it did not yesterday. Touch it once with a clean finger, then leave it alone.
• A torn frenum, the thin band running from inside the upper lip down to the gum. It splits easily in a face first landing and bleeds like something far worse. Gentle pressure settles it and it heals on its own.
• Chipped or rough edges, and cuts on the lip, tongue or cheek.

A cold compress on the outside of the lip keeps swelling down, never inside the mouth. Nothing gets tucked against a gum to numb it, aspirin least of all: it burns tissue that thin.

Then call (239) 482-2722 and read the list out loud.

Why a pushed up or loosened baby tooth always earns a call

The part that surprises parents: the baby tooth is not our main concern. What sits above it is.

In a toddler, the permanent tooth is already forming in the bone above each baby tooth, enamel still hardening, and the baby tooth root points right at it. A tooth driven up into the gum travels toward it. So a pushed up tooth gets looked at even after she is back in the sandbox.

Now the unexciting truth. Sometimes nothing comes of it at all, and sometimes the permanent tooth turns up with a mark on the enamel, a different shape, or later than its neighbors. Nobody can predict which from the outside, and nobody can undo it afterward, which is why we want a look and a record rather than a guess.

What a visit gives you is a record and a plan. We look at that tooth and its neighbors, check the lip and gum, and use a digital X-ray only if needed. Pushed up teeth often come back down over a few weeks and loose ones tighten. We would rather watch that with you than leave you wondering. Nobody hurries a frightened toddler, and what to expect at a visit covers how it runs.

Two things to watch for in the weeks after

Injured baby teeth sometimes react late, long after everyone has moved on. Neither is an emergency, and neither is a reason to inspect her mouth nightly with a flashlight. Just know them.

• The tooth changes color. Grey, brown, or nearly black, usually a front tooth, usually weeks later. It is reacting to the bruise it took. Some fade back toward normal, some do not. Either way we want to see it.
• A bump on the gum above it. A small pimple like swelling, tender or not. Call about that one sooner rather than later.

Two quieter signals count too: she avoids that side to eat, or the tooth turns sore again after settling. Ringing us twice about one fall is never a bother.

What prevention can and cannot do

Padding the sharp corners where she plays helps. So does a gate at the stairs, a hand on her near the pool edge, and keeping the carrier on the floor rather than up on a table. Supervision matters more than any of it.

None of it gets you to zero. A child learning to run has to practice falling, and she will practice while you stand three feet away. That is not a supervision failure. That is a toddler, and no product on a shelf keeps a mouth from meeting a coffee table.

Keep (239) 482-2722 where you can find it in a hurry. Our other guides sit on the dental emergencies page, and if she has not had a first look at her teeth yet, that is a good reason to book a visit.