Your child chipped a tooth. Here is what to do.

Take a breath, then take a look

Pool decks. Bike handlebars. A sibling's elbow at exactly the wrong moment. Teeth chip constantly, and it is one of the calls parents make most. Plenty of these end in a small repair.

Here is the honest version, though, because you deserve that more than reassurance. Plenty of chips can wait for a regular appointment. Some cannot. And the difference is frequently impossible to see at home: a chip the size of a grain of rice can be nothing, or it can have opened a path toward the nerve.

Parents are not supposed to sort that out at home, and you are not failing at anything by not knowing. So the plan is small. Steady your child, do the steps below, then call and describe what you see. The sorting is our job.

When this belongs at the hospital instead

Teeth are ours. The rest of the body is not, and a broken tooth usually arrives with a fall attached to it. Call 911 or head for the emergency room first if, along with the damaged tooth, your child has any of this:

• Trouble breathing, or trouble swallowing
• Bleeding you cannot slow by pressing gently with clean gauze
• Taken a knock to the head, or seems drowsy, confused, sick to the stomach, or blacked out even for a second
• A jaw that sits crooked, will not open and close the usual way, or hurts to move, which can point to a broken jaw
• A cut that goes deep or splits the edge of the lip, or any injury from a crash or a serious fall

The tooth will keep. After the hospital has looked your child over, call us for the tooth.

The first few minutes

1. Rinse with warm water. Enough to clear blood and grit so you can see what you are dealing with. Water only, gently, nothing scrubbing.
2. Hunt for the piece, and keep it wet. Check the sink, the shirt, the ground where it happened. Anything you find goes into a cup of cold milk, or plain water if there is no milk, and comes with you. Do not wrap it in a tissue, where it dries out and gets tidied into the trash.
3. Cold, on the outside. If the lip or cheek is puffing up, press a cold compress to the outside of the face. Never against the tooth, never inside the mouth.
4. Call and describe it. (239) 482-2722.

One thing never to do: do not tuck an aspirin against the gum or the sore tooth. It does not reach pain that way, and it can burn the tissue it rests on. Anything by mouth is a question to put to us or your pediatrician.

What to tell us on the phone

Call us at (239) 482-2722 and a real person at the front desk picks up. One number reaches both offices, Monday to Friday, 8 to 5.

You are not being asked to diagnose your child. You are being asked to describe. These details move a broken tooth up or down the schedule, so look once, report plainly, and let us weigh it:

• How big the break looks. A rough edge you can barely feel, or an obvious piece of tooth gone.
• What shows in the middle of it. Any pink, red, or a dark spot in the broken surface. Say that one first, because it changes how fast we want your child here.
• Whether the tooth moves. Wobbly, pushed back or sideways, or sitting lower than the teeth beside it.
• Whether cold air bothers it. A tooth that stings when your child breathes in through the mouth may be more damaged than it looks.
• Which tooth, and how it happened. A front tooth on concrete gets different questions than a back tooth on a fork.

Nothing there is a quiz you can fail, and "I honestly cannot tell" is a fine answer. While you have the front desk, mention what makes a visit easier: first visit ever, child is nervous, sensory sensitivities, prefiere español.

What the repair usually looks like

We will not know until we see the tooth, and it would be wrong to hand you a plan over the phone. In general terms, though:

A small chip is often a short visit and a shorter conversation. Sometimes a sharp edge simply needs smoothing so it stops catching on a lip or a tongue. Sometimes the corner is rebuilt with tooth-colored composite material, the same kind used for our fillings, which parents often know by the word bonding.

A bigger break is handled the way any damaged tooth is handled here, and the options are the ordinary honest ones. A tooth-colored composite filling that preserves healthy tooth structure. A crown, when too little of the tooth is left to rebuild: durable stainless steel on a back molar, natural-looking resin up front. If the break reached the nerve, there are nerve treatments that save a hurting tooth, usually finished with a crown.

Which of those belongs to your child's tooth is a decision you make with your pediatric dentist, with your questions answered. Digital X-rays are taken only as needed. Nothing happens without you.

It is still an ordinary visit

Your child walks into the same room they would on a happy day: the shipwreck in Fort Myers, the whale shark hanging over Naples. Comfort options are discussed with you before anything begins, and nobody asks you to leave your child's side. What to expect walks through it.

While you wait, and the weeks after

How soon your child is seen is settled on that phone call, and it may be right now, later today, or the next open visit. Whatever the wait turns out to be, children tend to be more comfortable with softer food and with chewing on the other side, and a rough edge usually irritates the tongue more than it hurts.

Two things are worth another call, even after a repair, and even after we said it can wait:

• The tooth begins to look grey, dark, or noticeably different in color from the ones beside it. That can surface weeks later.
• Pain turns up where there was none, the gum above the tooth swells, or your child quietly stops chewing on that side.

An injured tooth can change well after the injury. Calling a second time is never a bother, and it beats catching something late. Our other emergency guides cover the rest.