A hit on the field. Check your child first, then the teeth.

Year round play, year round mouth injuries

Down here the season never really ends. Baseball hands off to flag football, football to soccer, and a skate ramp fills the gaps. More hours on the field means more chances for an elbow, a ball or the ground to find your child's mouth.

Most of it turns out to be a small chip and a large scare. Some of it does not. This page sorts the two in the order you need them.

The number is (239) 482-2722. One number reaches both offices, Monday to Friday, 8 to 5, and a real human answers. Anything that happens outside those hours can be described first thing when the phones open.

The first minute belongs to your child, not the tooth

A tooth gets hurt because something struck it hard, and whatever struck it also struck everything around it. So before you look in the mouth, look at the kid. Get them off the field and sit them down.

Get medical care, at the emergency room or by calling 911, if any of this is true:

• They were knocked out even briefly, or seem dazed, foggy, or slow to answer a plain question.
• A headache that keeps building, repeated vomiting, unsteady balance, blurred vision, or speech that sounds wrong.
• Any struggle to breathe or swallow, or a cough that will not settle after the impact.
• Bleeding that keeps soaking through gauze after several minutes of firm, steady pressure.
• The bite no longer lines up, the jaw will not open or close normally, or the lip or chin feels numb.

A blow to the head is a doctor's call, not a coach's and not ours. A tooth can usually wait the couple of hours that takes; a head injury cannot. The one exception is a permanent tooth knocked out entirely: tell the emergency room staff about it the moment you arrive.

Then account for the teeth

Your child is steady and nothing on that list applies. Now look in the mouth, and find your situation below.

• A permanent tooth is out of the mouth completely. Minutes decide this one. Handle it by the crown and never the root, get it into cold milk, and come in immediately. The best window is roughly thirty minutes, according to the American Association of Endodontists.
• A baby tooth is out. It never goes back in the socket. Steady pressure with clean gauze, an ice pack against the cheek from the outside, and a call to us.
• A tooth is loose, shoved sideways, or pushed up into the gum. Leave it where it sits, do not test it with a finger, soft food only, and call today.
• A tooth is chipped or broken. Collect any pieces, put them in milk, and call. Tell us how deep the break looks.
• A lip, tongue or cheek is cut. Clean gauze, firm and steady. If it keeps bleeding, or the cut crosses the lip border, that is an emergency room trip.
• Everything looks fine. If the hit was hard, call anyway. Teeth get bruised without showing it, and a tooth that darkens weeks later often traces back to a day like this.

Call from the parking lot, not from home

(239) 482-2722. What helps us most: which tooth, what hit it, how long ago, whether your child hit their head, and whether anything is loose, missing or bleeding.

At the visit we look at the tooth you are worried about and at the ones on either side, because the neighbors get overlooked while everyone stares at the obvious one. A digital X-ray, taken only as needed, shows what the impact did below the gum line. What follows depends on what we find: a tooth-colored composite filling, a crown, a nerve treatment, or sometimes just a plan to watch that tooth.

Nobody moves fast around a scared kid here. Your child gets the plan in plain words before anything starts, comfort options are discussed with your pediatric dentist first, and you stay beside the chair. What to expect at a visit describes an ordinary appointment.

The mouthguard conversation, without a sales pitch

Sooner or later another parent tells you to get a mouthguard, usually right after somebody's kid lost a tooth. Here is the general picture.

The American Dental Association recommends a properly fitted mouthguard for athletes in sports that carry contact or collision, and the list is longer than parents expect: hockey and football, yes, but also basketball, soccer, wrestling and skateboarding. The important word there is fitted. A guard that fits badly gets chewed up or left in the bag.

Families take one of two routes:

• Store bought. Stock guards come ready to wear, and boil and bite versions soften in hot water so your child bites an impression into them. Easy to find, and the fit varies a great deal.
• Custom made. A guard built from an impression of your child's own teeth sits closer and is easier to talk and breathe through. That is a conversation with your pediatric dentist, not a shelf decision.

What we will not do is choose for a child we have not seen. Mouths at these ages change constantly, and a guard that fit in spring may not fit by fall. Ask us about the options at a regular checkup.

The honest footnote: no mouthguard makes a mouth injury impossible. It is protection, not a promise.

What lives in the equipment bag

Two minutes of packing beats a frantic search in a parking lot. Three items.

• Clean gauze pads. A folded washcloth does the job, but gauze rides in a side pocket all season.
• A small clean container with a lid. Any rinsed out screw top jar, for a knocked out tooth or the pieces of a broken one.
• Our number in the phone. (239) 482-2722, saved in both parents' phones and worth passing to whoever drives the carpool.

The one thing you cannot pack is cold milk, which is the best thing for a knocked out permanent tooth. If a concession stand or cafeteria is steps away, grab it; if it is not, an older child can hold the tooth safely against the inside of their cheek, and nobody spends any of that window hunting for milk before driving in.

More of these sit in our emergency guides. Read one while nothing is happening.