What are the signs of a traumatic dental injury?

The range this actually covers

Not every bump to the mouth is the same kind of event, and recognizing which category fits is the first useful step. A tooth can simply be bruised, tender to bite on with nothing visibly different about it. It can be loosened or pushed out of its normal position, sideways, deeper into the gum, or partly out of the socket. It can be chipped or fractured, losing a piece of its visible structure. It can be knocked out completely. Or the injury can be entirely to the soft tissue, a cut lip, tongue, cheek, or gum, with the teeth themselves untouched.

This page is about recognizing which of those you are looking at and how urgent it is, not about handling each one. Our emergencies guide walks through the actual first-aid steps once you know what you are dealing with.

Signs that show up right away

Compare the injured tooth to its twin on the other side, since that comparison reveals a lot on its own. A tooth sitting noticeably higher, lower, or at a different angle than the matching tooth has likely moved. A tooth that wobbles when your child bites down, even slightly, is a different situation than one that simply feels sore. A visibly missing corner or edge, or a tooth that is simply gone from the socket altogether, are the most obvious signs of all.

Bleeding is worth reading carefully too. A cut lip or tongue tends to bleed generously from a small wound. Blood coming specifically from the gumline around one particular tooth, rather than more generally across the mouth, points toward that tooth itself rather than the surrounding soft tissue, and is worth naming specifically when you call.

Signs that show up later

A tooth can look completely normal on the day of a fall and tell a different story weeks afterward. The parts of a tooth that actually absorb an impact, the nerve and blood supply inside it and the ligament holding the root in place, are out of sight and do not always announce themselves right away. A tooth that gradually turns gray, brown, or dusky compared to its neighbors in the weeks after a hit is one of the more common delayed signs, and it means the inside of that tooth was affected even though the outside looked fine at the time.

New sensitivity to cold or to biting pressure that develops days after an impact is another delayed sign worth mentioning, and so is gum swelling or a small bump on the gum that appears well after the original injury seemed to have settled down. None of these mean something was missed. They mean the tooth is still telling its story, and that story is worth following up on.

When this is a call, and when it's 911 first

For the dental signs described above, call us at (239) 482-2722, describe what you are seeing, and we will help you sort out how soon your child needs to be seen.

Call 911 or go straight to the emergency room first, before worrying about the tooth at all, if any of the following is true: your child is having trouble breathing or swallowing; there was any loss of consciousness, confusion, or repeated vomiting after the hit; bleeding will not slow down under several minutes of steady, gentle pressure; or the jaw will not open and close the normal way, or the bite suddenly feels crooked, which can point to a broken jaw. A hit hard enough to injure a tooth is hard enough to affect other things on the way through, and those signs come first every time.