A dental emergency? Here is what to do first.

The first move is a phone call, not a decision

You do not have to work out how bad this is on your own. Call (239) 482-2722, describe what you can see, and let the front desk sort the urgency with you. One number reaches both offices, Monday to Friday, 8 to 5, and a real human answers.

One set of things comes first, though. Any trouble breathing or swallowing, bleeding that will not stop under steady, gentle pressure, a blow to the head, a jaw that will not line up, swelling near the eye, a fever alongside facial swelling, or a child who is hard to rouse: that is 911 or the emergency room first, before anyone goes looking for a dentist. Once the hospital's part is done, call us and we will take the dental half.

The full walk-through of what outranks any dental office, and what the phone call itself is like, lives at our emergencies hub. What follows here is the first few minutes, one injury at a time.

If a tooth gets knocked out

First work out which kind of tooth you are holding. Baby teeth are small, very white, and short-rooted. Permanent teeth are bigger, with a long root. If you cannot tell, keep the tooth wet, keep it with you, and call.

A knocked-out permanent tooth

This is the emergency where minutes genuinely matter.

1. Pick the tooth up by the crown, the flat white part your child chews with. Do not touch the root.
2. If it is dirty, rinse it gently with milk or water. Do not scrub it, do not use soap, and do not dry it off.
3. Keep it moist. A cup of cold milk is the best container in the house. If there is no milk, keep the tooth wet rather than dry.
4. Have your child bite gently on clean gauze or a folded washcloth over the empty socket to slow the bleeding.
5. Call (239) 482-2722 and come in right away. Bring the tooth.

The sooner that tooth is back where it belongs, the better its chances.

A knocked-out baby tooth

Do not try to put it back. That is the most important line on this page, because pushing a baby tooth into the socket can damage the permanent tooth developing behind it.

Instead: gentle pressure with clean gauze until the bleeding slows, a cold compress on the outside of the cheek, and a call to us. We will check that nothing else was hurt in the fall, and talk with you about whether a space maintainer belongs in the gap.

A toothache that will not settle

A toothache is worth taking seriously even when the pain fades by morning, because whatever causes it does not fade. In the meantime:

• Rinse the mouth gently with warm water.
• Floss carefully on both sides of the sore tooth. Sometimes a toothache turns out to be food caught against the gum.
• Hold a cold compress against the outside of the cheek, not inside the mouth.
• Do not put aspirin on the gum or against the sore tooth. It does not work that way, and it can burn the soft tissue.
• Call and describe it. If the face or gum is swollen, or the pain woke your child from sleep, say so, because that changes how quickly we want to see them.

A tooth that hurts on its own, with nothing touching it, needs to be looked at. The repair is often smaller than parents fear: sometimes a filling, sometimes a nerve treatment that saves the tooth and finishes with a crown. Our services page walks through both.

A chipped, cracked or broken tooth

Chips happen constantly: pool decks, handlebars, a sibling's elbow. Plenty are cosmetic and can wait for a regular appointment. Some are not, and the only way to know which is to have it looked at.

• Rinse gently with warm water.
• Find the broken pieces if you can, put them in a container of milk, and bring them.
• Cold compress on the outside of the lip or cheek if there is swelling.
• Call and tell us how big the break is, whether you can see pink or red in the middle of it, and whether the tooth is loose.

A small chip on the corner of a front tooth is usually a short, easy fix. A deeper break is handled like any other repair here: a tooth-colored composite filling, or a crown, natural-looking resin on a front tooth and durable stainless steel on a back molar.

A bitten lip, tongue or cheek

Mouths bleed dramatically. There is a lot of blood supply in a lip, and the amount of red in the sink is a poor guide to how serious the cut is.

• Clean the area gently with water.
• Press steadily and gently on the spot with clean gauze or a washcloth, and try not to keep lifting it to check.
• Hold a cold compress on the outside of the lip or cheek to keep the swelling down.
• If the bleeding will not stop, or the cut is deep or goes through the edge of the lip, head for the emergency room.

Once the bleeding has stopped, call us so we can check that no teeth were loosened. A fall that splits a lip often knocks a tooth loose too, and that is easy to miss.

What to bring, and what the visit is like

Bring the tooth or the broken pieces, in milk if you have it, and bring the blanket or the bear, whatever your child holds onto. If you were given anything at a hospital first, bring that paperwork too.

An urgent visit is still a kid's visit

The room your child walks into is the same one they would walk into on a happy day: the shipwreck and the surfboard game consoles in Fort Myers, the whale shark overhead in Naples. A hard afternoon does not change how the team talks to a frightened child.

Comfort options get talked through with your pediatric dentist before anything begins: topical anesthetic cream, gentle local anesthetics, nitrous oxide, better known as laughing gas, and IV sedation with a highly trained pediatric anesthesiologist when a treatment plan calls for it. Nothing happens without you, and you are welcome to stay in the room.

Later, when everyone is home and calm, The Bravest Little Diver is a good one to read together.