Dealing With Dental Trauma - Your Guide to Dental First-aid.
- andrew30050
- Sep 30
- 4 min read
By Dr Amar Khosa
A few weeks ago, I was invited to do a practical demonstration with a group of up-and-coming paramedics at AUT on managing dental trauma. It struck me that while health professionals need this knowledge, it’s equally important for everyday people at home. Dental accidents don’t just happen on sports fields, they can happen in the kitchen, at school, or even during a stumble in the driveway.
The first few minutes after an accident can make a real difference to whether a tooth can be saved, or whether pain can be managed until professional help is available. So, here are some practical first aid steps you can take if you or someone you care for has a dental emergency.
Knocked out (avulsed) tooth
This is one of the most time-sensitive dental emergencies. If an adult tooth is knocked out, every minute counts.
Imagine you trip on a run and end up with your tooth in your hand. What do you do?
Handle with care: Only touch the crown (the part you normally see in your mouth), not the root.
Clean (gently!): If it's dirty, rinse it briefly (no more than 10 seconds) under cold running water. Do not scrub it or use soap.
Replant if possible: If you can, gently try to place the tooth back into its socket. Make sure it's facing the right way. Once it's in, bite down gently on a clean cloth or gauze to hold it in place.
If replanting isn't possible (or safe): This is where storage becomes crucial. You need to keep the tooth moist and viable until you can see a dentist. Here are the best options, in order of preference:
Milk (full cream milk is best!): This is usually the most readily available and provides a good environment for the tooth cells.
Specialised solutions: If you happen to have a "save-a-tooth" kit, use that!
Saliva: If milk isn't an option, place the tooth in your mouth, between your cheek and gum (the buccal vestibule). Only do this if the person is conscious and old enough not to swallow the tooth. For a child, an adult can hold it in their own mouth.
Saline solution: A clean saline solution is better than nothing, but not as good as milk or specialised solutions.
What to avoid: Never store a tooth in tap water (it can damage the tooth cells), dry storage, or alcohol/disinfectants.
Time is critical: The sooner the tooth is replanted or placed in a suitable storage medium, the better the chance of success. Aim for dental care within 30-60 minutes if possible.
Then get to a dentist as soon as possible. Teeth replanted within 30 minutes have the best chance of survival.
Broken tooth
Not all accidents knock a tooth out completely. Sometimes a chunk breaks off, maybe biting into something hard, or from a knock to the face. This can leave the tooth sharp, jagged, and painful.
Here’s what you can do while waiting to see us:
Rinse your mouth with warm saltwater to help keep the area clean.
If it’s sore, take your usual over-the-counter pain relief.
If the sharp edge is cutting your tongue or cheek, cover it with dental wax, temporary filling material from a pharmacy, or even sugar-free chewing gum in a pinch.
Only have soft foods and chew on the opposite side.
A cold pack on your cheek for 15 minutes at a time can ease pain and swelling.
Keep up with brushing, but be gentle. An antiseptic mouthwash can also help reduce irritation.
Sensitive tooth
Sometimes a tooth isn’t broken, but suddenly becomes sensitive. A blast of cold air, a sip of coffee, or a spoonful of ice cream can set it off.
While sensitivity isn’t usually an emergency, it can be uncomfortable:
Use a toothpaste designed for sensitive teeth. Rub a little directly onto the area and leave it.
Avoid whitening toothpastes, which can make things worse.
Clove oil on a cotton ball can give quick relief if the sensitivity feels more like pain.
Try to avoid acidic or very hot and cold foods until you’ve had your tooth checked by a dentist.
Mouth ulcers
Most of us have had an ulcer or two, and while they aren’t dangerous, they can be irritating. The good news is, they usually heal themselves within a couple of weeks.
In the meantime:
Rinse with warm saltwater.
Apply an ulcer gel from the pharmacy to help with pain.
Avoid foods that sting — like citrus, tomatoes, or chilli.
If an ulcer lasts more than 2 weeks, it’s time to see a dentist.
Facial swelling
This is one to take seriously. Swelling in the face is often a sign of infection. Unlike ulcers or sensitivity, infections don’t just go away, and they can spread.
If you notice swelling:
Apply a cold compress to the area.
Take pain relief if needed.
Do not apply heat, as it can make an infection worse.
Arrange to see a dentist urgently. Sometimes antibiotics are needed, and the sooner the infection is treated, the better.
Broken braces or wires
Orthodontic emergencies can be uncomfortable but usually aren’t dangerous. A broken bracket or poking wire can feel like a needle in your cheek.
If a wire is poking, cover it with orthodontic wax (or a piece of clean cotton) to stop it rubbing.
Don’t cut the wire yourself — this can cause more trouble than it solves.
Call your orthodontist to arrange a repair.
Broken denture
If a denture snaps in two or a tooth pops off, it’s frustrating, but resist the urge to superglue it. Glues are toxic and can permanently damage the denture.
Keep the pieces safe and clean, and bring them to your dentist or dental technician for a professional repair.
When to get urgent care
First aid at home is about buying time and making things more comfortable. It’s not a substitute for treatment. If you have a knocked-out tooth, swelling, severe pain, or uncontrolled bleeding, seek urgent dental care straight away.
Dental accidents can be stressful, but a calm, informed response makes a big difference. If you remember nothing else, remember this: keep knocked-out teeth moist, avoid home “fixes” with glue or scissors, and get professional help as soon as possible.