Emergency Dental Care for Children — A Parent’s Guide

Children are active, curious, and still developing their coordination — which means dental injuries and emergencies are a regular part of childhood. A tumble off a scooter, a collision during footy, a fall at the playground, or a sudden toothache in the middle of the night can leave parents feeling panicked and unsure of what to do.

The most important thing you can do in a dental emergency is stay calm. Children take their cues from the adults around them, and a calm parent helps a distressed child settle more quickly. The second most important thing is knowing the right first aid — and that is exactly what this guide provides.

At Compass Dental in Darwin, we see children with dental emergencies regularly, and we prioritise these cases. Dr Thien Pham and our team have been caring for Darwin families for over 10 years, and we understand that a dental emergency involving your child can be one of the most stressful moments you face as a parent. We are here to help.

Common Dental Emergencies in Children

1. Knocked-Out Tooth (Avulsed Tooth)

A tooth that has been completely knocked out of the socket is one of the most time-critical dental emergencies — but how you respond depends entirely on whether it is a baby tooth or a permanent tooth.

Baby Tooth Knocked Out

Do NOT try to reimplant a baby tooth. This is critically important. Pushing a baby tooth back into the socket can damage the developing permanent tooth bud sitting underneath in the jawbone. Baby teeth are not reimplanted.

What to do instead:

1. Stay calm and comfort your child.
2. Control bleeding by having your child bite gently on a clean piece of gauze or a damp face washer.
3. Apply a cold compress to the outside of the cheek to reduce swelling — a bag of frozen peas wrapped in a tea towel works well.
4. Check that no tooth fragments remain in the mouth. In young children, loose fragments can be a choking hazard.
5. Call Compass Dental for an assessment. Even though the tooth will not be reimplanted, the dentist should check for damage to the gum, jawbone, and surrounding teeth, and may discuss whether a space maintainer is needed.

Permanent Tooth Knocked Out

For a permanent tooth (which start coming through from around age six), time is critical. The best outcomes occur when the tooth is reimplanted within 30 minutes.

What to do:

1. Find the tooth. Pick it up by the crown (the white part) only — never touch the root.
2. If the tooth is dirty, rinse it briefly under gentle running water for no more than 10 seconds. Do not scrub it.
3. If your child is old enough and cooperative, try to gently push the tooth back into the socket with the smooth side facing the lip. Have them bite down on gauze to hold it in place.
4. If you cannot reimplant it, place the tooth in a container of cold milk or have your child spit saliva into a cup and store the tooth in that. Do not store it in water, tissue, or your pocket.
5. Get to Compass Dental immediately. Call us on the way so we can prepare.

2. Broken or Chipped Tooth

Children break and chip teeth frequently — from falls, sports, bike accidents, or biting on hard objects. The urgency depends on the severity.

Minor chip (enamel only, no pain):

• Rinse the mouth with warm water.
• Apply a cold compress if there is any swelling.
• Save the broken piece if you can find it.
• Book an appointment within a day or two.

Significant break (pain, sharp edges, or visible pink/red tissue inside):

• Rinse gently with warm water.
• Apply a cold compress.
• If there is bleeding, apply gentle pressure with clean gauze.
• Cover any sharp edges with dental wax (from the pharmacy) or a small piece of sugar-free chewing gum to protect the tongue and cheeks.
• Call Compass Dental for same-day emergency care.

If you can see pink or red tissue inside the broken tooth, the nerve is likely exposed. This needs urgent treatment.

3. Toothache

Toothache in children can range from mild sensitivity to severe, throbbing pain. Common causes include tooth decay (the most frequent cause), a tooth that is about to fall out naturally, food trapped between teeth, a cracked or chipped tooth, or infection.

What to do:

1. Ask your child where it hurts and look in their mouth for any obvious problems — swelling, redness, a visible hole, or a dark spot on a tooth.
2. Rinse the mouth with warm salt water (half a teaspoon of salt in a glass of warm water). For young children who cannot rinse and spit reliably, skip this step.
3. Gently floss around the affected tooth to remove any trapped food that might be causing pressure.
4. Give age-appropriate pain relief. Check with your pharmacist for the correct dose for your child’s age and weight. Ibuprofen (children’s Nurofen) is generally effective for dental pain. Paracetamol (children’s Panadol) can also be used. Never give aspirin to children under 16.
5. Apply a cold compress to the outside of the cheek if there is swelling.
6. Call Compass Dental and describe the symptoms. If the pain is severe, there is facial swelling, or your child has a fever, let us know so we can see them urgently.

4. Bitten Lip, Tongue, or Cheek

Children frequently bite their lip, tongue, or inner cheek — often during a fall, while eating, or after dental treatment when the area is still numb.

What to do:

1. Clean the area gently with a clean, damp cloth.
2. Apply firm pressure with clean gauze to control bleeding. Lip and tongue wounds bleed a lot because these tissues have a rich blood supply — it often looks worse than it is.
3. Apply a cold compress to the outside of the face (for lip injuries) or have the child suck on an ice block or ice chips (for tongue or inner cheek injuries).
4. The bleeding should slow and stop within 10 to 15 minutes of steady pressure.

See a dentist or doctor if:

• The wound is deep and may need stitches
• The bleeding does not stop after 15 to 20 minutes of firm pressure
• The wound is on both sides of the lip (inside and outside), which may indicate a bite that goes all the way through
• There is a tooth injury as well

5. Object Stuck Between Teeth

Children sometimes get food, small objects, or even pieces of a broken toy wedged between their teeth.

What to do:

1. Try gently flossing around the object to dislodge it. Use a careful, sliding motion — do not snap the floss or force it.
2. Do not use sharp instruments (pins, needles, or anything metal) to try to prise the object out. You may damage the gum tissue or push the object further in.
3. If gentle flossing does not work, call Compass Dental. We can remove the object safely.

6. Dental Injury with a Loose Tooth

Sometimes a knock does not fully dislodge a tooth but leaves it loose, displaced, or pushed up into the gum.

What to do:

1. Do not try to wiggle, pull, or reposition the tooth yourself.
2. Have your child bite gently on a clean cloth to stabilise the tooth.
3. Apply a cold compress to reduce swelling.
4. Call Compass Dental for an urgent assessment. Displaced or intruded teeth (pushed up into the gum) need professional evaluation, especially in young children where the developing permanent teeth may be affected.

Baby Teeth vs Permanent Teeth — Why It Matters

One of the most important things for parents to understand is that baby teeth and permanent teeth are handled very differently in a dental emergency.

Baby Teeth (Primary Teeth)

• Do NOT reimplant a knocked-out baby tooth. The risk of damaging the permanent tooth developing underneath is too high.
• Baby teeth that are loose from trauma should be assessed, but minor looseness may not require treatment — the tooth may tighten up on its own.
• Even though baby teeth are eventually replaced, injuries should still be assessed. Damage to a baby tooth can affect the permanent tooth forming beneath it.

Permanent Teeth

• A knocked-out permanent tooth should be reimplanted if possible. Time is critical.
• Broken permanent teeth need prompt treatment to protect the nerve and prevent infection.
• Injuries to permanent teeth in children can have lifelong consequences, so early and thorough treatment is essential.

Not Sure Which Type of Tooth It Is?

If you are unsure whether the injured tooth is a baby tooth or a permanent tooth, treat it as a permanent tooth and seek urgent care. Your dentist will be able to tell you definitively.

As a rough guide:

• Children under five typically have only baby teeth
• From age six to twelve, children have a mix of both (the “mixed dentition” stage)
• From around age twelve, most teeth are permanent (though wisdom teeth arrive later)

How Compass Dental Helps Children in an Emergency

We understand that bringing a child to the dentist during an emergency can be daunting — for both the child and the parent. Our team is experienced in working with children of all ages, and we take a gentle, patient approach to every visit.

A Child-Friendly Environment

Our practice is welcoming and non-threatening. We explain everything in age-appropriate language, show children the instruments before we use them, and let them ask questions. For younger children, we use a “tell, show, do” approach — telling them what we are going to do, showing them the tools, and then proceeding slowly with their cooperation.

Happy Gas for Gentle Sedation

For children who are anxious, scared, or finding it hard to sit still, we offer happy gas (nitrous oxide) sedation. Happy gas is inhaled through a small nose piece and takes effect within minutes. It helps children feel relaxed, calm, and less aware of the procedure, while remaining fully conscious and able to communicate.

Happy gas is extremely safe, widely used in paediatric dentistry, and wears off within minutes once the nose piece is removed. There are no lasting effects — your child can go back to normal activities straight away.

Combined with local anaesthetic to numb the area, happy gas ensures that even anxious children can receive the treatment they need comfortably.

Patience and Desensitisation

If a child is very distressed and the situation is not immediately urgent, we may take a staged approach — managing pain and protecting the tooth at the first visit, then completing treatment once the child is calmer. Forcing treatment on a terrified child is rarely in their long-term interest.

We also support desensitisation for children who have had a negative dental experience. Short, positive visits can help rebuild confidence and trust over time.

For more about how we care for younger patients, visit our children’s dentistry page.

When to Go to the Hospital Emergency Department Instead

Most children’s dental emergencies are best managed by a dentist. However, there are situations where the hospital emergency department is the more appropriate first stop.

Go to the Royal Darwin Hospital ED if:

• Your child has sustained a significant head injury, loss of consciousness, or concussion alongside the dental injury
• There is a suspected jaw fracture (difficulty opening or closing the mouth, misaligned bite, severe swelling)
• There is difficulty breathing or swallowing
• Facial swelling is severe or spreading toward the eye or neck
• There is uncontrolled bleeding that does not stop after 20 minutes of firm pressure
• Your child has a high fever (over 38.5 degrees Celsius) with facial swelling — this may indicate a spreading infection
• The dental injury is part of a larger trauma (car accident, significant fall, sporting collision with other injuries)

Call 000 if your child has difficulty breathing, is losing consciousness, or has sustained a serious head or facial injury.

Once any medical emergency has been stabilised, follow up with Compass Dental for the dental component of the injury. We will coordinate with the hospital team as needed.

Prevention — Reducing the Risk of Dental Emergencies

While you cannot prevent every accident, these measures significantly reduce the risk of dental injuries in children.

Mouthguards for Sport

If your child plays any contact or collision sport — AFL, rugby, rugby league, basketball, soccer, hockey, martial arts, cricket, or any activity with a risk of contact to the face — a properly fitted mouthguard is essential. Custom mouthguards made by your dentist provide far better protection and comfort than the boil-and-bite varieties from the chemist. Children are also more likely to wear them consistently because they fit well and do not interfere with breathing or talking.

Avoid Hard Lollies and Chewing Ice

Hard lollies, jawbreakers, and chewing on ice are common causes of cracked and broken teeth in children. Encourage softer alternatives.

Supervise Active Play

Supervise young children on playground equipment, trampolines, scooters, and bicycles. Ensure helmets are worn for cycling, scooting, and skateboarding. Consider helmets with face guards for high-risk activities.

Childproof the Home

For toddlers and preschoolers, the most common dental injuries occur from falls against furniture, steps, and hard floors. Secure heavy furniture, use safety gates, and pad sharp corners where practical.

Address Protruding Teeth

Children with front teeth that protrude significantly (a large overjet) are at higher risk of dental trauma. Orthodontic treatment to bring protruding teeth into alignment can reduce this risk. Talk to your dentist about the right time to assess your child for orthodontic treatment.

Maintain Good Oral Hygiene

Healthy teeth are stronger teeth. Brush twice a day with fluoride toothpaste, limit sugary snacks and drinks, and attend regular dental check-ups. Decay weakens teeth and makes them more susceptible to fracture.

Families from Regional and Remote NT

We understand that families in Katherine, Alice Springs, Nhulunbuy, Tennant Creek, and other remote Northern Territory communities may not have immediate access to a dentist for their child’s dental emergency. If you are remote, call Compass Dental and we can provide first aid advice over the phone and help you arrange an appointment as soon as you are able to travel to Darwin. We regularly accommodate families from across the NT and will work with you to arrange timely care.

Frequently Asked Questions

My child knocked out a baby tooth. Should I put it back in?

No. Never reimplant a baby tooth. Pushing it back into the socket can damage the permanent tooth developing underneath. Control the bleeding, apply a cold compress, and see your dentist for an assessment.

My child is screaming and will not let me look in their mouth. What do I do?

Stay calm — your child will mirror your energy. Offer comfort and reassurance. If you can manage any obvious bleeding with gentle pressure, that is enough for now. Call Compass Dental and we will advise you. In many cases, a distressed child will settle once they are in a safe, calm environment with a gentle dental team.

How do I know if my child needs to see a dentist or go to the hospital?

As a general rule, dental injuries are best managed by a dentist. Go to the hospital if there is a head injury, suspected jaw fracture, difficulty breathing, severe spreading swelling, or the dental injury is part of a larger trauma. When in doubt, call us and we can help you decide.

Is happy gas safe for children?

Yes. Nitrous oxide (happy gas) has been used safely in paediatric dentistry for decades. It takes effect quickly, wears off within minutes, and has an excellent safety profile. Your child remains conscious and responsive throughout. It is one of the gentlest forms of sedation available.

What if the dental emergency happens after hours?

Call Compass Dental — our voicemail will provide instructions for after-hours emergencies. For severe situations (difficulty breathing, uncontrolled bleeding, high fever with swelling, or significant trauma), go directly to the Royal Darwin Hospital emergency department.

Do I need to bring the knocked-out or broken tooth to the appointment?

Yes, if you have it. For a knocked-out permanent tooth, store it in milk or saliva and bring it immediately. For broken tooth fragments, store them in water or milk. In some cases, the piece can be bonded back on.

At what age should my child start seeing a dentist?

We recommend bringing your child for their first dental visit by age one, or within six months of their first tooth appearing. Early visits help us monitor development, catch any issues early, and — importantly — help your child become comfortable in the dental environment before they ever need treatment.

Act Quickly — Call Compass Dental

If your child has a dental emergency, call Compass Dental right away. We prioritise children’s dental emergencies and will make room to see your child as soon as possible.

Dr Thien Pham and our team have extensive experience managing dental injuries and emergencies in children. We will care for your child with patience, gentleness, and skill — and we will keep you informed every step of the way.

Call Compass Dental now or book an emergency appointment online.

If your child has a head injury, difficulty breathing, severe facial swelling, or other significant injuries, call 000 or go to the Royal Darwin Hospital emergency department first.