This is a picture of Asher, my 3-year-old son.  Notice his discolored front tooth. In August, he was playing around at the pool and hit his front tooth against something (the wall of the pool, another kid’s elbow, who knows?).  When I got to him, the tooth had a minor chip in it and there was some bleeding around the gums of that one tooth. The tooth was firmly in place and had not been moved from its normal location. In dentistry, we call that injury a subluxation injury.  

Since that accident, I’ve had two different friends send pictures of their children’s teeth, both with similar stories of an accident in which the front teeth were hit. If you are in this unfortunate club, or think you might be someday, this post is for you!

Here is what you need to know about Asher’s tooth and what to do if this happens to your child:

  1. A tooth that has turned gray is dead.  Yup, dead. It is discolored because the trauma caused internal bleeding in the tooth.  
  2. What do you do with a dead baby tooth?  You carefully monitor the tooth for signs of infectsubluxationion: pain around that tooth or a non-painful red bump on the gums around that tooth. If no signs of infection exist, do nothing.
  3. If an infection occurs, the tooth will have to come out.  A root canal is a possibility, but it’s typically not recommended on baby teeth. More likely, the tooth will simply have to be pulled.
  4. If the tooth is pulled, your child will be missing a front tooth.  You do not “replace” the baby tooth.
  5. Assuming there is no infection, watch to make sure that this gray tooth gets loose around the same time as the other front tooth. This will typically happen at age 5-7.  If It doesn’t get loose on its own, again, most likely you will have to get the tooth pulled so that the permanent tooth can come in safely.
  6. Finally, in rare cases, injuries like this to baby teeth can cause damage to the permanent tooth that is developing underneath the gums.  Your dentist should monitor this area with the appropriate x-rays.

Hopefully this does not happen to your child, but, if it does, make sure to consult with a dental professional.  Although a subluxation injury is not that serious, I recommend seeing a dentist as soon as possible to rule out the possibility of more serious injury.  In future blog posts, I’ll cover some other common dental injuries. And, don’t worry, that gray tooth won’t be there too long!

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