Broken, Dislocated or Lost Permanent Teeth in Children: What to Do and What to Expect

Has your child or teenager just lost, dislocated or broken one or more permanent teeth? This situation immediately raises a thousand questions: what should be done in the days and weeks that follow? What are the chances of saving the tooth? What treatments are available if it can’t be saved?

As a mother and ex-physiotherapist accustomed to delving into scientific literature, I found myself confronted with this problem. And as is often the case when it affects those close to me, I looked for answers beyond personal experience.

What I’ve discovered is that there’ s very little clear information, in either French or English, on this very subject: broken or pulled permanent teeth in children.

In this article, I share with you my research, my scientific readings and my viewpoint as a person indirectly concerned, to shed some light on the choices available to you.

♻️ Last update: November 26, 2025
Written by Nelly Darbois, physiotherapist and scientific editor

What is a permanent tooth and why is it different from a baby tooth?

Permanent teeth are those that appear after the milk teeth. They will never fall out or be replaced naturally.

👉 So it’s very different from a baby tooth, which always falls out and is replaced by a new one.
👉 When a permanent tooth is broken or pulled, it’s a real long-term issue, both for health, nutrition and aesthetics.

That’s why the treatment is nothing like that of a baby tooth.

Do children often suffer traumatic injuries to their teeth?

Trauma to teeth (both deciduous and permanent) is relatively frequent, particularly in boys, who are twice as likely to be affected, and before the age of 1, then between the ages of 7 and 9, especially in summer (Antipoviene 2021).

2 to 3 out of 10 children will be affected by dental trauma (to a temporary or permanent tooth) during their childhood.

This most often occurs during :

• falls, by far the most frequent cause (up to 2 out of 3 children);
• sports, especially contact sports (around 4 out of 10 cases);
• cycling (nearly 2 out of 10 cases);
• road accidents (about 1 in 10 cases);
• physical violence (less than 1 in 10 cases).

Source : Goswami 2021

A study (Lembacher 2022) carried out in Austria on 578 people who had suffered trauma to their permanent teeth also gives us a good overview of these accidents.

Age of onset :

Time to first treatment :

The number of teeth affected by the trauma:

And which teeth are most often affected (dark purple for boys, light purple for girls):

What to do immediately after the accident

It all depends on the situation.

• 🦷 If the tooth is broken: keep the piece if you can find it, and consult a dentist as soon as possible (ideally the same day via emergency or in the days that follow).
• 🦷 If the tooth is dislocated (displaced or mobile): consult a dentist the same day.
• 🦷 If the tooth is knocked out: it can sometimes be re-implanted. In this case, don’t touch the root, keep it in milk or saliva (never in water), and seek urgent advice.

Even if you’re not reading this article “in the heat of the moment”, it’s important to know what to do. It could come in handy if you’re ever present at an accident of this type, and these precautions are valid for adults too.

The first few hours count for a lot. In all cases, a quick visit to the dentist or dental emergency room is essential.

Personal note: in our case, the firefighters responding to the accident retrieved the knocked-out tooth and wrapped it in paper with saliva. The tooth was re-implanted in the emergency room around 3 hours after the accident.

Care was also given to 3 other permanent teeth (2 dislocated stage 3, one broken; all in front) and some 30 stitches were applied to the lip and mouth.

What care and follow-up is required in the weeks and months that follow?

Care and precautions will depend on whether the tooth is broken, knocked out or dislocated (i.e. displaced in its axis).

Restraint

If the tooth has been pulled out and then put back in, or if it has been badly dislocated, the dentist will often fit a retainer: a kind of small wire glued to the teeth to hold them in place.

• It usually lasts from a few weeks to a month.
• During this period, brushing remains essential 🪥 but with a very soft, gentle brush.
• As long as the tooth is retained, it is advisable to avoid chewing with the affected tooth. Diet must therefore be adapted.

Mouth care

• If stitches are required (gums, lips, sometimes even jaw fractures), you must follow the instructions given by your dentist or surgeon.
• Mouthwashes are sometimes prescribed to prevent infection, as are antibiotics.

Feeding

• For the first few weeks, give preference to soft foods that don’t require chewing effort.
• But beware: anything cold, such as ice cream ❄️, can sometimes accentuate the pain, and foods that are too liquid, such as soft drinks, can be difficult to swallow when the mouth is less mobile.
• Soft” textures such as dessert creams, compotes, highly cooked pasta, purées and yoghurt are often easier to eat.
• The most important thing is to encourage a balanced diet rich in proteins, as they help healing.

Personal note: our child found it very difficult to eat for the first few days, mainly because of the stitches. What went down best: compote, very ripe peaches cut into tiny pieces and danette, but in very small quantities and very slowly.

We stayed positive and encouraged him at every meal. We try to offer him as many different things as possible. We allowed him to eat with his fingers for several weeks (it was easier to put food in the right place in his mouth).

We also gave him hyper-protein creams bought in pharmacies or on the internet. It was also easier for him to drink systematically from a gourd rather than a glass for several weeks.

Monitoring over time

• Follow-up appointments allow us to monitor the condition of the root, the vitality of the tooth, and the evolution of the gums.
• Broken teeth are not necessarily repaired right away: protection is sometimes applied while awaiting repair.

According to a study conducted in Lithuania on 579 children with damaged permanent teeth (Antipoviene 2021), the most frequent treatment is:

• approximately 2 to 3 cases out of 10: a small splint (contention) is applied to hold the tooth in place,
• about 2 out of 10 cases: regular follow-up,
• about 2 out of 10 cases: a temporary dressing (temporary filling) is applied.

The most frequent complications are related to pulp necrosis (death of the nerve, infection at the root tip, abscess), which occurs in 9 cases out of 10 for deciduous teeth, and 1 case out of 2 for permanent teeth.

👉 The traumas that most often lead to complications are :

• enamel-dentin fractures (even without nerve damage),
• and avulsion (complete expulsion of the tooth) for permanent teeth.

What if the tooth can’t be saved?

Sometimes, the tooth cannot be retained. In this case, there are various options.

• Temporary solutions: for example, a small removable appliance that replaces the missing tooth while the jaw grows (dentures).
• Adolescence: more aesthetic and functional solutions can be proposed, especially for front teeth.
• In adulthood: implants, bridges or fixed prostheses can be considered once growth is complete.

A dental implant is a small screw (often made of titanium) placed directly into the jawbone to replace the root of a tooth. It’s a solid, long-lasting solution… but only possible once growth is complete.

👉 In children and adolescents, the jawbone is still developing. If an implant were placed too early :

• The implant would remain fixed while the bone and neighboring teeth continue to grow.
• This would cause the artificial tooth to appear “too short” or misaligned over time.
• The result would therefore be both aesthetic and functionally poor, sometimes with complications.

For this reason, we wait until the end of bone growth (generally around 18-20 years, sometimes a little later depending on the individual) before considering an implant.

Personal note: in our case, the re-implanted tooth is holding for the time being, even once the retainer has been removed. We have regular check-ups with a private dentist.

What financial support is available (social security, mutual insurance, insurance)?

The question of cost is often a source of concern. In France, dental care is increasingly reimbursed, mainly by 3 different players.

• Social security: covers certain treatments, but not always cosmetic or prosthetic solutions.
• Mutuelle: these supplement the coverage provided by the French national health insurance system for basic care. For more specific treatments, such as implants or prostheses, it very much depends on your contract. It may be worth re-examining it, and possibly changing your mutual insurance or contract if you know you’re going to incur a lot of dental and orthodontic costs.
• Civil liability insurance (school, sports or home): if the accident occurred in this context or was caused by a third party, it must be declared to the victim’s insurance company. Care may be covered, including for procedures or devices such as implants, which are not covered by the French social security system or mutual insurance companies.

👉 Remember to keep all supporting documents and contact your insurer as soon as possible.

Personal note: in our case, the accident occurred during a sports camp and was caused by a third party, outside the camp. We reported the accident to our home insurance (home insurance often covers civil liability) and to our son’s insurance as a licensee.

Our insurer then contacted the insurance company of the third party responsible and the sports club. We’re keeping all the invoices until we know which insurance company will cover the costs (this could take several months).

Should teeth be protected after this type of accident?

It’s a common question. Many parents think they have to protect a weakened tooth at all times. But this is not always the case.

• Wearing a mouthguard on a daily basis is generally not recommended, except in certain high-risk sports.
• On the contrary, overprotection can sometimes be counterproductive.

A mouthguard may seem reassuring, but outside of sport :

• it prevents the tooth from regaining its normal function: eating, speaking and chewing. Yet these very stimuli are important for the healing and strength of the tooth.
• it can create abnormal pressure on the gums or neighbouring teeth, slowing down recovery;
• it can sometimes lead to local irritation or infection, especially if the child keeps it on for a long time or if hygiene is not perfect.

The tooth needs to regain its function gradually, not be “hidden” all the time. Mouthguards are therefore useful for contact sports, but not for everyday life.

👉 Teeth may remain a little more sensitive, but that shouldn’t stop your child from eating, smiling and playing as before.

Personal note: our child resumed non-risky physical activities (ping pong, pétanque, walking, swimming) 1 week after his accident. The more intense physical activities (athletics, tennis) were resumed 2 months later. Fortunately, he had no particular interest in combat sports or sports with a higher risk of falling.

In short: what attitude should you adopt as a parent?

This type of accident involving your child can be very frightening and cause a great deal of concern.

These days, however, dentistry has plenty of solutions to offer. There are even people living with full-mouth implants, and not necessarily at the age of 80.

Children are notorious for adapting quickly, and this is also true in the context of tooth loss. Staying positive, reassuring your child, answering questions honestly, not overdoing it… all this will help your child’s recovery.

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That’s all I wanted to say on the subject! Any questions or comments? See you in comments!