5.3 Identify signs of urgent dental attention in children

This guide will help you answer 5.3 Identify signs of urgent dental attention in children.

Children rely on adults to recognise and respond to their health needs. Dental health is no different. Knowing when a child requires urgent dental attention can prevent long-term damage and ease their pain. Acting quickly ensures problems don’t escalate into serious health issues.

What Is Meant by “Urgent Dental Attention”?

Urgent dental attention refers to situations where immediate professional intervention from a dentist is needed. This can involve dealing with severe pain, infections, trauma, or other symptoms affecting a child’s oral health. If left untreated, these issues could lead to more serious complications.

Signs of Severe Toothache

Toothaches are a common sign of dental problems, but not all require urgent care. For urgent situations, watch for the following:

• Severe, constant pain that disrupts eating, sleeping, or playing
• Pain that spreads to the ear, jaw, or head
• Tenderness when pressure is applied to a specific tooth or area of the mouth
• Swelling in the gums or cheek surrounding the painful tooth

Pain this intense is often caused by tooth decay, infection, or abscesses. If you notice any of these signs, a child should see a dentist immediately.

Facial Swelling

Swelling in the face is a serious indicator. It could point to:

• An infection spreading from a tooth or gum
• An abscess – a pocket of pus caused by bacterial infection
• Trauma to the mouth, such as from a fall or accident

Facial swelling is sometimes accompanied by throbbing pain, heat in the swollen area, and redness. Since untreated infections can spread to other parts of the body, this situation requires urgent attention.

Bleeding That Won’t Stop

A child may suffer from bleeding gums or teeth for minor reasons like brushing too hard or losing a baby tooth. But in cases where the bleeding is heavy or prolonged, it could signify something more serious, such as:

• Injury to the gum or tooth
• Advanced gum disease (although rare in young children)
• A blood clotting issue

Persistent bleeding can lead to blood loss and slow healing. Take the child to the dentist as soon as possible.

Injuries to the Teeth

Accidents are common with children. They often fall or bump themselves, leading to injuries in the mouth. Examples of injuries needing urgent dental attention include:

• A knocked-out tooth – If a permanent tooth is completely dislodged, urgent care is needed to reattach it.
• A chipped or broken tooth – This can feel sharp or expose the sensitive inner layers of the tooth, making it prone to infection.
• Teeth that have shifted or loosened from their natural position after impact.

In these situations, quick treatment improves the chances of saving the tooth and minimising discomfort.

Signs of Infection

Infections in the mouth can quickly become an emergency. Signs that a child might have an infection include:

• A fever, usually above 38°C
• A foul taste or smell in the mouth
• Pus near a tooth or gum (abscess)
• Difficulty opening the mouth properly

An untreated dental infection can lead to serious complications, such as spreading bacteria to other areas of the body.

Difficulties Eating or Drinking

Children with dental problems may avoid food or drinks because of pain or discomfort. This could signal:

• Sensitivity to temperature changes (hot or cold food/drinks)
• Cavities, which are holes in the teeth caused by tooth decay
• Enamel erosion, the wearing down of tooth surfaces

If eating or drinking becomes too painful, the problem could worsen without proper care. A dentist can evaluate and treat the underlying cause.

Changes in Tooth Colour

Tooth discolouration can occur naturally, but it can also indicate a serious issue. Watch for:

• Grey or black areas on a tooth – this could signal decay or a dying tooth
• Yellow or brown spots
• Discolouration following trauma

Quick action prevents further damage and restores the tooth where possible. Ignoring these changes increases the risk of losing the affected tooth.

Unusual Lumps or Growths

If you observe any lumps, bumps, or unusual growths in a child’s mouth, it is best to take them for an immediate dental assessment. These could signal:

• Gum infections
• Cysts – fluid-filled sacs that are usually painless but may grow or become infected
• Less commonly, early signs of serious conditions, such as oral cancer (although extremely rare in children)

Early detection helps identify the cause and manage any issues effectively.

Difficulty Speaking or Breathing

In severe cases, dental problems can interfere with essential functions like speaking or breathing. Urgent attention is needed when a child shows:

• Obstructed airways – caused by swelling or injury blocking proper breathing
• A lisp or other sudden speech changes linked to teeth trauma
• Pain when talking

These symptoms point to potentially life-threatening conditions, so immediate action is important.

Preventing Dental Emergencies

Preventative care reduces the risk of dental problems. Here’s how you can support children to maintain good oral health:

• Regular dental check-ups, ideally every six months
• Brushing twice daily with fluoride toothpaste
• Encouraging a diet low in sugar
• Teaching safe habits, such as wearing a mouthguard when playing contact sports

By taking these proactive steps, the chances of children experiencing dental emergencies are lowered.

When to Contact a Dentist Immediately

It’s always better to seek advice when in doubt. Call a dentist urgently if:

• The symptoms are severe or worsen rapidly
• The child has a fever or general unwellness accompanying oral health issues
• There are visible signs of trauma, broken teeth, or an infection

Dentists are trained to identify and address issues before they escalate. Prompt care prevents unnecessary suffering or complications.

How to Comfort a Child in Pain

Dental problems can be distressing. Reassuring and comforting the child is important while waiting for treatment. You can:

• Provide age-appropriate pain relief, such as paracetamol, but check dosages carefully
• Use a cold compress for swelling
• Distract the child with quiet activities or their favourite toys

Staying calm will help the child feel safe and less afraid of visiting the dentist.

The Role of an Early Years Practitioner

As an Early Years Practitioner, you may spot some of these symptoms in children under your care. Parents may not always notice the early signs, so your observations may prompt important, timely action. You can:

• Record any ongoing problems, like recurring pain or changes in behaviour linked to eating
• Share your concerns with parents or carers
• Support children in practising good dental hygiene in the setting

Your role is key to spotting potential problems and ensuring children receive the right care to stay healthy. Always act quickly with concerns to avoid delays in treatment.

Summary

Key signs a child needs urgent dental help include:

• Severe or persistent toothache
• Facial swelling or signs of infection
• Heavy or prolonged bleeding
• Injuries, such as knocked-out or broken teeth
• Difficulty eating, speaking, or breathing
• Discolouration, lumps, or unusual changes in the mouth

Teaching children about the importance of oral health, recognising problems early, and staying alert to changes in their behaviour will make a big difference.

By understanding these signs, Early Years Practitioners can take swift action. Some dental issues may seem minor but can quickly turn into emergencies. Observing, reporting, and working with families helps protect children’s health and wellbeing.