Broken or Chipped Tooth in Children: What to Do in the Next 24 Hours

Children's teeth are constantly at risk a fall from a bike, a collision on the playground, biting down on something hard, or even a minor stumble can chip, crack, or break a tooth in seconds. While it is natural to panic in the moment, staying calm and acting quickly can make an enormous difference to the outcome. Not every fracture is a five-alarm emergency, but none should be dismissed or left to "wait and see" for more than a day or two.

This guide covers everything you need to know: how to tell one type of fracture from another, what to do in the first hour, when to call us immediately, and what treatments are available depending on the severity.

Types of Tooth Fractures

Not all broken teeth are alike. Dentists classify tooth fractures by how deep the damage goes, and this classification directly determines how urgently you need to act and what treatment will be needed.

Infraction (Hairline Crack) Mild

An infraction is a microscopic crack in the enamel that does not go all the way through. The tooth looks intact; there may be no pain at all. These are the most common result of minor trauma and often require only monitoring. However, they should still be evaluated because repeated trauma to the same tooth can deepen the crack over time.

Uncomplicated Crown Fracture (Chip) Mild to Moderate

This is the classic "chipped tooth" a piece of enamel (or enamel and dentine) has broken off, but the pulp (the nerve and blood supply inside the tooth) is not exposed. The tooth may be sensitive to cold air and liquids. This is the most treatable category and can often be fixed with cosmetic bonding or a composite resin repair in a single visit.

Complicated Crown Fracture Moderate to Severe

The break has reached the pulp. You may be able to see a pink or red dot at the centre of the broken surface this is exposed pulp tissue. This is genuinely painful and requires same-day or next-day care. Bacteria can infect an exposed pulp within hours, turning a manageable injury into the need for a root canal or, in severe cases, extraction.

Crown-Root Fracture Severe

The fracture extends from the crown of the tooth down below the gum line into the root. This is a complex injury that usually requires specialist assessment and may involve extraction followed by space maintenance.

Root Fracture Severe

The fracture is entirely within the root, invisible to the naked eye. The tooth may feel loose or tender to biting pressure. Diagnosis requires an X-ray. Depending on where in the root the fracture lies, the tooth may be splinted and monitored, or it may need to be removed.

First Aid: What to Do Right Now

The minutes immediately after a tooth fracture matter. Here is a clear, step-by-step first-aid plan every parent should know:

1. Stay calm and comfort your child. Panic is contagious. Take a breath, reassure your child that you are going to take care of them, and then assess the situation.
2. Rinse the mouth gently with warm water. Do not use cold water it can trigger sharp pain if the dentine or pulp is exposed. Warm water rinses away blood and debris so you can see clearly what has happened.
3. Save any broken tooth fragments. Even small chips can sometimes be bonded back onto the tooth. Place the fragment in a small container of milk or saline (not water), or wrap it in cling film moistened with saliva. Bring it to the appointment.
4. Apply a cold compress to the face. Wrap ice or a frozen bag of peas in a cloth and hold it against the cheek for 10 minutes on, 10 minutes off. This reduces swelling and numbs discomfort. Never place ice directly on the broken tooth.
5. Avoid hot and cold foods and drinks. Anything temperature-extreme will cause significant pain if the dentine is exposed. Stick to room-temperature soft foods and drinks until seen by a dentist.
6. Give age-appropriate pain relief if needed. Paracetamol (not aspirin) at the correct dose for your child's weight is appropriate for pain management while you arrange dental care. Do not place aspirin directly on the gum it can cause a chemical burn.
7. Call your dentist immediately. Even if it seems like a minor chip, call the clinic so we can advise you over the phone on urgency and book the right appointment slot.

When Is It an Emergency?

Not every broken tooth requires a midnight dash to the clinic, but some situations genuinely cannot wait. Here is how to triage the urgency:

Call Immediately Same Hour

• Exposed nerve (pulp visible): A pink or red dot visible at the fracture surface, accompanied by extreme pain, especially to air and temperature. Bacteria can infect exposed pulp within hours.
• Tooth completely knocked out (avulsion): Time is critical ideally re-implanted within 30–60 minutes. See our full guide on knocked-out teeth.
• Bleeding that will not stop after 10 minutes of gentle pressure.
• Jaw pain, difficulty opening or closing the mouth, which may suggest a jaw fracture requiring hospital evaluation.

Call the Same Day

• Visible tooth sensitivity to air, temperature, or sweet foods
• A large piece of tooth missing (more than one-third of the visible crown)
• The tooth feels loose or has shifted position
• Facial swelling beginning around the jaw

Book Within 48 Hours

• A small chip with no pain and no sensitivity still needs evaluation and possibly bonding to prevent the rough edge from injuring the tongue or cheek
• A hairline crack that is not causing significant discomfort

Treatment Options

The treatment your child needs depends on the type and severity of the fracture, the age of your child, and whether the tooth in question is a baby tooth or a permanent tooth. Here is an overview of the most common approaches:

Dental Bonding (Composite Resin)

For simple chips that involve only enamel or enamel and dentine (without pulp exposure), tooth-coloured composite resin is applied to the broken surface, shaped, and polished. The result is virtually invisible and usually completed in a single appointment. If you have saved the broken fragment, your dentist can sometimes bond the original piece back directly so always bring it along.

Dental Crown

When the fracture is more extensive covering a significant portion of the crown a crown may be recommended to restore the tooth's full structure and protect against further damage. For children, stainless steel crowns are commonly used on back teeth as they are durable and cost-effective. For front teeth, tooth-coloured crowns are available.

Pulp Therapy (Root Canal for Children)

If the pulp is exposed or has become infected, pulp therapy is required. In children, this may be a pulpotomy (removal of the infected portion of the pulp in the crown of the tooth while preserving the root pulp) or, in more severe cases, a full pulpectomy similar to a root canal in adults. This procedure relieves pain, stops infection, and allows the tooth to be retained until natural exfoliation or until the permanent tooth is ready to erupt.

Extraction and Space Maintenance

If a tooth is completely unsalvageable for example, a root fracture too close to the apex, or a heavily infected tooth extraction may be the only option. For baby teeth, this is sometimes straightforward, but it is critically important that a space maintainer is placed afterwards to prevent the surrounding teeth from drifting and blocking the path of the incoming permanent tooth. For permanent teeth, extraction is a last resort, and options for replacement (such as implants in adulthood or a bridge) should be discussed.

Preventing Tooth Fractures in Children

While accidents happen, many dental injuries in children are preventable. The following measures significantly reduce risk:

• Mouthguards for sport: Any contact sport cricket, football, basketball, martial arts, even cycling warrants a properly fitted mouthguard. Custom-fitted mouthguards from your dentist are far more protective than over-the-counter options. Ask us about sports mouthguards at your next appointment.
• No chewing on hard objects: Ice, pen caps, hard candies, and unpopped popcorn kernels are among the most common causes of fractured teeth in children. Build the habit early of not biting down on non-food items.
• Address teeth-grinding (bruxism): Children who grind their teeth at night are at higher risk of hairline cracks and enamel wear. If your child grinds, speak to us about a night guard.
• Regular check-ups: Routine dental X-rays can detect hairline cracks and developing problems before they become emergencies.