My Daughter Chipped Her Front Tooth on the Water Fountain

Quick answer: A chipped permanent front tooth in a child should be seen the same day, even with no pain. Find the fragment if you can, keep it in milk, and phone the clinic. The size of the chip matters far less than whether the nerve has been exposed.

The call

A mother in Sheinfeld phoned at 11:40 on a Tuesday morning. Her nine-year-old, Tehila, had been shoved from behind at the school water fountain and caught the metal spout with her top front tooth. The office rinsed her mouth and phoned home. By the time she reached us she had stopped crying and was simply mortified, which at nine is its own kind of emergency.

What we found

A clean oblique chip through the corner of the upper right central incisor, taking about a third of the biting edge. The lip was bruised but not cut through, and no other teeth were loose.

With a chipped front tooth in a child the first question is not cosmetic, it is how deep the fracture went.

• Enamel only. A rough edge, no sensitivity. Smooth it or bond it.
• Into dentine. A yellow patch in the middle of the break, sensitive to air. Needs covering, and soon.
• Into the pulp. A pinpoint of red or a bead of blood. That is a true emergency, because a child's root is still developing and the nerve is worth fighting for.

Tehila's fracture was into dentine with the nerve still covered. In a nine-year-old the pulp sits close to the surface and the dentine tubules are wide open, which is why she flinched the moment we put air on it.

What we did

We covered the exposed dentine with a protective liner and rebuilt the corner in layered composite, matching the translucency along the edge so it would not read as a flat grey block in photographs. Twenty-five minutes, no injection, and no drilling into healthy tooth.

We also recorded a baseline sensibility test. This is the step most often skipped, and the one parents later wish had been done. A tooth that takes a hard knock can lose its nerve quietly, six months or two years afterwards, and the first sign is usually a change in colour rather than pain.

The outcome

Tehila went back to school that afternoon. We reviewed her at six weeks, six months and a year. The tooth stayed vital, the colour stayed matched, and the bonding has been polished once since. Composite on a child's front tooth is not permanent — expect to refresh it every few years, and to plan something more definitive once growth has finished.

What to do if this happens to you

1. Find the fragment. If it is clean and reasonably large we can often bond the child's own piece back on, and the colour match is perfect.
2. Store it in milk, or in the child's own saliva. Not water, not a tissue.
3. Check the whole mouth, not only the obvious tooth. Look for other loose teeth and cuts inside the lip.
4. Cold compress on the lip for swelling.
5. Call the same day, even without pain, and especially if you can see any yellow or red at the break.
6. Write down the date. You will want it years later if that tooth ever discolours.

Child chipped a tooth in Beit Shemesh or RBS? Ramat Beit Shemesh Urgent Dental Care holds same-day slots for children's dental trauma. 055-985-8845 · WhatsApp https://wa.me/972559858845 · Harav Kook 28/1, Beit Shemesh.

Based on real cases treated at the clinic. Names have been changed.