When a toddler falls and a front baby tooth is driven up into the gum so it looks shorter or missing, it is called an intrusion, and around 90 percent of intruded baby teeth re-erupt on their own within one to six months. Intrusion is one of the most common dental injuries in young children, because the bone around baby teeth is soft and absorbs the force of a fall by letting the tooth push inward. It can be frightening to see, yet the modern approach is usually to let the tooth come back down by itself rather than remove it straight away.
Key takeaways
- An intruded baby tooth has been pushed up into the gum and socket, often after a fall.
- Around 90 percent re-erupt on their own, usually over one to six months.
- Dentists no longer pull these teeth straight away in most cases, because re-eruption is common and pulling can risk the adult tooth underneath.
- The main concern is the developing adult tooth, which is why follow-up matters.
- See a dentist promptly so the position can be checked, often with an x-ray.
What an intrusion injury looks like
After a knock to the mouth, the tooth may appear much shorter than its neighbour, or look as though it has disappeared into the gum. There is often bleeding around the gum line and the child will be upset. It can be hard to tell at a glance whether the tooth has been pushed up (intrusion) or knocked out completely (avulsion). If a whole tooth is missing and you cannot find it, our guide to a knocked-out baby tooth explains what to do. A baby tooth that comes out should never be pushed back in, as explained in our guide on why baby teeth are not replanted.
First aid at home
Keep your child calm and sit them upright. A cold compress held to the lip or cheek can ease swelling and discomfort. Offer water and a soft diet, and keep the area clean. Do not try to pull the tooth down or push it anywhere; the position is best assessed by a dentist. If your child has been given paracetamol or ibuprofen before, you can use the usual weight-based dose for pain, following the packet instructions. Then arrange to see a dentist as soon as practical so the injury can be examined.
Why dentists usually wait rather than pull
International dental trauma guidelines now favour leaving most intruded baby teeth to re-erupt. There are three reasons. First, the large majority come back down on their own. Second, removing the tooth can disturb the developing adult tooth sitting close behind it. Third, there is no good evidence that pulling the tooth early reduces harm to the adult tooth. The exception is when the tooth has been pushed toward the developing adult tooth, in which case removal may be recommended to protect it. This is why an x-ray is so useful, as it shows which direction the root has moved.
What to expect during recovery
| Time after injury | What commonly happens |
|---|---|
| First few days | Sore gum, mild swelling, the tooth looks short or hidden |
| 2 to 8 weeks | Gum settles; the tooth may begin to move back down |
| 1 to 6 months | Most teeth re-erupt partially or fully |
| Ongoing | The tooth may darken over time, which is common after trauma and not always a problem |
A baby tooth that darkens after a knock has often laid down extra dentine or had a change in the nerve. Many stay healthy, but some develop infection later, which can show up as a gum boil or swelling near the tooth. That is a sign to return for assessment.
The risk to the adult tooth
The developing adult tooth sits very close to the root of the baby tooth, so a significant intrusion can affect it. Possible effects range from a small white or brown mark on the enamel to a change in the shape of the adult tooth. A single discoloured or malformed adult tooth from an earlier baby-tooth injury is sometimes called a Turner's tooth. This is why dentists recommend monitoring for several years, until the adult tooth comes through.
When to seek urgent care
See a dentist promptly for any baby-tooth injury. Seek same-day or emergency care if there is heavy bleeding that will not stop, a tooth pushed so far it cannot be seen, signs of a broken jaw, or spreading facial swelling and fever. For a suspected jaw injury or any trouble breathing, call 000 or go to your nearest emergency department.
Frequently asked questions
Will the baby tooth grow back down?
In around 90 percent of cases an intruded baby tooth re-erupts on its own, usually within one to six months. Your dentist will monitor its progress.
Should the tooth be pulled out?
Usually not. Current guidelines favour leaving it to re-erupt, unless an x-ray shows it has been pushed toward the developing adult tooth.
Why has the tooth turned grey?
Darkening is common after trauma and reflects changes in the nerve or dentine. Many darkened baby teeth stay healthy, but it is worth a check to rule out infection.
Will this damage my child's adult teeth?
It can. Effects range from a small enamel mark to a change in tooth shape. Long-term monitoring helps pick up and manage any changes early.
How can I help prevent dental injuries?
Supervision around hard surfaces and, for older children in sport, a mouthguard all help. Soft furnishings and corner guards reduce the impact of falls at home.
Speak with the team at Lumi Dental
If your child has knocked a tooth up into the gum, the team at Lumi Dental in Melrose Park can examine the injury, take an x-ray if needed, and set up a follow-up plan. You can see current new-patient offers on our current deals page or read more about general dental care. Children may be eligible for support through the Child Dental Benefits Schedule, which we are happy to discuss.
This article is general information only and is not a substitute for personal dental advice. Please see a dentist or doctor for advice about your child's situation.
