A fall on the playground, a bracket that pops loose, a toothache at bedtime: dental emergencies rarely wait for a convenient time. Montgomery, Prattville & Pike Road Pediatric Dentistry & Family Orthodontics cares for children’s teeth and for orthodontic patients of every age, so one call reaches a team that can help with both. Here is what to do first, what needs a call right away, and how to reach us after hours.
Is It a Dental Emergency or Can It Wait?
Most dental problems are uncomfortable rather than urgent. Use this table to decide whether to call now, call during office hours or go to the ER.
| Situation | What to do |
|---|---|
| Knocked-out permanent tooth | Call right away. Time matters for saving the tooth. |
| Knocked-out baby tooth | Do not put it back. Call us so a dentist can check the area. |
| Chipped, cracked or broken tooth | Call us. Save any broken piece in milk. |
| Toothache with facial swelling or fever | Call right away. Swelling can signal an infection. |
| Loose bracket, band or wire | Call the office so we can decide on next steps. Usually not urgent. |
| Poking wire or irritated cheeks | Use relief wax at home, then let us know. |
| Soreness after an adjustment | Normal for a day or two. Soft foods and warm salt water help. |
| Deep cut that won’t stop bleeding, possible jaw fracture or head injury, or trouble breathing | Go to the nearest emergency room or call 911 first. |
What Should I Do If My Child Knocks Out a Tooth?
First, figure out whether it is a baby tooth or a permanent tooth.
Baby tooth: do not try to put it back in the socket, because replanting a baby tooth can damage the permanent tooth growing underneath. Have your child bite gently on clean gauze to stop bleeding and call us so a pediatric dentist can check for other injuries.
Permanent tooth: pick the tooth up by the crown, the white part you normally see, and avoid touching the root. If it is dirty, rinse it briefly with milk or water without scrubbing. If your child is old enough to cooperate, gently place it back in the socket and have them bite on a clean cloth to hold it. If that isn’t possible, put the tooth in a cup of cold milk and call us immediately. A permanent tooth has the best chance of reattaching when it is replanted quickly, ideally within the first hour.
How Do I Handle a Chipped or Broken Tooth?
Rinse your child’s mouth with warm water and hold a cold compress against the cheek to keep swelling down. If you can find the broken piece, keep it in milk and bring it to the appointment.
Treatment depends on how much of the tooth is damaged. Our pediatric dentists repair chipped or cracked front teeth with cosmetic bonding, fill damaged areas with tooth-colored composite, and use stainless steel crowns or tooth-colored crowns for front teeth when a tooth is badly damaged but still salvageable. When a tooth can’t be saved, we remove it. You can see the full list of treatments on our pediatric dental services page.
What Helps a Child’s Toothache Until We Can See Them?
- Rinse with warm water and floss gently around the sore tooth. Sometimes trapped food is the whole problem.
- Give a children’s pain reliever, such as acetaminophen or ibuprofen, at the dose on the label for your child’s age and weight.
- Hold a cold compress on the outside of the cheek if there is swelling.
- Don’t put aspirin or any tablet directly on the gums, since it can burn the tissue.
Call us if the pain lasts more than a day, keeps your child up at night, or comes with swelling or a fever. A toothache is often a sign of decay or infection, and both are easier to treat early.
Orthodontic Emergencies: Braces, Wires and Appliances
True orthodontic emergencies are uncommon. Most braces problems can be eased at home until your next visit, but you should still let Dr. Rob or Dr. Frank know so they can keep treatment on track. Our orthodontists, Dr. Rob Owen and Dr. Frank Litchfield, are both board certified by the American Board of Orthodontics.
Loose Brackets, Bands or Wires
Brackets are attached to each tooth with a special adhesive. Hard or crunchy foods and a hit to the mouth during play are the usual reasons one comes loose. If the braces have come loose in any way, call the office so we can decide on next steps. If a loose bracket has spun around on the wire and is rubbing, and you can’t get to the office soon, you can use sterile tweezers to slide it along the wire until it sits between two teeth, turn it back to its normal position, and slide it back to the center of the tooth.
A Wire That Pokes
Use a cotton swab or pencil eraser to push the end of the wire flat against the tooth. If it won’t stay put, cover it with relief wax and call us. If the wire is very bothersome and your child can’t see the orthodontist soon, you may clip it as a last resort with sharp clippers, holding folded tissue or gauze around the area so the snipped piece isn’t swallowed.
Ligatures That Come Off
Ligatures are the tiny rubber bands or fine wires that hold the archwire to each bracket. A rubber ligature can sometimes be put back with sterile tweezers. A wire ligature sticking into the lip can be bent down with a cotton swab or pencil eraser. Tell us about any that are missing or broken.
Sore Teeth and Irritated Cheeks
Teeth often ache for a day or two after braces or retainers are adjusted. Soft foods and warm salt-water rinses help. New braces can rub the cheeks and lips: pinch off a pea-sized piece of relief wax, flatten it and press it over the bracket that is causing trouble. For mouth sores, a small amount of an over-the-counter topical anesthetic such as Orabase or Ora-Gel, applied with a cotton swab, can bring quick relief.
A Swallowed Piece of an Appliance
This is rare. If you can see the piece, you may carefully try to remove it, but don’t try if you could cause harm. If your child is coughing hard or having trouble breathing, the piece may have been inhaled. Get emergency medical help right away, then notify the orthodontist.
Our braces FAQs cover the foods to avoid during treatment, and the retainers page explains how to care for a retainer after braces come off.
How Do I Reach Someone After Hours?
If your family has a dental emergency after our office closes, call us. Our on-call service provides after-hours treatment when needed. For braces problems after hours, call (334) 277-6690 or (334) 358-6411 and you will receive an on-call number where an orthodontic assistant can be reached.
- Montgomery: 2600 Bell Road, Montgomery, AL 36117 · (334) 277-6690
- Prattville: 460 McQueen Smith Road, Prattville, AL 36066 · (334) 358-6411
- Pike Road: 9547 Vaughn Road, Pike Road, AL 36064 · (334) 675-9777
Why Families in Montgomery Call Us First
Our pediatric dentists are specially trained in behavior guidance, which matters most when a child is hurt and scared. Dr. David Stanley, Dr. Davis Denney and Dr. Andrew Owens are board certified by the American Board of Pediatric Dentistry, and Dr. Owens completed his pediatric dentistry residency at UPMC Children’s Hospital of Pittsburgh, a level 1 trauma center, where his training focused on trauma, general anesthesia and sedation. Dr. John Payne opened Montgomery Pediatric Dentistry on Bell Road in 1999. You can read each doctor’s background on Our Doctors.
For comfort during a repair, we use local anesthesia (“sleepy juice”) and nitrous oxide. Children who can’t safely cooperate in the chair can be treated under general anesthesia at Baptist East Hospital, where our pediatric dentists are on staff, or with in-office IV sedation. Learn more about hospital and sedation dentistry. For permanent tooth extractions and impacted teeth, oral surgeon Dr. David Ashley treats children and adolescents at our Montgomery and Prattville offices.
Because our dentists and orthodontists work together, a child in braces who chips a tooth is cared for by one team.
How Can We Prevent Dental Emergencies?
- Have your child wear a mouthguard for sports, especially with braces.
- Skip hard, sticky, chewy and crunchy foods during orthodontic treatment, such as nuts, pretzels, gum and hard candy.
- Keep up with checkups every six months so small cavities don’t turn into painful ones.
Need to see a pediatric dentist? Request a pediatric appointment or call the office closest to you.
Emergency Dental Care FAQs
Should I take my child to the ER or the dentist for a knocked-out tooth?
For a knocked-out tooth alone, call us right away. Go to the emergency room first if your child may have a head injury, a broken jaw, bleeding you can’t control or any trouble breathing.
What number do I call after hours?
Call your office’s main number. For orthodontic problems after hours, calling (334) 277-6690 or (334) 358-6411 gives you an on-call number for an orthodontic assistant.
Does my child need to be a current patient?
Call us and we’ll talk through the situation. Our orthodontists already see children who go to another dentist for routine care, and new pediatric patients can request an appointment online.