Keep calm. It often looks much worse than it really is.

The way you as a parent act in this situation has a considerable bearing on the way your child behaves in the dental office. A child who cooperates with emergency treatment is essential for a successful resolution of the problem.

Fortunately, modern dentistry can often make these injured teeth look like new.

Always contact your dentist immediately for advice, diagnosis and treatment if your child has received an injury to the mouth.

Primary (baby) teeth which have been injured may only require observation, although severe displacement may require extraction.

Accidents to permanent teeth are quite common with active children. Your child will be more susceptible to tooth injury if the teeth protrude. You should ask your dentist about orthodontic treatment or the use of a sports mouth guard.

Permanent teeth which have been injured require (1) emergency treatment, (2) short term treatment and (3) long term observation.

Emergency treatment may be needed to protect or remove the nerve. A loose tooth or a fractured root may require a splint for stabilisation.

Occasionally, with severe fractures, the tooth may need to be extracted.

Since time is an important factor in the success of most cases, it is important to call your dentist immediately.

Sometimes you have to help yourself. A permanent tooth which has been knocked out has a better chance of survival if it is put back in soon after displacement.

Hold the tooth by the crown taking care not to touch or rub the root. Rinse it gently under tepid or moderately cool running water. Then, push it back into place.

If this is not possible, place the tooth under the child's tongue or in a container of milk and go straight to the dentist. Remember this is for children with permanent teeth.

Primary teeth can not be re-implanted and a very young child may swallow a tooth if it is placed under the tongue.

Short term treatment involves nerve protection or treatment, and buildup of the tooth with tooth coloured filling materials.

Sometimes trauma may result in death of the nerve or degeneration of the root.

These changes may take a few weeks or several years to develop.

Therefore, long term observation involves periodic x-rays of the root and nerve tests to detect problems.

Also, advanced restorations like crowns or veneers may be required in adulthood when the dentition is stable.

So remember -- in the event of dental trauma -- keep calm and call your dentist. Also, think about prevention by using corrective orthodontics or sports mouth guards.

DR. D. WINWICK Dental Officer