Both of my children have matching chipped front teeth. For both of them, playground equipment was the enemy against which their teeth fought and lost. Fortunately, both times it was a small chip off the corner, which is usually inconsequential in a baby tooth, (the proper term being "deciduous" tooth). Besides, it give their smiles "character". If it's any more than a tiny chip though, there could be big problems ahead. So what do you do when you've got a screaming toddler in your arms, a tooth on the floor, and blood coming out of their mouth from goodness-knows-where? There are important differences between deciduous and permanent teeth which you should know before attempting dental first aid.
Around a year ago I explained what to do if a permanent tooth is completely knocked out. But if your child is talented enough to have knocked out a deciduous tooth, it's a very different matter. For starters, a good portion of deciduous teeth that get knocked out were due to fall out anyway. If you have a vague idea of normal dental development, (just search for "tooth eruption" for a guide), then you'll know whether or not that rapidly expelled tooth was due for eviction anyway. Other signs that the deciduous tooth's time was up are it being wobbly prior to the incident, or the permanent tooth showing through in the space left behind. If this is all that's happened, there's probably no need for any further treatment. Just don't forget to alert the tooth fairy.
If the deciduous tooth has been knocked out prematurely, the best thing to do is get straight to a dentist. Under no circumstances should you ever try to put the tooth back in its socket. NEVER! I assure you there's a good reason to put that in capitals. Within the jawbone, underneath the gum surface, is the developing permanent tooth which is going to eventually replace the lost deciduous tooth. Before the permanent tooth becomes the hard, white thing we're all used to looking at, it starts in a sort of "jelly" state. If the knocked out deciduous tooth is poked back into the socket, it's very easy to damage the soft and squishy developing permanent tooth. The result will be a permanent tooth which is malformed, perhaps dented, or discoloured in an area.
Here's a quick guide on what the right thing to do is:
Try to stop any bleeding by applying pressure to the area. Sterile gauze is ideal, but a folded up clean handkerchief works well, as does a new kitchen wipe. Avoid using anything like tissues, sponge, or cotton wool, as they will draw more blood out which encourages bleeding. If your little one is cooperative, the best way to apply pressure is to get them to bite down on the material.
If you can find the tooth within a few minutes, grab it. Don't forget to check your child's mouth, as it may have been forced back up into the gum, or even lodged itself in a lip or cheek. The dentist will be able to have a look at the lost tooth and determine whether the whole thing was knocked out, or if there may still be a bit of root lodged in the gum. If the tooth can't be found anywhere, there's a possibility it was swallowed or inhaled by your child. Your dentist will recommend a chest x-ray to rule out the tooth being stuck in the wind pipe or lungs.
Get to a dentist ASAP. Your child will need an x-ray to check if there are any bits of tooth left behind, and to check on the permanent tooth underneath. The dentist will also be able to check the other teeth which may have suffered more minor trauma, but still require treatment.
We never like to see our kids hurt, but part of the adventure of life is finding out what happens when you try to climb a wet playground ladder with your gumboots on. I hope this is knowledge that you never need to use, but should your small child knock out a baby tooth at least you'll know what to do!