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A. Bruised: Sore jaw joint, can move jaw up and down, teeth fit together. Treatment: Minimize movement, soft diet, and if continues second day, see dentist.

B. Dislocated: Locked open (subluxated) or locked closed (not common). Inability to close mouth, jaw forward and open or if locked closed, unable to open. Treatment: Due to the trauma and potential additional damage, this problem should be treated by a professional including: dentist, orthodontist, chiropractor or a physician. Then same as I. A.

C. Broken: "I can't put my teeth together," common statement. Or obvious break or bulge. Treatment: Do not move the jaw. Secure jaw in place with "Christmas Package Wrap." If swelling occurs, apply cold compress. Go immediately to hospital or oral surgeon or dentist.

II. Soft Tissue: lips, tongue, cheeks

A. Cut or split or self bite: Apply direct pressure to the bleeding area with 4"x4" cotton gauze. Usually bleeding will stop in 15-30 min. If not, go to dentist, oral surgeon or emergency room. If swollen, apply cold compress.

B. Bleeding from mouth: Determine source. If cut is in mouth, identify and treat. If no oral source, ID other injury. Cuts in mouth bleed generously plus mix with saliva therefore it looks like much more bleeding than in reality.

III. Teeth

A. Fractured (one or more): Check below, using 4"x4" gauze.

1. Crown of tooth: Either missing or still attached to gums, will move with gentle pressure and will elicit pain in one direction only. Immediate care required, see dentist.

2. Crown/Root: Tissue blanches above tooth with pressure, hurts in both directions (in and out) of movement. Same care as A. 1.

3. Multiple teeth: If multiple teeth move together, probable fractured jaw. Immediate care: Oral surgeon, hospital.

B. Luxated tooth: (dislodged partially or all the way out)

1. Dislodged: Displaced down, out or in. With 4"x4" cotton gauze, move tooth back into location. Note position of crown portion to determine direction of pressure. Root may be dislodged in front of socket, place pressure down then torque root back and press tooth into socket. Because shock is present, little pain at time of accident. Go to dentist or orthodontist as soon as possible.

2. Avulsed: Whole tooth out of socket.

a. Locate tooth
b. Touch crown portion only, do not touch root!!!
c. Within first 30 minutes: Insert tooth: Check for debris, very carefully clean (lightly move debris off or lightly rinse), identify front of tooth (convex), reinsert into socket as evenly with adjacent teeth as possible. Go to dentist, orthodontist, or oral surgeon.
d. If out more than 30 minutes: Store tooth: Place tooth in Hank's pH Balanced Solution (SAVE-A-TOOTH) (treat very gently). Immediately go to dentist, orthodontist, oral surgeon (over 95% success if placed within 12-24 hours.)

-OR- If SAVE-A-TOOTH not available:

e, Place tooth in cold fresh milk for no more than one hour. Locate Hank's solution (SAVE-A-TOOTH). Water and saliva are very destructive to root cells. In either case, go immediately to dentist, orthodontist, or oral surgeon. (10% success if no Hank's solution is used).

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