If a tooth is pushed up into the gum after impact, treat it as a dental emergency. Do not try to pull it back down. Rinse gently with cool water, apply a cold compress, and call an emergency dentist immediately. Head to the ER first if there is head injury, unconsciousness, or a suspected jaw fracture.

At Line Dental Aloha, we see this injury more often than parents expect, usually after a soccer collision, a fall from a scooter, or an elbow to the mouth during basketball. The tooth is still there. It just looks shorter, or almost gone. That mismatch confuses families into waiting. Waiting is the mistake.

Here is what parents and coaches in Aloha need to know.

What does it mean when a tooth gets pushed up into the gum?

Dentists call this intrusive luxation, or intrusion. It happens when a direct blow drives a tooth upward into its socket, deeper into the bone. Unlike a knocked-out tooth, which lands on the ground, or a loose tooth that wobbles outward, an intruded tooth moves in the wrong direction. Up, not out.

Common causes we see at our office off TV Highway:

• Contact during Aloha High School football, soccer, or basketball

• Playground falls at neighborhood elementary schools in the Beaverton School District

• Bike, scooter, and skateboard accidents on suburban sidewalks

• Car accidents, especially without a properly fitted seatbelt

Parents often describe it the same way. "His front tooth looks shorter than the other one." Or, "It's like the tooth disappeared into her gum." That's intrusion. And it is not something to sleep on.

Is a pushed-in tooth a dental emergency?

Yes. According to the International Association of Dental Traumatology (IADT), intrusive luxation is classified as one of the most severe forms of dental trauma because it damages the periodontal ligament, the pulp inside the tooth, and the surrounding bone all at the same time. Three tissues, one impact.

Left untreated, complications include pulp necrosis (the nerve dies), root resorption (the root slowly dissolves), and ankylosis (the tooth fuses to the bone and stops moving normally). All of these can lead to tooth loss down the road.

The IADT recommends prompt evaluation, ideally within a few hours. Time matters here.

An intruded tooth is not "still there." It is buried in bone, and every hour changes the treatment plan.

What should I do in the first hour?

Stay calm. Then work through this list:

• Do not try to pull the tooth back down. You can cause more damage to the root and the bone. Leave it alone.

• Rinse the mouth gently with cool water to clear away dirt or blood.

• Apply a cold compress to the lip or cheek to reduce swelling. Ten minutes on, ten minutes off.

• Control bleeding by having your child bite gently on clean gauze or a folded piece of paper towel.

• Call an emergency dentist immediately. Line Dental Aloha at (503) 259-8641 can guide you through the next steps.

Go to the ER first, not the dentist, if there is any sign of head injury, loss of consciousness, vomiting, confusion, or a suspected jaw fracture. Teeth can wait a few extra hours. Brains cannot.

Baby tooth versus adult tooth: does the treatment differ?

Yes, and this is where a lot of parents get surprised.

Baby teeth. The American Academy of Pediatric Dentistry (AAPD) generally recommends that intruded primary teeth be allowed to re-erupt on their own rather than repositioned. The reason: the roots of baby teeth sit very close to the developing permanent teeth above them. Aggressive repositioning can damage the adult tooth waiting underneath. Instead, we monitor, watch for infection, and check that the permanent tooth is developing normally on follow-up X-rays.

Adult teeth. Permanent teeth need active treatment. Depending on how deeply the tooth is intruded, options include:

• Waiting for spontaneous re-eruption in mild cases, especially in younger patients whose roots are not fully formed

• Orthodontic repositioning, using light forces to guide the tooth back into place

• Surgical repositioning and splinting, for deeper intrusions

• Root canal therapy, often needed within a few weeks because the pulp usually dies after this kind of injury

Severity is graded by how many millimeters the tooth is displaced. Deeper intrusion means more complex care.

What happens at the emergency dental visit?

When a family walks into Line Dental Aloha with a suspected intrusion, here is what to expect.

First, a careful clinical exam. We check the tooth, the surrounding gum, the bite, and look for signs of jaw or facial fracture. Next, imaging. We take dental X-rays, and in more complex cases we may recommend a CBCT scan to see the exact depth and root position in three dimensions.

Then we build a treatment plan. That might mean monitoring for spontaneous re-eruption, scheduling orthodontic movement, or repositioning and splinting the tooth to stabilize it while the ligament heals. We also set a follow-up schedule for pulp vitality testing, usually at two weeks, six weeks, three months, six months, and one year.

Long-term, we watch for discoloration (a gray or dark tooth signals a dying nerve), infection, and root resorption. Early detection keeps options open.

How can Aloha families prevent tooth intrusion injuries?

You cannot prevent every accident. But you can lower the odds.

• Custom-fit mouthguards for youth and high school athletes. The American Dental Association reports that properly fitted mouthguards significantly reduce the risk of orofacial injuries in sports. Store-bought boil-and-bite guards help, but a custom guard fits better, stays in place, and gets worn more often. We make them for Aloha High School athletes and Mountain View Middle School players every fall.

• Seatbelts and car seats, every ride, no exceptions. Many of the worst intrusions we have seen come from car accidents, not sports.

• Home safety for toddlers. Baby gates on stairs, non-slip rugs, and padded corners on coffee tables prevent the falls that push front teeth into little gums.

• Annual dental checkups so we have baseline records. If an injury happens later, we already know what the tooth looked like before.

We sponsor Aloha High School sports teams and run free education tables at school health fairs because we want fewer of these calls, not more.

Frequently Asked Questions

How long can I wait to see a dentist if my child's tooth got pushed up?

Ideally, within a few hours. The IADT guidelines emphasize that prompt evaluation improves long-term prognosis for intruded permanent teeth. Even for baby teeth, we want to rule out damage to the developing adult tooth underneath and check for infection risk. If it is after hours, call our emergency line at (503) 259-8641 and we will guide you.

Will an intruded tooth come back down on its own?

Sometimes, yes. Baby teeth often re-erupt spontaneously over weeks or months. Permanent teeth with immature roots may also re-erupt on their own. Deeper intrusions in adult teeth with fully formed roots usually need orthodontic or surgical repositioning. A dentist has to grade the injury to know which path fits your child.

Can a pushed-in adult tooth be saved?

Very often, yes, especially with prompt care. Treatment usually combines repositioning, splinting, and eventually a root canal because the nerve typically dies after intrusion. Long-term follow-up watches for root resorption. Many intruded permanent teeth stay functional for years when treated early.

Should I go to the ER or an emergency dentist first?

Go to the ER first if there is any head injury, loss of consciousness, vomiting, confusion, heavy uncontrolled bleeding, or a suspected jaw or facial fracture. If the injury is limited to the tooth and gum, an emergency dentist is the right first call. When in doubt, call 911 or head to the ER, then contact us afterward.

How much does emergency treatment for an intruded tooth cost?

Cost varies with the injury. A visit and X-rays are relatively modest. Repositioning, splinting, root canal therapy, and follow-up imaging add up over time. Most PPO dental insurance plans cover emergency exams and much of the trauma care. During your visit we verify coverage and walk through the numbers before treatment starts.

If it just happened, call us now

Line Dental Aloha is at 18425 SW Alexander St, just off Highway 217 and TV Highway, easy to reach from Beaverton, Hillsboro, and the youth sports fields all over Washington County. If your child's tooth has been pushed up into the gum, call us at (503) 259-8641. We will make room the same day when we can, and we will tell you exactly what to do while you drive over.