In Times of Trauma, See Your Dentist!

      Spring is in the air, and with nice weather comes more outdoor physical activity.  Unfortunately, that can also bring injuries to the mouth and teeth. Injuries to children’s teeth can be alarming for both the child and the child’s parents or caretakers.  These injuries may include a chipped or cracked tooth or teeth, or teeth that are partially displaced or completely dislodged from the socket. The consequences of the injury will depend on whether the tooth is a primary or permanent tooth, and the nature and severity of the injury.  It is best to see a dentist whenever a child’s tooth has been injured.  However, if the child has suffered a blow to the head (which can be life threatening), or has injured another part of the body, it may be necessary to be seen in the hospital emergency room.

      There are several reasons for the importance of having the tooth injury evaluated by a dentist.  Teeth that are chipped can lacerate tissues in the mouth, cheeks, lips, or gums; or these tissues may be wounded at the time of the trauma and need attention.  If the tooth has a sharp edge, it may cause further damage to the tissues without treatment. Tooth fragments may be embedded in soft tissue that may need to be re-moved.  Also, depending on the severity of the injury, some damage may not be visually seen.  For instance, some falls may injure the developing permanent tooth bud, or there may be a crack the tooth or some surrounding bone that may not be detected without an x-ray.

All of these injuries can be painful and cause complications without treatment.

    Traumas to primary teeth are most common in toddlers between the ages of 18 to 40 months of age that occur from falls and collisions as they learn to walk and run.  Tooth injuries to permanent teeth occur most often with teenage boys from sports injuries and fights.  Teenage boys have tooth trauma almost twice as much as teenage girls. The upper (maxillary) central front teeth are the most commonly injured teeth, especially if they protrude (stick out) more than 4 millimeters.

     If your infant or young child experiences an injury to the gums or teeth that cause bleeding, it is usually advised to run cold water over a piece of gauze or washcloth and use it to gently apply pressure to the injured site.  If you have some available, have your child suck on a popsicle or piece of ice to keep the swelling down. Watch your child for the next several days following an injury to make sure the tooth does not develop an abscess.  Signs for a developing abscess may include fever and swollen or tender gums at the site of the injury.  A pain reliever medication may be recommended to help reduce your child’s discomfort, but again, check with your pediatric dentist or doctor, and have your child examined as soon as possible after the injury.  Aspirin should always be avoided with children, as it has been linked to a potentially fatal condition called Reye’s Syndrome. 

    If the tooth is completely knocked out, and it is a primary or “baby” tooth, do not attempt to place it back into the socket, as this may injure the permanent tooth bud.  The primary tooth will eventually be replaced, but your dentist may decide to place a space maintainer to hold or save the space for the erupting tooth, depending on the location of the knocked-out tooth and how soon the permanent tooth will be erupting.  If the avulsed (knocked-out) tooth is a permanent tooth, it is imperative that quick action be taken.  Do not touch the root of the tooth, but handle by touching the crown (the part you see in the mouth) only.  Do not rinse the tooth off unless there is dirt covering it.  Do not scrub or scrape the tooth.  If possible, put the tooth back into the socket (after rinsing, if needed).  If you are unable to place the tooth back into the socket, place it in some milk or keep it wet with some saliva (in a baggie or cup) –DO NOT LET IT DRY OUT--and get to the dentist as soon as possible. 

    Of course, prevention is always the best strategy.  It is important to child-proof the home as much as possible.  This includes removing items that can be tripped over, such as electrical or extension cords.  Place things that can be pulled over, such as lamps, up where the child cannot reach them, or remove them altogether, such as tablecloths.  Keep small items that can be inserted into their mouth out of reach, such as toys with small parts, or loose change.  Do not allow your child to walk or run while holding something in the mouth, such as a lollipop.  Keep them from chewing on hard or sharp objects.  Teach them not to push or shove, especially near a water fountain or on the playground.  Make sure your child wears protective head gear with mouth protection when roller skating, skateboarding, riding bikes, or rollerblading.    It is highly recommended that a mouth guard be worn when playing any sport that might result in mouth injuries such as baseball, football, soccer, or hockey.   In this way, parents can help reduce the risk for mouth injuries.

See also:
http://dentalresource.org/topic50trauma.html


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