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Dental Trauma in Children

07 December 2011

These consist of injuries to the teeth, gums and bone of the jaw. Most often this is a broken or displaced tooth.

Children just starting to walk are most prone to injury ie. 1.5 to 3.5 years of age. 30-50% of children experience dental injury with boys twice as much as girls. 
With trauma, teeth may be chipped, broken, loose, out of place or knocked out. The type of treatment with vary with the type of tooth and the age of the patient but here are some guidelines.

Baby Teeth

Normally it is not necessary to repair chipped teeth but broken teeth can be easily repaired with some treatment of the nerve. It is important the the tooth pulp is sealed within a day.

A loose tooth is usually left to recover on its own while observing a soft diet. A displaced baby tooth may need to be removed to prevent damage to the developing permanent tooth underneath it. A knocked out baby tooth however should NEVER be replaced. It is not uncommon for the tooth to do dark but no treatment is necessary unless there is pain or swelling. Treatment in these cases is extraction.

Adult teeth

A chipped tooth can easily be repaired with white filling material that can serve for many years. A broken tooth will require sealing of the nerve or in more severe cases root canal therapy. Loose teeth may heal on their own or splinted depending on the severity. 

If a tooth has moved inward, outward, and/or upward, try to reposition it back to its normal position with very light finger pressure. Do not force the tooth back into position. Hold the tooth in place with a tissue or gauze if it is very loose. Call our office so we can decide on a treatment plan. After an exam, we may have to numb the area and then reposition the tooth if you have not been able to move it back into its original position with light finger pressure. To keep the tooth steady, we place an orthodontic wire retainer across several teeth to stabilise the traumatised teeth. If the damage is very extensive, future root canal treatment may be needed to keep the tooth.

There is a possibility that a permanent tooth that has been knocked out can be re-implanted if handled promptly and correctly. If possible, the tooth should be rinsed and reinserted in the socket and held there until the child sees a dentist or visits the emergency room. If it is not possible to replace the tooth in the socket, the tooth should immediately be placed in milk or saliva (in the child’s cheek if possible). The tooth should be handled only by the crown and never be allowed to dry out. If a dentist can see the child within half an hour and the tooth has been preserved correctly, there is a possibility that it may be successfully re-implanted. Root canal treatment is most likely if the child is older.

In most cases, it is best to bring your child in to be assessed as soon as possible to minimise complications. We will often take x-rays to confirm what is observed and assess the region.

 Use Panadol or Nurofen for Kids to relieve pain and use ice compresses over swollen areas. Neosporin can be used to prevent infection for any external cuts or scratches. Keep your child on a soft diet for 2 weeks to prevent further damage. Mouthguards and helmets may be appropriate depending on the sport to minimise injuries.
Call the office on 9904 2880 if you have any other questions or if symptoms get worse.