Traumatic dental injuries occur with great frequency in today’s children. Reports show that 25% of school children experience dental trauma. One of the most common dental injuries in baby teeth are luxation injuries, when the teeth is displaced. Another common injury in permanent teeth is a fracture. Today’s blog will discuss some of the common injuries in pediatric dental patients.
1) Soft tissue tear- The injury to the upper frenum, or tissue connecting the upper lip to the gingiva, is often torn on children at a young age when they are learning to walk. This is a self-resolving injury, and rarely requires any treatment. If this occurs, call you dentist as soon as possible to set up an exam to rule out any other potential injuries, and to discuss management. Firm pressure with moist gauze of towel can help to stop bleeding in the area. Soft and bland diet during the healing phase will help avoid any discomfort. Good oral hygiene is still crucial, being gentle around this area.
2) Bumped teeth
a) Concussion- Bumped tooth that is in the same place as before
b) Luxation- Bumped tooth that is in a different place (see photo below)
c) Chipped tooth (See photo)
All of these injuries can be painful, and it important to see a dentist soon after the injury in order to properly manage the teeth to give the child’s teeth the best prognosis. Sometimes, no treatment is needed, and the teeth are monitored. Other times, treatment may be indicated to prevent any nerve damage and/or to place the teeth in the proper position.
3) Avulsion Injuries (knocked out teeth)-
a) Baby Tooth- If a baby tooth is knocked out, do not attempt to re-implant the tooth. Call your dentist as soon as possible to have your child seen. Weighing the risks and benefits of re-implanting the tooth or leaving it out, the best option is to leave the tooth out of the mouth in order to protect the underlying permanent tooth from damage.
b) Permanent Tooth- *Call a dentist immediately to arrange for care*
Here are the proper steps to manage a permanent tooth that has been knocked out.
After getting a hold of a dentist immediately, follow the steps below:
1) Pending the injury, rule out any potential head damage that would require immediate emergent hospital treatment. If the child is unconscious, vomiting, has memory loss, is lethargic, it may indicate there are other more serious problems than the tooth.
2) Find the tooth, and pick it up by the crown (not the root, see photo).
3) Rinse the tooth gently and briefly (10 seconds) with cold tap water
4) Do not scrub the tooth, do not clean the tooth with soap, alcohol, mouthwash or any other chemical
5) Do not wrap the tooth in tissue, cloth or plastic
6) Do not allow the tooth to dry
7) Place the tooth back into socket immediately and with gentle finger pressure (Best chance of saving the tooth). If you are not comfortable with this, that is OK. Getting to a dentist as soon as possible is crucial to give the tooth the best prognosis.
8) If unable to place the tooth back into its socket, transport the tooth in the following liquids listed in order of preference:
i) Hanks Balanced Salt Solution (Save-A-Tooth®); sometimes found in first aid kits (tooth may be kept in this solution up to 24 hours) http://www.save-a-tooth.com/
ii) Milk: preferably cold and low fat (tooth may be kept in milk up to 3 hours)
iii) Cold tap water or inside the child’s mouth (last resort – living cells on tooth may completely die within 1 hour)
GET TO A DENTIST AS SOON AS POSSIBLE! The sooner the tooth is placed back in the socket, the better chance the tooth has of surviving long term.
We hope this blog was informational and helpful. Please contact our office at 605-242-4700 with any questions or concerns. Thanks for reading!