Check your child’s gums for any trapped food or foreign objects. Help them floss and rinse their mouth for about 10 seconds with lukewarm salt water made from half a teaspoon of table salt dissolved in one cup of water. Give your child Ibuprofen every six hours if needed for pain. Call us immediately if the pain does not subside or if your child has facial swelling.
Dental concussion refers to a tooth that has been “banged” or “knocked” without being dislodged from its socket or fractured. You will often see bleeding around a concussed tooth. Typically occurring in toddlers, dental concussion can cause the tooth to discolor temporarily and sometimes permanently. If you notice a discolored tooth post-trauma, make an appointment with your pediatric dentist to have it evaluated with an x-ray. Unless the tooth turns gray, indicating that the tooth is dying and may require root canal therapy, dental concussion does not require emergency treatment.
Teeth that are mildly displaced and slightly loose after injury will usually tighten up over time. To ensure that this happens, a soft diet is recommended for seven to ten days after trauma occurs. It is important to continue to have these teeth evaluated as infection may start later. Possible signs of infection can include color change, increased mobility, swelling, an abscess or “gum boil”, and discomfort. X-rays are recommended six weeks, three months, and six months post-trauma to determine the health and prognosis of a traumatized tooth.
If a tooth has been knocked out of your child’s mouth completely, it is important to contact your pediatric dentist immediately. Avulsed primary teeth should not be reimplanted because the reimplantation procedure can cause damage to the underlying developing permanent tooth bud. Avulsed permanent teeth should be reimplanted as soon as possible. The reimplantation procedure is most successful if it is performed within one hour of the avulsion. Only handle the tooth by the crown and avoid touching the root. If the tooth is not broken, attempt to place the tooth back into the socket. If this is not possible, place the tooth in a cup of milk or in a cup of your child’s saliva and contact your pediatric dentist immediately.
Dental intrusion occurs when the force of dental trauma pushes a tooth or several teeth upwards into the jawbone. The prognosis is generally better for teeth that have been intruded less than 3 mm. Sometimes the force of the trauma is strong enough to injure the tooth’s ligament and fracture its socket. Contact your pediatric dentist immediately if dental intrusion of either your child’s primary or permanent teeth is suspected. Depending on the nature and depth of the intrusion, your dentist will either wait for the tooth to descend naturally, or perform
root canal therapy to preserve the tooth.
Tooth displacement is generally classified as “luxation”, “extrusion”, or “lateral displacement” depending on the orientation of the tooth following trauma. A luxated tooth remains in the socket with the pulp intact about half of the time. However, the tooth protrudes at an unnatural angle and the underlying jawbone is often fractured.
“Extrusion” refers to a tooth that has become partially removed from its socket. In young children, primary tooth extrusions tend to heal themselves without any treatment. However, you should contact your child’s dentist immediately to reposition and splint a laterally displaced primary or permanent tooth or an extruded permanent tooth in order to preserve its blood supply and prevent infection.
It is important to have chipped teeth evaluated in order to determine how deep the fracture is. If there is a visible area of bleeding within the fracture line, the pulp may have been exposed and immediate dental treatment is required to prevent further bacterial contamination. Some mild fractures can simply be monitored or smoothed, while others may require more extensive bonding. If the fractured piece is large and can be located, it should be brought to your pediatric dentist for possible re-bonding.
The best treatment for dental trauma is prevention. Children who are just learning to walk or run should be monitored closely as they are often prone to stumbling and their height makes it easy for them to bump into corners of chairs and tables. In addition, all children who play contact sports should wear protective mouth guards. Research has shown that the use of protective mouth guards significantly decreases the occurrence and severity of dental trauma.