Dental Injuries & Traumas

Kavina Mansukhani
Consultant Pediatric Dentist, Mumbai, India
First Created: 01/15/2004 


One of the most upsetting things - to a parent and a child is an accident in which a child's tooth is fractured, displaced, or knocked out.

It's painful for the child and an emergency situation for the parent.

The majority of these injuries result from simple accidents - minor falls, sports mishaps, or childish pranks. They most often involve the front teeth, so in addition to the discomfort and pain, aesthetics is often an issue. Although most of these accidents befall the toddler, statistics show that children aged 9 to 10 yrs. are most susceptible, and boys are about twice as likely as girls to have such an accident.

Hidden Damage

Any injury to the child's primary tooth has the potential to damage the developing permanent one, especially if the damage occurs before age 3. This is why it is important to report any such injury promptly to the child's dentist.

The permanent top central incisors begin mineralization at birth and take about 3 years to completely form. If during this critical time the root of a primary tooth is pushed into the crown of the developing permanent, a defect may develop in the permanent tooth.

Don't be surprised then, if the pediatric dentist recommends removing the primary tooth following an injury to an infant's tooth. If removal may help prevent infection or injury to the developing permanent tooth, the dentist is likely to advise this treatment - even if it makes the parents feel guilty and unhappy.

Loss of a top front tooth in a child under 3 generally does not affect speech, growth patterns, or psychological development. Children are generally not tooth conscious until 5 or 6 years of age. And by that time, all their friends are losing their front teeth anyway.

What to do in case of an injury? (Permanent Teeth)

Sometimes, a fall or injury may result in knocking the tooth out completely. The best thing to do then is to rinse the tooth free of dirt, (if necessary) under cold water, and stick it firmly back in the socket - as far as it will go. Most parents cannot bring themselves to do this, but if the tooth isn't back in the mouth within, at most, 20 minutes, the chances of successful reimplantation diminish rapidly.

The next best way to transport a tooth that has been knocked out of the child's mouth is to have the child hold the tooth in the mouth, under the tongue, until the dentist places it back in its the correct position. The saliva in the mouth provides the best emergency environment.

Even if the tooth is not back in place within 20 minutes, all is not lost. Get the tooth (WHICH MUST BE KEPT DAMP) and child to a dentist. Depending on the condition of the tooth and the child, the dentist may be able to replace the tooth in the mouth. Sometimes a replanted tooth will give several more years of service. Sometimes the replanted tooth may last only a few years before it begins to resorb, loosen and fall out. It has not been figured how to arrest this process, although we now know that the technique of re-implantation plays an important part in its success.

If an accident results in a fractured or chipped tooth in which the tooth stays in the mouth, you should keep the mouth clean, and rush to the dentist who can place a covering over the exposed tooth structure and thus allowing it to heal.

With the fractured permanent teeth, there have been amazing advances in repair. In the past, the dentist would cut the tooth down and put a cap on it. Today, there are several materials, which can be bonded directly to the tooth, without the use of anesthesia, and with minimal cutting of the tooth. The resulting restoration is indistinguishable from a natural, whole tooth.

Dental Injuries & Traumas Dental Injuries & Traumas 2004-01-15
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