We all know that kids like to test gravity and sometimes suffer the consequences (ex, Tongue Laceration, Eyelid Laceration, and Concussions). One of the most common consequences of testing gravity (or general poor coordination) is dental trauma. This is true for adults and older children also, but what needs to be done when the trauma involves a young child’s primary dentition?
When a Tooth Is Chipped
The most common injury to a tooth is a chip. Young children might chip a tooth when falling, playing at the park, or even when taking a bath at home. Chipped teeth are not usually a dental emergency, but you should make an appointment to have the tooth examined shortly after the accident.
Some chips are not serious. They may not even extend deep enough to harm the tooth. If your child is very young and the chip is shallow, your dentist might recommend waiting a year or two before filling the chip so your child will be able to sit still for the appointment.
However, some chips can break through the enamel of a baby tooth, exposing the soft dentin underneath. These chips will need to be filled immediately to prevent further decay. Don't rely on your exam to determine whether or not a chip is serious. Some chips may look mild, but even a hairline crack in the dentin will expose the tooth to harmful bacteria.
When a Tooth Is Knocked Loose
When your child's tooth is knocked hard enough to make it loose in the socket, there can be some cause for concern, but your child will generally recover quickly. Your child might:
- experience some bleeding from the gums around the tooth.
- Have some swelling, like a bruise, from the force of the blow.
- Complain of some tooth pain and soreness.
- Have trouble chewing with the loose tooth.
These are normal symptoms of a loosened tooth because of trauma. The best solution is to encourage soft foods and to keep your child from playing with the loose tooth as it resettles and heals. However, you should still have the tooth examined by a dentist because sometimes a tooth can have deep nerve damage.
In rare cases, the permanent tooth might become damaged, especially if the baby tooth is forced upwards into the socket. An x-ray will help determine whether or not there is any damage.
When a Tooth Is Lost
With a lot of external force, your child may lose his or her tooth. Usually, if the tooth is primary or baby, your dentist might recommend just allowing the Tooth Fairy to come and collect the tooth. Replacing the tooth might affect the growth of the primary tooth, and it's often not worth the risk. A spacer can help keep your child's teeth from crowding.
A dental exam is still necessary to make sure that there are no underlying problems from the accident, but you won't have to worry about chewing food or speech problems. It will only be a short while before the primary tooth comes to fill in the gap.
Dangers and Concerns of Dental Trauma
Each of the above situations can lead to more serious dental problems. Parents might become concerned to see a tooth turning grey or brown shortly after trauma. This is normal for damaged teeth.
Think of the discoloration as a bruise. Increased blood flow to broken vessels in the tooth leads to a grayish tinge. It sometimes fades, but many times, the tooth will stay slightly darker than its fellows. The lack of rich blood supply to the tooth will not fully resolve the color change. In a baby tooth, this is not a concern most of the time.
In months following the trauma, whether it was a chip or a loose tooth, be careful to watch the tooth for signs of trouble. Even if the color does not fully return, the tooth could be perfectly healthy, and it will remain that way with the right hygiene.
In rare cases, though, sometimes the pulp inside the tooth can die as a reaction to the trauma and reduced blood flow to the tooth. An abscess will form. These infections are painful and often result in tooth loss for young children. The only other alternative is a root canal, but the care and expense required are often too much for a baby tooth, considering the tooth will fall out to make way for adult teeth.
Signs of an abscess include a high fever, gum, and facial swelling, and great pain. Some children may not be able to communicate the pain they are feeling. For example, if a front tooth becomes abscessed, a child might complain of nasal pain, even though the infection is based on the root of the tooth.
Dental Trauma Basic Home Care
- Oral hygiene is important after (and yes, even before) dental trauma.
- A soft diet is recommended for the first ~10 days after injury.
- Pacifier or digit sucking should be restricted.
- If a tooth is extracted/avulsed, patients who suck pacifiers/fingers may require a spacer.
- Antibiotics are NOT needed empirically for most patients.
- Monitor for signs of discoloration, gingival swelling, and/or facial swelling.
We love our patients and love to help them form healthy dental life that will last them a lifetime. Growing Smiles is a pediatric dentist in Anna, Richardson, Plano, Garland, Murphy we have Pediatric Services in Texas: Early Childhood Care, Preventive Care, General Treatments, Sedation Dentistry, Special Needs Dentistry, Emergency Service and Orthodontic (Braces & Invisalign) For more information call us to answer all of your questions.