Traumatic Dental Injuries

Traumatic dental injuries can occur in people of all ages and activity levels. The cause might be a car accident, a fall down the stairs, or an elbow to the face during a basketball game. As with most types of dental treatment, the primary goal when treating a traumatic dental injury is to save teeth at risk of being lost, and restore them to full function and normal appearance. In many cases, the difference between saving and losing a tooth depends on taking the proper action in the immediate aftermath of an injury. Here are some guidelines on how to prevent sports-related dental injuries and what to do after a dental injury occurs.

Sports-Related Dental Injuries

Americans of all ages love playing sports — so much so that participation in high school sports has been increasing for 24 consecutive years, according to one survey. Yet to gain the very real benefits that sports offer, it's necessary to accept — and prepare for — the risk of injury.

Dental trauma accounts for a significant portion of all sports injuries, yet so many of these injuries are preventable. How? With a high-quality mouthguard.

 

When you consider that the lifetime cost of replacing a permanent tooth has been estimated to exceed $15,000, a good mouthguard is one of the best investments you can make in sports equipment: It has been shown to reduce the risk of sports-related dental injury by 60 times.

The best kind of mouthguard is one that comes from your dentist's office. It's custom-made from a model of your own teeth, so it's strong, lightweight, and perfectly fitted. If you (or your child) are active in sports, ask about this indispensable piece of safety gear. And continue reading below to find out what to do in the case of specific types of dental injuries.

Knocked-Out Teeth (Dental Avulsion)

For baby teeth in general, dentists do not attempt to reimplant avulsed primary (baby) teeth, because the reimplantation procedure itself can cause damage to the tooth bud, and thereby damage the emerging permanent tooth.

If a permanent tooth has been knocked-out of its socket (avulsed), it's important to contact Children's Dentistry of Longwood immediately, because time is an important factor in saving and reimplantation of a tooth. Your child’s dentist will always try to reimplant an adult tooth that has been knocked out, unless the trauma has caused irreparable damage. The reimplantation procedure is almost always more successful if it is performed within one hour of the avulsion.

How you can help:

  1. Recover the tooth; Do not touch the tooth roots! Handle the crown only.
  2. Gently rinse off dirt and debris with water; Do not scrub or scrape the tooth.
  3. For older children, insert the tooth into its original socket using gentle pressure, or encourage the child to place the tooth in the cheek pouch.

    For younger children, place the tooth in a glass of milk or saliva; Do not try to put the tooth back in a young child’s mouth, as they may swallow it.

  4. Keep the tooth wet during transportation; Moisture is critically important for reimplantation success.
  5. Then call or visit Children's Dentistry of Longwood, if it is after hours don't worry we have someone on call 24/7, if you're unable to reach us please take the child to the closest Emergency Room.

 

Chipped or Knocked-OutBroken/Fractured Teeth

 

Chipped or Broken/Fractured teeth are the most common dental injury, according to the American Association of Endodontists. If teeth have been chipped or fractured, or if they are loose or tender to the touch, make sure to see a dentist within 12 hours. Also make sure to tell the child to becareful as jagged enamel can irritate and inflame soft oral tissues, causing infection.

Dr. Donald can readily assess the severity of the fracture using dental X-rays, but any change in tooth color (for example, pinkish or yellowish tinges inside the tooth) is an emergency warning sign. Minor fractures may require the application of dental sealant, whereas more severe crown fractures sometimes require pulp treatments. Until then here is a list of things you can do.

How you can help:

  1. Rinse the child’s mouth with warm water.
  2. Place a cold, moist compress on the affected area.
  3. Offer a pediatrician approved pain relief such as Tylenol
  4. Pack the tooth with a material that can be near a tooth but will eventually break down, such as a wet paper towel.
  5. Then call or visit Children's Dentistry of Longwood, if it is after hours don't worry we have someone on call 24/7, if you're unable to reach us please take the child to the closest Emergency Room.

 

Root Fracture

A root fracture is caused by direct trauma, and isn’t noticeable to the naked eye. If a root fracture is suspected, dental x-rays will need to be taken. Depending on the exact positioning of the fracture and the child’s level of discomfort, the tooth can be monitored, treated, or extracted as a worst case scenario. Until then there are a couple things you can do below.

How you can help:

  1. Place a cold, moist compress on the affected area.
  2. Offer a pediatrician approved pain relief such as Tylenol
  3. Offer a pediatrician approved pain relief such as Tylenol
  4. Pack the tooth with a material that can be near a tooth but will eventually break down, such as a wet paper towel.
  5. Then call or visit Children's Dentistry of Longwood for the next step in the process.

 

Partially Displaced Teeth (Luxation, Extrusion)

If teeth are driven into or pushed partially out of the jaw, or if they are out of alignment, the patient should see a dentist or oral surgeon within six hours of the accident. A careful examination of the mouth (plus x-rays if needed) should reveal the extent of the damage, and indicate what restorative treatments are likely to be required.

Tooth displacement is generally classified as “luxation”, “extrusion”, or “lateral displacement”, depending on how the tooth is angled after the trauma.

 

A luxated tooth remains in the socket with the pulp intact some of the time. However, the tooth protrudes at an unnatural angle and the underlying jawbone is oftentimes fractured.

The term “extrusion” refers to a tooth that has become partly removed from its socket. In young children, primary tooth extrusions tend to heal themselves without medical treatment. However, dental treatment should be sought for permanent teeth that have been displaced in any manner in order to save the tooth and prevent infection. It is important to contact Children's Dentistry of Longwood if displacement is suspected. There is a list below of things you could do to help.

How you can help:

  1. Place a cold, moist compress on the affected area.
  2. Offer a pediatrician approved pain relief such as Tylenol
  3. Then call or visit Children's Dentistry of Longwood, if it is after hours don't worry we have someone on call 24/7, if you're unable to reach us please take the child to the closest Emergency Room.

 

Soft-Tissue Injuries

In addition to the teeth, dental injuries often involve damage to the gums, the tongue, and the inside of the mouth. When these soft-tissue injuries occur, it's best to take the following immediate actions, and then see a dentist as soon as possible. For immediate attention you can do the following.

How you can help:

  1. Wash and rinse the area with soap and water if possible, or remove debris and foreign material by hand.
  2. Bleeding can usually be controlled by applying direct, gentle pressure to gauze pads placed on the wound

    (If it can't be controlled after about 10 minutes, go to the nearest emergency room)

  3. Then call or visit Children's Dentistry of Longwood, if it is after hours don't worry we have someone on call 24/7, if you're unable to reach us please take the child to the closest Emergency Room.

 

Dental Concussion

A tooth that has not been dislodged from its socket or fractured, but has received a bang or knock, can be described as “concussed”. This typically occurring in toddlers, dental concussion can cause a tooth to discolor permanently or temporarily. Unless the tooth turns black or dark (indicating that the tooth is dying and may require root canal therapy), dental concussion normally does not require emergency treatment. But is recommended to contact Children's Dentistry of Longwood for further advise.

Please don't hesitate to call or visit Children's Dentistry of Longwood for more specific information about handling a traumatic dental injury.
Reviewed by Dr. David E. Donald D.D.S. P.A.