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Dental Trauma and Emergencies

Spring time brings all of our patients’ favorite outdoor activities – biking, swimming, and many visits to the neighborhood playground or splash pad. As much fun as these activities are, they can also bring about a lot of unwanted dental emergencies. In the past few weeks we have seen numerous patients with chipped and/or injured teeth due to accidents around their own backyards and pool decks. It’s important to enforce strict rules around the pool for children, but it’s also important to have some basic knowledge about different types of dental trauma and what to do if your child bumps a tooth this summer!

If your child falls face-first and you see a lot of blood, first determine that the accident only affected their teeth and there aren’t any more serious injuries that would require a trip to the emergency room. If there is severe injury, loss of consciousness, or uncontrollable bleeding, seek help immediately from the ER. If the injury does not appear to require attention from the ER, you can call Dr. T. on her 24/7-hour emergency call system. To reach Dr. T. in an emergency situation, just call the office at (407) 205-1114 and then 9 for emergencies to reach him at any time.

Bumped Tooth

Many children, especially young ones, will fall and bump their teeth without any obvious break in the enamel. Sometimes the teeth are pushed backwards, inwards into the gums, outwards down into the mouth, or they don’t move at all. This can happen with or without bleeding of the surrounding gum tissue as well. Many times the teeth will be slightly loose, or in the more serious instances, very loose. Depending on the severity of the bump, sometimes treatment is indicated and sometimes we simply monitor the teeth. We will usually take an x-ray to examine the underlying roots of the teeth and surrounding bone because even if the tooth doesn’t appear fractured, there could be damage underneath the gums.

If we choose to do nothing and simply monitor the tooth, it is hard to predict the prognosis based on the injury alone. Some teeth heal exceptionally well and will never cause a problem. If a tooth was bumped particularly hard, it could suffer a sort of “concussion” in that there was interior damage that is not visible visually or even on an x-ray. Sometimes you will notice a color change of the bumped tooth after a few weeks or months – usually a yellowish-grey color as the body lays down reparative tooth structure to help repair the tooth from the inside. This color can darker or lighten with time, but it is not usually indicative of any problem with the tooth. If the blood or nerve supply of the tooth was damaged in the injury, sometimes after months or even years the tooth can eventually die. Once the tooth dies, bacteria moves in and can cause an abscess or “pimple” on the gums above the tooth. Whenever a patient bumps a tooth, our office always makes a note and we will forever follow the tooth closely to check for any developing problems.

Chipped Tooth

If a tooth is chipped, particularly if it’s a permanent tooth, do your best to find the fragment and store it in a plastic baggie until you’re able to come to the office. There is no need to store the fragment in milk, but sometimes the fragment can be reattached for the most natural appearing fix. If the chip was severe enough to expose the nerve of the tooth (usually seen as a red dot inside the crown of the tooth), treatment will need to be sooner rather than later. We’ll want to see your child to do an exam as well as take an x-ray to rule out any root fractures or other issues with the surrounding teeth and tissues.

Babies chip their front teeth frequently as they’re learning to walk and chewing on everything. Small chips are usually nothing to worry about, especially if your child is completely asymptomatic, but it’s never a bad idea to call the office to have the teeth looked at if you’re concerned at all.

Knocked Out Tooth

If your child completely loses a permanent tooth, time is of the essence and it’s imperative to see a dentist ASAP. The sooner your child is seen, the better the chances of a full recovery for that tooth. Find the tooth and pick it up by the crown (the part that is usually visible in the mouth), being careful not to touch the root if you can avoid it. Rinse off the tooth, but resist the urge to scrape or scrub it clean. For an older child, place the tooth back into the socket the right way and have your child bite on gauze or some tissues to hold it in place until getting to the dentist. If you can’t get the tooth in properly, have your child hold the tooth in their cheek so the saliva will keep the root clean and moist. If your child is too young to handle keeping the tooth in their cheek without swallowing it, it’s important to still keep the tooth moist and milk is recommended. Next step – call our office immediately!

If the tooth that is lost is a baby tooth, do not try to place the tooth back into the socket. This can damage the permanent tooth underneath and reimplantation of baby teeth does not have high success rates. It is still important to call your dentist right away to rule out any other injuries to surrounding teeth or bone.

In general, injuries in the mouth bleed a lot, but heal quickly. Whenever there is an oral injury, there tends to be A LOT of blood because the mouth is a very vascular area and when saliva mixes with blood, it makes an even bigger mess. So rest assured that even if it looks like a scene from Dexter in your backyard, the damage might not be as bad as it appears. Remember that Dr. T.  is always just a phone call away to help guide you through managing any dental emergencies that happen this Spring!

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