teeth, injuries to

Injuries to the teeth are common in children. They fall into three basic categories:

  • fracture - the tooth is broken off
    • minor chips of teeth can wait for dental attention
    • broken teeth or crown fracture - recover the fragment if possible, handle it by the enamel portion, and take it with you to the dentist
    • exposed nerve roots are very painful; gently biting on a towel or gauze will usually control bleeding
  • luxation - the tooth has been loosened and pushed out of position
    • care: immediate consultation with a dentist; if you can gently reposition the tooth without causing too much pain, you may do so unless the tooth is pushed into the gum; leave that for the dentist
    • some apparent luxations are really fractures of the root of the tooth and will require dental xray to determine the true injury
    • loosened teeth may require stabilization while the socket tightens again
  • avulsion - the tooth is knocked completely out
    • find the tooth and handle it by the enamel surface; rinse it clean with clear water
    • best outcome when reimplanted within 30 minutes - after two hours, the chances of saving the tooth are slim
    • put the tooth in cold milk (whole, 2% or skim); milk is a good transport solution
    • call and get to a dentist immediately

Reasonable rules of thumb:

  • most dental injuries more serious than a minor chipped tooth probably warrant a call to the family dentist or the child´s physician for management instructions
  • when in doubt, always recover any teeth or parts of teeth, handle them by the enamel only, dunk them in cold milk, call the dentist, and take the pieces with you

Teeth that turn dark after trauma are "dead,"; because the blood and nerve supply to the tooth was severed. Deciduous ("baby&dquot;) teeth that turn grey are usually left alone unless they become infected. In that case, the dentist may have to pull the tooth to prevent infection from damaging the permanent tooth bud beneath the deciduous tooth.

See lacerations, mouth.

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