Although dental injuries and dental emergencies are often distressing for both children and parents, they are also extremely common. Approximately one third of children have experienced some type of dental trauma, and more have experienced a dental emergency.
There are two peak risk periods for dental trauma - the first being toddlerhood (18-40 months) when environmental exploration begins, and the second being the preadolescent/adolescent period, when sporting injuries become commonplace.
Detailed below are some of the most common childhood dental emergencies, in addition to helpful advice on how to deal with them.
Toothache is common in children of all ages and rarely occurs without cause. Impacted food can cause discomfort in young children, and can be dislodged using a toothbrush, a clean finger, or dental floss. If pain persists, contact the dentist. Some common causes of toothache include: tooth fractures, tooth decay, tooth trauma, and wisdom teeth eruption (adolescence).
Dental avulsion (knocked-out tooth)
If a tooth has been knocked-out of the child’s mouth completely, it is important to contact the dentist immediately. 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.
Dentists always attempt to reimplant avulsed permanent teeth, 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, so time is of the essence!
How you can help:
Recover the tooth. Do not touch the tooth roots! Handle the crown only.
Rinse off dirt and debris with water without scrubbing or scraping the tooth.
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, submerge the tooth in a glass of milk or saliva (do not attempt to reinsert the tooth in case the child swallows it).
Do not allow the tooth to dry during transportation. Moisture is critically important for reimplantation success.
Visit the dentist or take the child to the Emergency Room immediately –time is critical in saving the tooth.
The crown is the largest, most visible part of the tooth. In most cases, the crown is the part of the tooth that sustains trauma. There are several classifications of crown fracture, ranging from minor enamel cracks (not an emergency) to pulp exposure (requiring immediate treatment).
The dentist 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 crown fractures often warrant the application of dental sealant, whereas more severe crown fractures sometimes require pulp treatments. In the case of crown fracture, the dentist should be contacted. Jagged enamel can irritate and inflame soft oral tissues, causing infection.
A tooth that has not been dislodged from its socket or fractured, but has received a bang or knock, can be described as “concussed.” Typically occurring in toddlers, dental concussion can cause the 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 does not require emergency treatment.
Injured cheek, lip or tongue
If the child’s cheek, lip or tongue is bleeding due to an accidental cut or bite, apply firm direct pressure to the area using a clean cloth or gauze. To reduce swelling, apply ice to the affected areas. If the bleeding becomes uncontrollable, proceed to the Emergency Room or call a medical professional immediately.
If a broken or fractured jaw is suspected, proceed immediately to the Emergency Room. In the meantime, encourage the child not to move the jaw. In the case of a very young child, gently tie a scarf lengthways around the head and jaw to prevent movement.
Head injury/head trauma
If the child has received trauma to the head, proceed immediately to the Emergency Room. Even if consciousness has not been lost, it is important for pediatric doctors to rule out delayed concussion and internal bleeding.
If you have questions about dental emergencies, please contact our office.