Dental Trauma in Children

School has started and sporting activities for kids are in a full swing. Unfortunately, that means dental emergencies are also on the rise in our office. Dental trauma is common in children and teens since they are more active in team sports. For little ones, it is also a time when they are learning to walk and run.

When a child has an avulsed tooth (completely extracted due to trauma), parents and teachers must know what to do which ranges from properly saving the avulsed teeth to avoiding additional trauma to the child.

Primary Teeth:

Children under the age of six or seven have primary teeth that later give way to adult permanent teeth. It is not so uncommon for the primary front tooth to be avulsed because kids fall frequently while learning to walk and run.

It is not recommended to reimplant (or put back into socket) “knocked out” primary teeth because it can effect development of permanent adult teeth and surrounding tissue. The tooth can fuse to the bone after reimplantation, a process called ankylosis, and hinder the formation of a permanent tooth.

If a primary tooth is avulsed, your first priority should be to perform a full assessment of the injured child, as well as containing any bleeding and keep the child calm. Even if no visible injury is noted, it is important for the child to be seen by a dental professional to assess the bone, tissue, and possible trauma to the adjacent teeth. Radiographs might be necessary to assess the bone health. Prosthetic replacement of the tooth is not necessary, but some parents chose to have one made to prevent any social implications of missing teeth.

 Permanent Teeth:

Avulsed permanent teeth are a serious dental emergency and need to be handled with great care to result in a long term positive outcome for the injured child. Immediate reimplantation is critical, so call the dentist right away to be seen and follow his or hers instructions. If your dentist is not available, you can do the first aid yourself.

First, calm the injured child. Then find the tooth and pick it up by the wider part, the crown only. If the tooth is dirty, wash it under cold running water for 10 seconds; make sure not to touch the root of the tooth. Reposition the tooth in the mouth with the “shovel looking” concave surface towards the back to match the adjacent one as soon as possible. Ask the child to bite in gently to hold the tooth in place. If the child cannot bite the tooth, place the tooth in saline solution or glass of milk (container of saliva works even better) and see your dentist at once. Do not store the tooth is a napkin or water.

The tooth must be secured with a splint or temporary braces by the dentist immediately after reimplantation. A soft diet and avoidance of contact sports will be advised for at least the next 2 weeks. The child will also require follow up appointments with the dentist and a root canal specialist for proper diagnosis and treatment of the injury.

Sports such as cheerleading, wrestling, and basketball are usually on my list for the most dental emergencies in my practice. Although they are not viewed as contact sports like football and hockey, injuries due to flying elbows and falls happen frequently. Prevention is key and it is important that mouth guards are used regularly to prevent any physical injuries in a first place. Therefore, at Artful Smiles we encourage parents to discuss trauma preventing mouth guards with coaches. They are inexpensive and very effective in preventing dental traumas. Keep in mind that an ounce of prevention is worth a pound of cure!