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By Dr. Brian Rask

                            

I hope everyone had a wonderful holiday season and is starting the New Year well.  Last issue I spoke about how to care for your child’s first teeth and now I want to continue on with how to handle an injury or emergency.

Having a dental emergency is a big fear for every parent but if you are prepared on how to manage the situation, you could save your child’s tooth or minimize complications.

If your child knocks out one of their primary or baby teeth, you should get them to the dentist as soon as possible.  If the tooth is out all the way, you should not try to reinsert it back into the socket, in order to prevent damaging the permanent tooth which is developing below it.  If the tooth is only mobile from trauma, your dentist may be able to stabilize and save it.  Primary teeth may become ankylosed (fused to the bone) or abscessed (infected) from trauma, which may affect the adult tooth forming underneath it. Teeth that have received trauma should be consistently monitored with x-rays and dental exams.

A permanent or adult tooth that is avulsed should be inserted back into the socket.  Hold the tooth by the crown and take care not to touch the root.  Gently rinse it with water or saliva to clean any dirt off of it but do not scrub the root or remove any of the tissue on it.  Carefully reinsert it and see a dentist immediately.  If you cannot put the tooth back in, have the child hold the tooth in their mouth in saliva or place it in a container with milk, water, saliva, or Hank’s buffered salt solution and rush your child to the dentist.  Hopefully, the dentist can reinsert it but there are still the risks of the tooth becoming ankylosed or abscessed, which could require a root canal or extraction later in life.

If there is severe trauma to the chin or the possibility of a broken jaw, apply ice to the injured area and see an oral surgeon, pediatric dentist, ER physician or dentist who is trained in treating injuries right away.  Being treated by a doctor who is competent is the most important thing, because the development of the face, upper and lower jaws and the TMJ’s can be affected by a blow to the chin or mandible.  The injured child should have continual follow-ups throughout development as problems may not show up until teen or young adult years.

When a child only has mild trauma, causing a bloody tongue or lip, clean the area gently with warm water and apply an icepack or washcloth with ice to reduce swelling, using light pressure.  If the bleeding does not stop after 30 minutes or so, see a dentist or physician as your child may require stitches.

For a broken tooth, try to find the piece or pieces and
wrap them in a damp paper towel or gauze and bring them with you to see a dentist.  Apply an icepack if there is swelling and clean the area with a wet washcloth.  The tooth may be able to be repaired conservatively with special bonding procedures.

If your child develops a toothache, inquire about the symptoms they are having and give them Tylenol for pain.  Schedule an appointment with your dentist to have the problem examined and diagnosed.  Do not let it go untreated, as a decayed or infected tooth may affect the child’s developing dentition.  If a tooth needs to be extracted for any reason, a space maintainer or fixed or removable prosthesis should be made to stabilize the occlusion.

The best way to avoid these injuries is to have your child wear a mouth guard while playing sports.  There are different types of guards for contact and non-contact sports that your dentist can custom make for you or that may be purchased from a drug store.  Not all injuries can be avoided, but mouth guards can protect against broken or avulsed teeth, cut lips or longue and TMJ or jaw trauma.  A small amount of money for a mouth guard can save thousands of dollars in dental treatment.

Helping you smile with confidence.