Trauma
Trauma to the primary dentition
Approximately one-third of babies and toddlers sustain oral trauma as they are prone to accidents around the home, in the playground or at childcare. As a result of trauma, baby or primary teeth can be chipped, displaced or knocked out completely. Often, the lips, tongue and gums can also be damaged. Dental trauma also has a high prevalence in school-aged children who are active in outdoor activities and sport.
Trauma to the permanent dentition
Dental trauma can occur at any age, with 1 in 4 adolescents and 1 in 3 adults experiencing dental trauma. It can affect the surrounding gums, bone and/or tooth.
There are many types of dental trauma, which can range from a small ‘bruise’ to the tooth and surrounding structures (concussion), to displacement of the tooth (luxation injuries), to complete loss of the tooth (avulsion), to fracture of the tooth’s crown or root (crown/root fractures).
The possible healing and subsequent care required for the tooth depends on the severity of the injury, the type of injury involved and age/maturity of the tooth. The long-term outlook for the tooth is also best achieved if there is proper and immediate care for the tooth. Therefore, after your child’s injury, it is best to see a dental clinician as soon as conveniently possible.
At home care following the emergency visit:
At the emergency consultation, your dental clinician will advise and discuss what is required for the traumatised tooth, which may include a temporary or permanent filling, initial nerve treatment, repositioning of the tooth or splinting. Regular dental reviews will also be required.
When you go home, continue to take care of the injured tooth, to give it the best chance to heal:
- soft diet for two weeks
- analgesics as required (Panadol or Nurofen)
- chlorhexidine antibacterial mouthwash or gel can be applied twice daily with clean finger or spongette
- maintain excellent oral hygiene with toothbrushing twice daily with fluoridated toothpaste
- avoid all contact sports
- monitor and contact Children’s Dentistry if swelling, severe pain or pimple to the gum occurs
Why are regular trauma reviews required?
Following the dental trauma, your dental clinician will inform you of how regularly follow-up visits are required. This will depend on a case-by-case basis, but in general, trauma reviews will be regular, such as 2-4 weeks after the injury, followed by several 1-3 month reviews, then 3-6 month reviews, then every 6 months. These reviews are a necessity to monitor the health of the affected tooth and each review may include special nerve tests and radiographs (xrays). Radiographs are vital to review how the tooth is healing underneath the gums and to check for the presence of infections.
What can happen to a tooth after dental trauma?
- this will greatly depend on the severity of the injury, the type of injury involved, the development of the tooth, and what emergency dental care was completed after the injury
- possible complications can include pain/discomfort, swelling, loosening of teeth, nerve dying, nerve infection (necessitating root canal treatment), loss of tooth
- in some cases of trauma to adult teeth, a referral to a specialist endodontist is recommended, especially if a root canal treatment is required
How to prevent future dental trauma?
- post-traumatic injury dental visits (as previously discussed)
- regular dental check-ups
- wearing a mouthguard