May 15, 2014

Dental Trauma

        Accidents happen!  The majority of people have had trauma to their teeth at some point in their lives. Depending on whether the trauma is to a primary/ baby tooth, or to an adult/ permanent tooth is an important distinction for both the outcome and treatment of the tooth.

        Trauma is even more common in children, whether from roughhousing with siblings, playing sports or sometimes just falling down.  If a baby tooth is knocked out, it is unlikely to cause long term problems, but it's always important to contact our office to evaluate the area.  

When a primary or baby  tooth is knocked hard enough to loosen, but not completely out of the mouth it will again be important to call our office for evaluation.

        Sometimes baby teeth are hit hard, but don't loosen or get knocked out.  In these cases there are a couple of possible outcomes.  The first possibility is mild soreness that resolves anywhere between a few hours to several days.  For these cases I would recommend over the counter childrens tylenol or motrin.  In these cases it is not uncommon for the tooth to change color just like a bruise. Teeth can have a tint of purple, blue, pink, grey or brown for several months but often times just like a bruise they return to the normal color.  

        The third possibility is less likely but important to be aware of, in some instances of trauma the nerve of the tooth slowly dies and an abscess or boil forms on the gums below the tooth.  This can occur anytime up to several months after trauma to the tooth.  It is important to contact our office right away so we can get your child on an antibiotic and make an appointment to likely have the tooth removed.  If not treated an abscessed baby tooth could damage the underlying permanent or adult teeth.

         Unfortunately, not all trauma happens to baby teeth.  Usually by age 6 or 7 kids will have their front permanent teeth, giving them many years to fracture or knock them out.  A knocked out permanent tooth is a Dental Emergency and it is important to call Dr Gill ASAP.  If the person has had serious injury or is unconscious, first call 911!  Otherwise, follow the following steps if you or your child has a tooth broken or knocked out.

  1. Collect the teeth or tooth fragments.  Handle teeth carefully as damage may prevent saving them.  Touch only the top part of the tooth, not the root.  Rinse gently if necessary.  Do not scrub, scrape or use alcohol to remove dirt.
  2. Re-insert or store teeth.  Rinse mouth with warm water.  If possible place the tooth back into the socket and bite down on gauze or a towel to keep the teeth in place. If you cannot re-insert the teeth, then place them in whole milk or coconut water to prevent them from drying out.  If not placed back into the socket or in milk right away, it will reduce the chance of keeping the tooth long term.
  3. Control bleeding with sterile gauze or cloth.  For pain and swelling apply an icepack or encourage your child to suck on a popsicle.  For pain take ibuprofen or tylenol.
  4. Call our office immediately.  The sooner you can get the teeth back into place and see Dr Gill the more successful the chance of the tooth surviving.

If you or your child are having a dental emergency call our office at (360) 794-9055!  If after hours, there is always a number to reach someone from our office on the answering machine.