Dental injuries

Dental injuries

What are dental injuries?

Dental injuries or dental trauma occurs when the tooth receives some sort of a blow. This can happen in a number of ways, such as while playing sport or as the result of a car accident.

The tooth may be knocked out, loosened or broken (fractured). It is important to act immediately if you suffer a dental injury, otherwise you may lose the tooth.

What are tooth fractures?

A tooth fracture is also known as a broken tooth. The fracture may be minor, for example the enamel (the hard outer surface of the tooth) may be chipped. In such a case, the tooth is not displaced and there is no bleeding from the gums.

A fracture may include both the enamel and the dentine (the layer under the enamel). The tooth is still not displaced, and there is still no bleeding. However, this needs to be treated as soon as possible because if the dentine is over-exposed to oral bacteria this may lead to death of the pulp (the living tooth tissue). This in turn can result in serious infection.

In a serious fracture, the pulp may be exposed or damaged, the tooth may be loose and the gums may bleed. In such cases, extraction of the affected tooth or root canal treatment may be required.

My five-year-old had her two front teeth knocked out. The dentist did not replace them. Why?

Because of their position, the upper front permanent teeth are the most common teeth to be knocked out. This is especially true for children with protruding front teeth. Knocked out primary (baby) teeth are usually not re-implanted because they will be replaced naturally by permanent teeth later. Also, re-implanting the primary teeth may damage the permanent teeth underneath.

If, however, the teeth that have been knocked out are your permanent teeth, then you have to act fast. The teeth should be re-implanted as soon as possible. Teeth re-implanted within one hour of an accident often reattach to their sockets.

What should I do if I get a tooth knocked out?

Speed is essential here. If you or somebody you are with has a tooth (or multiple teeth) knocked out, locate the tooth and rinse it in milk. Then place it back into the socket from which it came. If you have to travel to the dentist, you can do this yourself or somebody with you may help you.

Make sure you only handle the tooth by the crown (the visible part of the tooth that you see in a person’s mouth). Do not touch the root.

If you are uncomfortable with re-implanting and think you can make it to a dentist in time, then store the tooth in a moist area. Milk is preferable. If the person is old enough and hasn’t gone into shock, they may store the tooth under their tongue.

After the dentist re-implants the tooth, he can then splint it to the adjacent teeth. You may need this splint for up to two months. If you have a splint, you will have to eat soft foods and avoid eating with the splinted teeth.

In adults, the re-implanted tooth will usually undergo root canal treatment in the weeks following the accident.

Children who have their permanent teeth knocked out may not require root canal treatment if their tooth root has not completely formed yet.

I was in an accident which resulted in one of my teeth being pushed backwards. What is the treatment for this?

A tooth can sometimes be displaced as the result of some sort of a blow to the mouth. The tooth can appear shorter or longer than normal or it may be pushed inwards or outwards, or even rotated.

A displaced tooth will probably require some sort of a brace to bring it back to its proper place. You will also have to be observed to see if the pulp was damaged as a result of the displacement. If so, you may require root canal treatment.

How can I prevent a dental injury?

It is essential that you protect yourself while playing particular sports such as rugby, football and basketball. Always wear a mouth-guard or a facemask where necessary. Protruding teeth are more at risk then properly aligned teeth so have these dealt with by a dentist/orthodontist as soon as possible. Always wear a seatbelt when travelling in a car, even as a back seat passenger.

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