Traumatic Dental Injury: What To Do
By Dr. Lida Alimorad
Dental trauma in children is one of the most common injuries and it is important to act quickly and appropriately to manage dental trauma in children to prevent further damage and ensure the best possible outcome. This guide will cover the essentials of dental trauma prevention and management, providing valuable insights for parents, caregivers, and dental professionals.
Types of dental injuries
1. Tooth fracture:
Enamel fracture: A minor chip or crack in the outer layer of the tooth.
Enamel-dentin fracture: A fracture that involves both the enamel and dentin (the layer beneath the enamel).
Crown fracture with pulp exposure: A fracture that exposes the inner pulp of the tooth, which contains nerves and blood vessels.
2. Tooth displacement:
Concussion: The tooth is tender to touch but not displaced or mobile.
Subluxation: The tooth is slightly mobile but not displaced.
Luxation: The tooth is displaced but still in the socket.
Intrusion: The tooth is pushed inward into the jawbone.
Extrusion: The tooth is partially pushed out of the socket.
3. Tooth avulsion: The tooth is completely knocked out of the socket.
4. Soft tissue injuries: Injuries to the gums, lips, tongue, or other soft tissues in the mouth.
What to do in case of dental trauma?
1. Stay calm: It’s important to remain calm to avoid additional stress or anxiety for the child.
2. Assess the situation: Check for any visible injuries to the teeth, mouth, or surrounding tissues. Determine if there is any bleeding, swelling, or pain.
3. Manage bleeding: If there is bleeding, apply gentle pressure to the area with a clean cloth or gauze.
4. Tooth fracture: If a tooth is chipped or fractured, try to locate the broken piece, and store it in a clean container. Rinse the child’s mouth with warm water to clean the area. Contact your dentist as soon as possible for an evaluation and treatment.
5. Tooth displacement: For luxation or extrusion injuries, gently try to reposition the tooth in its original position if possible. Avoid forcing the tooth into place. Seek immediate dental care.
6. Tooth avulsion:
If a permanent tooth is knocked out, try to locate the tooth and handle it by the crown (avoid touching the root part of the tooth).
Rinse the tooth with saline or milk if dirty, but do not scrub it.
If possible, try to reinsert the tooth into the socket and have the child bite down on a clean cloth to hold it in place. If reinsertion is not possible, it’s critical to keep the tooth moist to preserve the cells on the root surface.
7. Place the tooth in one of the following:
A container of milk.
The emergency tooth preserving system Hank’s balanced salt solution.
The child’s saliva (inside the mouth next to the cheek or under the tongue if the child is old enough to avoid swallowing it).
8. Pain management:
Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can be used to manage pain, but avoid giving aspirin to children.
A cold compress can help reduce pain and swelling.
There are specific scenarios when you should not attempt to replace an avulsed tooth:
1. Avulsed primary (baby) teeth: do not reinsert. Primary teeth should not be reinserted into the socket. Attempting to do so can damage the underlying developing permanent tooth, potentially leading to future dental issues such as misalignment or damage to the permanent tooth bud.
2. Child’s medical condition: If the child has a compromised immune system or children with certain heart conditions, particularly those at risk for infective endocarditis, may face additional risks if the tooth is reimplanted.
Prevention of dental trauma
1. Mouthguards: Encourage the use of mouth guards during sports or activities where there is a risk of dental injury.
2. Childproofing: Childproof your home to minimize the risk of falls and accidents that could lead to dental trauma.
3. Education: Teach children about the importance of protecting their teeth and avoiding activities that could lead to injury.
When to see a dentist?
Any dental trauma should be evaluated by a dentist as soon as possible, even if the injury seems minor. Immediate dental care is especially important for tooth avulsion, significant fractures, or if there is severe pain, bleeding, or tooth mobility. In the event of an accident, quick action, followed by professional dental care, is essential to manage the injury effectively. Our team is well trained and equipped to take care of your child in the event of traumatic injury. Schedule an appointment with Dr. Lida at Wilmington Pediatric Dentistry by calling 302-933-9900 or visiting www.wpdde.com.
Bio
Lida Alimorad, DDS. is an AAPD board-certified pediatric dentist. Before opening Wilmington Pediatric Dentistry she completed her post-doctoral pediatric dentistry residency at Nemours Children’s Hospital in Wilmington, DE and took a position as a hospital dentist there after graduating where she worked with children with a wide variety of special medical and dental needs. Dr Alimorad is inspired to build and grow the team at Wilmington Pediatric Dentistry and provide outstanding pediatric dental services in the area.
Dr. Alimorad graduated in 2010 with a degree in General Dentistry from the oldest dental school in the world at University of Maryland. After graduating from dental school, Dr. Alimorad served as dental director for 8 years at CCI Health and Wellness Services, a nonprofit organization, where she and her staff treated the underserved, underinsured, and refugee populations in the Capital Region of Maryland. Dr. Lida completed her post-doctoral pediatric dentistry training at Nemours Children’s Hospital in 2021 and stayed on board as an attending faculty at Nemours Dental clinic. In July 2023 she proudly opened Wilmington Pediatric Dentistry in Pike Creek, DE offering dental care to patients ranging in age from infants to young adult for routine dental care, emergencies, mild sedation and hospital dentistry.
Schedule your appointment with Dr. Lida Alimorad at Wilmington Pediatric Dentistry by calling 302-933-9900 or visiting www.wpdde.com
Wilmington Pediatric Dentistry
3105 Limestone Road, Suite #305, Wilmington, DE
302-933-9900
Monday -Friday 8am-5pm