Dental Trauma;  How to deal with broken or knocked out teeth

Approximately 50% of all children will experience some type of injury to either mouth or teeth at some point in their childhood.  Treatment for these injuries will depend upon the type of injury and whether or not we are dealing with a baby or adult tooth.

BABY TEETH

Injuries normally occur in this age group when they are learning how to walk and are quite unsteady on their feet.

Wobbly tooth;  the tooth can normally be left in place without carrying out any treatment unless the tooth has moved and is now affecting the child’s bite.  If this is the case, the tooth is normally removed as trying to move the tooth back into the correct position can damage the underlying permanent tooth.

If the baby tooth has been knocked out completely, DO NOT place tooth back in the gum as you could damage the permanent tooth developing within the gum.

Broken baby tooth;  it’s best to see a dentist as soon as possible so that they can determine whether or not the nerve or blood supply has been affected.  If so, the tooth will be removed.  If the broken tooth is not serious, the dentist may leave tooth as is, smooth off any sharp edges or place a filling but this will depend on how cooperative the child is.

ADULT TEETH

Knocked out tooth;  The tooth needs to be placed back into the socket ASAP, ideally within the first 15 minutes..

The following steps are recommended before re-implanting the tooth:

●Handle the tooth carefully by the top (crown)

●Remove any debris by gentle rinsing the tooth with saline or tap water; the tooth should not be scrubbed or steriled.

●Place the tooth by hand back into the socket.

●Keep the tooth in place by having the child bite on a clean towel or handkerchief.

●The child should see a dentist for treatment as soon as possible.

If you are not comfortable with placing the tooth into the socket yourself, place the tooth into a cup of the child’s own saliva and take it to a dentist immediately.

Loose permanent tooth; If the tooth has moved into an incorrect position, you need to see a dentist ASAP so they can reposition the tooth.  This may need to be carried out under local anaesthetic and may involve the tooth being splinted (attached) to the neighbouring teeth to help hold the tooth into position.

Broken permanent tooth;  depending on the size of the break, this may involve smoothing the broken tooth or filling the tooth.

Any trauma to permanent teeth will have to be closely monitored.  Your dentist may ask you to attend on a regular basis for reviews and X-rays.  The nerve inside the tooth may die and a root canal treatment may be needed at some point in the future.

MOUTH INJURIES

Tears may or may not need stitches.  If the wound continues to bleed after applying pressure, then seek advice from your local A&E department.

Puncture wounds; wounds to the back of the mouth/throat may occur if the child has a fall whilst holding something in their mouth such as a pen/pencil.  There is a risk of damaging large blood vessels so you need to seek advice from hospital straight away.

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