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Tooth injuries are an unfortunate reality, especially for young children who have not developed the best coordination and muscle control. Many times, tooth injuries are superficial, and they heal just as quickly as an injury to any other part of a fast-growing child’s body.

However, other times, the injury can be severe, and it could potentially affect your child’s dental health for years to come. Every parent should be prepared for tooth injuries and know how to detect the signs of more serious harm.

When a Tooth Is Chipped

The most common injury to a tooth is a chip. Young children might chip a tooth when falling, playing at the park, or even when taking a bath at home. Chipped teeth are not usually a dental emergency, but you should make an appointment to have the tooth examined shortly after the accident.

Some chips are not serious. They may not even extend deep enough to harm the tooth. If your child is very young and the chip is shallow, your dentist might recommend waiting a year or two before filling the chip so your child will be able to sit still for the appointment.

However, some chips can break through the enamel of a baby tooth, exposing the soft dentin underneath. These chips will need to be filled immediately to prevent further decay. Don’t rely on your exam to determine whether or not a chip is serious. Some chips may look mild, but even a hairline crack in the dentin will expose the tooth to harmful bacteria.

When a Tooth Is Knocked Loose

When your child’s tooth is knocked hard enough to make it loose in the socket, there can be some cause for concern, but your child will normally recover quickly. Your child might:

• experience some bleeding from the gums around the tooth.

• have some swelling, like a bruise, from the force of the blow.

• complain of some tooth pain and soreness.

• have trouble chewing with the loose tooth.

These are normal symptoms of a loosened tooth because of trauma. The best solution is to encourage soft foods and to keep your child from playing with the loose tooth as it resettles and heals. However, you should still have the tooth examined by a dentist, because sometimes a tooth can have deep nerve damage.

In rare cases, the permanent tooth might become damaged, especially if the baby tooth is forced upwards into the socket. An x-ray will help determine whether or not there is any damage.

When a Tooth Is Lost

With a lot of external force, your child may lose his or her tooth. Usually, if the tooth is primary or baby, your dentist might recommend just allowing the Tooth Fairy to come and collect the tooth. Replacing the tooth might affect the growth of the primary tooth, and it’s often not worth the risk. A spacer can help keep your child’s teeth from crowding.

A dental exam is still necessary to make sure that there are no underlying problems from the accident, but you won’t have to worry about chewing food or speech problems. It will only be a short while before the primary tooth comes to fill in the gap.

Dangers and Concerns

Each of the above situations can lead to more serious dental problems. Parents might become concerned to see a tooth turning grey or brown shortly after trauma. This is normal for damaged teeth.

Think of the discoloration as a bruise. Increased blood flow to broken vessels in the tooth leads to the grayish tinge. It sometimes fades, but many times, the tooth will stay slightly darker than its fellows. The lack of rich blood supply to the tooth will not fully resolve the change in color. In a baby tooth, this is not a concern most of the time.

In months following the trauma, whether it was a chip or a loose tooth, be careful to watch the tooth for signs of trouble. Even if the color does not fully return, the tooth could be perfectly healthy, and it will remain that way with the right hygiene.

In rare cases, though, sometimes the pulp inside the tooth can die as a reaction to the trauma and reduced blood flow to the tooth. An abscess will form. These infections are painful and often result in tooth loss for young children. The only other alternative is a root canal, but the care and expense required is often too much for a baby tooth, considering the tooth will fall out to make way for adult teeth.

Signs of an abscess include a high fever, gum and facial swelling, and great pain. Some children may not be able to communicate the pain they are feeling. For example, if a front tooth becomes abscessed, a child might complain of nasal pain, even though the infection is based on the root of the tooth.

Abscesses are a medical and dental emergency because these infections can spread and infect tissue throughout the body. Treatment includes rounds of antibiotics to fight the infection and the removal of the tooth.

Prevention of Teeth Trauma

One of the ways that parents can reduce the chances of mouth and dental injuries during recreational and sports activities is to have the child wear a mouthguard.

Mouth injuries can be prevented by teaching children not to put anything except food or drinks in their mouths. It is also important that children learn to sit while eating and drinking, particularly while using a straw or eating food on a stick (eg, popsicles, lollipops). Eating in the car can also lead to injuries, especially if the child is in a seat where an airbag could deploy.

Mouthguards can significantly reduce the risk of mouth injuries and the incidence of jaw fracture in athletes. The American Dental Association (ADA) and the Academy for Sports Dentistry (ASD) recommend properly fitted mouthguards for a variety of recreational activities and sports that place participants at risk for oral injury.

There are three main types of mouthguards:

●Stock mouthguards fit loosely over the upper teeth; they are not individually shaped. Stock mouthguards may interfere with breathing and speech because the wearer must hold the upper and lower teeth together to prevent the guard from moving.

●Self-adapted mouthguards, also known as “boil and bite” mouthguards, can be individually shaped. The wearer heats the guard in boiling water and bites into the warmed plastic for a customized fit. Self-adapted mouthguards are moderately priced and usually stay in place. However, they are subject to bite-through problems and are not as strong as custom-made mouthguards over time.

●Custom-made mouthguards are made by a dentist. The dentist takes an impression of the athlete’s mouth, makes a cast and then hen forms plastic around the cast. Custom-made mouthguards provide better protection, are more comfortable, and are more likely to stay in the mouth compared with other models. However, they may be more expensive than some athletes can afford. Self-adapted mouthguards are a reasonable alternative in this case.

Mouthguards should be stored in a plastic protective container. They should be regularly inspected for distortion, bite-through, and tears. They should be rinsed with water before use and washed after each use in cold or lukewarm water. They also may be cleaned with toothpaste and a soft-bristle toothbrush and rinsed with mouthwash. Daily washing minimizes the build-up of saliva, bacteria, and debris.




We love our patients and love to help them form healthy dental life that will last them a lifetime. For more information call us to answer all of your questions so get an appointment today.