Trauma

Dental Injuries

One of the most distressing times for a parent is when their child has a dental injury. In my experience, it’s the parents that are the ones crying, and the injured child often doesn’t seem too bothered at all! When it’s your turn to pick up the pieces (hopefully not literally) after a playground dental accident here are some guidelines.

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Firstly, I just want to mention something that often gets overlooked in the panic. This is the possibility of head injury. If the child has a suspected head injury, prioritise that first. Brain trumps teeth every time.

Fracture

A fractured tooth is exactly that. Half of the tooth is still attached to the child, and the other half is in the wood chips at the bottom of the slide. If you can, retrieve the tooth fragment to take to the dentist. Re-cementing the fragment, or essentially gluing it back together can be a very successful treatment. If the fragment can’t be found, white filling material can be so closely matched to the natural colour of the tooth, no one would ever know. There is the possibility that the nerve of the tooth has been exposed in which case it may need root canal treatment (not as scary as in the movies).

Displacement

A displaced tooth is when a tooth is still in, but has been pushed either up, down, to either side, or has rotated. If this happens, just leave the tooth where it is and go straight to your dentist who will gently move it to where it should be, and splint it in place. Time is of the essence with displaced teeth, the sooner it is moved back into line and stabilised, the better the outcome. Again, there is the possibility of root canal treatment down the track.

Avulsion

An avulsed tooth is one that has been knocked right out. The aim for these teeth is to be successfully re-implanted, however, there are a few important things to remember.

Only touch the tooth by the crown (the white part), the root surface has cells important for re-implantation that need to stay there. If the tooth is dirty it can be briefly rinsed with milk or water, but never wipe or brush the root surface. You may not get it perfectly clean, but that’s okay, your body can handle the last little bit of dirt itself.

If the tooth is an adult tooth, it can be replaced back into the socket. Ask the child to gently bite on a handkerchief or piece of gauze to keep it in place. If this cant be done, the tooth can be placed in a glass of milk, Hanks balanced saline solution (not many people have this handy at the playground, but you never know.), saliva, or if the child is older and won’t swallow it, between the cheek and the molars. Again, getting to a dentist straight away is most important. The longer the tooth has been out, the less chance it has of successfully re-implanting. It is important to note that baby teeth are not to be re-implanted, as there is the risk of disrupting the adult tooth growing underneath.

If all else fails and there ends up being a gap, still don’t panic too much. There are still implants,  bridges, plates and whatever science thinks up in the future to go through, before your child ends up toothless. Luckily, dentists can do all sorts of wonderful things to repair or replace teeth, so if you are a parent of the daredevil breathe a little easier.

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