The impact of dental trauma on baby teeth

Traumatic dental injuries frequently occur in 1 to 4 year old children. At this age, children are developing their walking and coordination skills and are more liable to fall. In children aged 5 onwards, dental injuries often occur due to sporting accidents.

WHY IS IT IMPORTANT TO SEEK DENTAL HELP FOLLOWING DENTAL TRAUMA? 

Most of the time tooth injuries are superficial and will heal quickly in a developing healthy child. However, at times dental trauma can be severe, and it could potentially disturb the development and health of the underlying permanent teeth.

Early detection is important, and this is why every parent should know how to identify signs of more serious dental trauma. In order to achieve an optimal treatment outcome, a prompt assessment by a paediatric dentist is essential. 

FRACTURED BABY TEETH 

The most common injury to the tooth in children is an enamel fracture. It is important to seek an opinion from your local dentist to ensure that fractures are only confined to the enamel and not deeper into the dentine or nerve/blood vessel (pulp) of the tooth.

A dental fracture can involve the crown (the portion of the tooth above the gum) or the root (the portion of the tooth below the gum) of the tooth.

Dental trauma to the crown may involve the enamel, dentine or pulp of the tooth. 

• Enamel only fractures often do not require any treatment.
• When the dentine or pulp are involved in the fracture, these injuries become time critical and often require treatment involving the dentine or pulp (pulpotomy).

DISPLACED OR LOOSE BABY TEETH

Sometimes the force of the injury is severe enough to displace the tooth in the bony socket that it sits in.

Below are common symptoms of displacement (also called luxation) injuries: 

• Bleeding from the gums around the tooth.
• Mobility or loose tooth/teeth.
• Displaced tooth/moved from its normal position.
• The tooth/teeth are tender to touch/chew with.

It is always helpful to seek attention from a paediatric dentist in cases of traumatic dental injuries so that an appropriate diagnosis can be made following which a treatment course can be formulated.

There are three ways that baby teeth can be displaced that are more severe:

• Intrusion: the tooth is pushed into the tooth socket and it looks shorter or absent.
• Extrusion: the tooth is partly pushed out of its socket and it looks longer.
• Lateral luxation: the tooth is displaced sideways, palatally or towards the lip.
• Avulsion: the tooth is entirely displaced from its socket.

Intrusion injuries present a high risk of damage to the developing teeth. Treatment will depend on the relationship between the root of the baby tooth and the crown of the permanent tooth. While radiographs (x-rays) can help, most times we will allow these teeth to naturally re-erupt into the mouth. In cases of severe intrusive injuries we may need to extract the tooth to avoid potential complications to the underlying adult tooth.

For extruded or laterally luxated teeth, the tooth should always be monitored even if there has only been a mild displacement. It may need to be extracted if the displacement is severe.

With any type of displacement from dental trauma, a long-term clinical and radiographic follow-up is essential to monitor the vitality of these teeth and to ensure that there is no delayed infection of the root which can damage the developing permanent tooth.

AVULSION

In severe injuries the tooth can be completely displaced or removed from the bony socket. We do not replant (put teeth back) baby teeth as the risk of infection and damage to the adult tooth beneath is too high. A visit from the tooth fairy is a far better outcome 🙂

Dental trauma can sometimes affect the developing teeth. Most of the time the effects are quite mild. In some cases the injury may affect development and eruption of the adult tooth significantly. 

WHAT TO LOOK OUT FOR AFTER DENTAL TRAUMA

• Bleeding from the gums
• Increased tooth mobility
• Pain when chewing or touching affected teeth 
• Discolouration – can be a mild yellow or grey discoloration of the tooth. 

In some cases, the pulp inside the tooth can die as a reaction to the trauma. This can present as a small pimple in the gum around the affected tooth/teeth and in more severe cases as a facial swelling outside the mouth.

It is important that you contact us should this occur.

Regardless of the type of dental injury, regular follow up is crucial to diagnose any conditions and issues early. Your dentist will advise you of what to expect and the guidelines for follow up that is routinely recommended following a traumatic dental injury.

GET IN TOUCH WITH US SO WE CAN HELP 

If your child has experienced dental trauma, then, the first thing you can do to help is stay calm and ensure your child is okay. Once all the tears and blood (if any) are all gone, carefully inspect the injured baby tooth to see if you can get a clearer picture of what has happened. 

If you’re unsure about the next steps then please get in touch with the team at MPD and we will be happy to help. 

If your child is overdue for their next appointment give us a call on (02) 9188-0202 or book online here. 

This article is intended to promote understanding of and knowledge about general oral health topics and to help begin the conversation with your children’s dentist. It should not be used as a substitute for professional advice, diagnosis or treatment. Always seek the advice of your health care professional prior to incorporating this as part of your child’s diet or health regimen.