dental accidents and trauma

According to the American Academy of Pediatric Dentistry (AAPD), the greatest incidence of trauma to the primary teeth occurs at 2 to 3 years of age, when motor coordination is developing. Having an established dental home within six months of the eruption of the first teeth or by age one is the first step towards preparing for possible tooth trauma and setting your child up for a lifetime of healthy smiles. 

As a mother and pediatric dentist, Dr. Halley White knows how difficult and stressful dental trauma can be for children and their parents or caregivers.  Accidents happen as children grow and develop their gross motor skills. Along the way there are many bumps and bruises before motor skills are finely honed; however, these tumbles which can seem harmless at first can lead to permanent oral damage if not cared for properly.  Tooth trauma can occur without a parent or caregivers knowledge and often times most children receive little, if any, visible damage to their primary teeth. However, according to findings from the AAPD, there could be hidden problems that have occurred to the bone or teeth which can result in “significant negative functional, aesthetic, and psychological effects on children”.  As an established patient with a pediatric dentist, a child has a better chance of receiving appropriate emergency dental care in a timely manner as opposed to a child that has not previously seen a dentist.  Established patients can contact their dentist on call to seek advice concerning an accident and then follow the doctor’s instructions concerning follow-up care.  Children without a dental home who experience trauma should seek assistance from their pediatrician.  Their physician may in turn refer them to a pediatric dentist for care.  Current active patients of Dr. Halley or referred patients with dental trauma will receive a thorough exam of the area and radiographs if necessary.  Treatment recommendations vary depending on the location and severity of the trauma.

 The following are signs to look for in the weeks and months following dental trauma:

• Color Change: Traumatized teeth may discolor.  The discoloration may vary from light gray or yellow or possibly dark grey or brown.

• Abscess: A “gum boil” or bubble may form above the traumatized tooth.  Call your dentist immediately if an abscess is spotted.  An abscess may look like a blister or swollen area on the gum.  

• Swelling: Generalized swelling may occur in the vicinity of the traumatized teeth/tooth and can cause temporary lip or facial disfiguration.

• Mobility: The traumatized teeth/tooth may become very loose even after they have initially tightened after the incident.

• Discomfort: Complaints of discomfort associated with the affected area can occur.  A child may not want to use their teeth for biting or chewing and may complain of pain in the area.

Extra-Oral Wounds 

• Using a Q-Tip, gently cleanse the wound with warm soap and water.

• Pat the wound dry.  Liberally apply Polysporin or Bactroban ointment two times daily: morning and bedtime.

• Have child wear a bandage or non-stick dressing during the day-this will keep the area clean and covered.

• At bedtime apply a thin layer of ointment and leave uncovered.

• If stitches are necessary, follow the above steps as long as the stitches are present.

 

Please have your child eat a soft diet for the first 5-7 days after the trauma.  Hard foods such as apples or raw carrots may further aggravate the area.  Children’s pain medicine may be taken every 4-6 hrs or as needed for discomfort.  In most cases, Dr. Halley will want to examine your child within 4-12 weeks following the incident.  In addition, a follow-up x-ray may be required to help monitor the condition of the areas unable to be seen by the naked eye.  Please call Dr. Halley’s office if any of the changes listed above occur or if you have any additional questions.

For more information on establishing a dental home please visit the American Academy of Pediatric Dentistry at http://www.aapd.org/.