Traumatic Injuries

Dental avulsion (knocked-out tooth)

If a tooth has been knocked out of the child’s mouth completely, it is important to contact the dental office immediately. In general, dentists do not attempt to reimplant avulsed primary (baby) teeth, because the reimplantation procedure itself can cause damage to the permanent tooth bud, and thereby may damage the emerging permanent tooth. Dentists always attempt to reimplant avulsed permanent teeth, unless the trauma has caused irreparable damage. The reimplantation procedure is almost always more successful if it is performed within one hour of the avulsion, so time is of the essence. How you can help:

1. Recover the tooth. Do not touch the tooth roots, handle the crown only.

2. Rinse off dirt and debris with water without scrubbing or scraping the tooth.

3. For older children, insert the tooth into its original socket using gentle pressure, or encourage the child to place the tooth in the cheek pouch. For younger children, submerge the tooth in a glass of milk or saliva (do not attempt to reinsert the tooth in case the child swallows it).

4. Do not allow the tooth to dry during transportation. Moisture is critically important for reimplantation success.

5. Visit the dental office or take the child to the hospital emergency room immediately, time is critical in saving the tooth.

Dental intrusion (tooth pushed into jawbone)

Sometimes, dental trauma forces a tooth (or several teeth) upwards into the jawbone. The prognosis is better for teeth that have been pushed up to a lesser extent (less than 3mm), but every situation is unique. Sometimes the force of the trauma is great enough to injure the tooth’s ligament and fracture the tooth socket. If dental intrusion of either the primary or permanent teeth is suspected, it is important to contact the dental office immediately. Depending on the nature and depth of the intrusion, the dentist will either wait for the tooth to descend naturally, or perform root canal therapy to preserve the structure of the tooth. How you can help:

1. Rinse the child’s mouth with cold water.

2. Place ice packs around affected areas to reduce swelling.

3. Use over the counter pain medications as needed.

4. Contact the dental office or proceed to the hospital emergency room.

Tooth luxation/extrusion/lateral displacement (tooth displacement)

Tooth displacement is generally classified as “luxation,” “extrusion,” or “lateral displacement,” depending on the orientation of the tooth following trauma. A luxated tooth remains in the socket, with the pulp intact about half of the time. However, the tooth protrudes at an unnatural angle and the underlying jawbone is oftentimes fractured. The term “extrusion” refers to a tooth that has become partly removed from its socket. In young children, primary tooth extrusions tend to heal themselves without medical treatment. However, dental treatment should be sought for permanent teeth that have been displaced in any manner in order to save the tooth and prevent infection. It is important to contact a dentist if displacement is suspected. How you can help:

1. Place a cold, moist compress on the affected area.

2. Offer over the counter pain relief as needed.

3. Contact the dental office immediately.