Dental Trauma: “Sometimes a kiss is not enough”

Approximately 30% of children have experienced dental injuries at some point in their childhood. The peak period for trauma to the primary teeth is between 18 and 40 months of age. Toddlers are increasingly mobile and curious but they are often quite uncoordinated. Injuries to primary teeth usually result from falls and collisions as the child learns to walk and run. Coffee tables,unfortunately, are usually at the same height as toddlers’ mouths. This article is intended to provide you with information if your child does have a dental injury.

Immediately when an injury occurs, there are three common reactions you can expect. They are 1) looseness of the tooth, 2) bleeding and swelling, and 3) pain. First, looseness occurs because the bone that supports the tooth has been expanded by the injury. This makes the tooth looser than normal. The tooth will tighten up as the bone returns to its normal position. Next, bleeding and swelling occur as with any injury as a normal reaction to injured tissues. The gums may appear purplish around the tooth and there may be bleeding around the tooth. Fortunately, children usually do not suffer much pain from dental injuries. Occasionally, there will be discomfort if the child tries to chew with the injured tooth. As with any injury, the area should be “babied” to avoid aggravating the injury. Your pediatric dentist will help advise you as to how to manage your child’s discomfort.

Over time the injured teeth may change color; they may darken over time and may even turn quite dark. Usually the color will be charcoal gray, although it may be brown or yellow. This may begin to lighten again, however it will never turn back to its original snow white color before the injury occurred.

As with any injury, it should be monitored over time. Look out for changes in eating and sleeping habits such complaining about pain when eating or drinking something cold. Watch for gum boils which may appear in the area where the gums and lip meet. This is an area not seen when smiling, so you will need to stretch the lip to see. Any increased swelling, looseness, or pain will require the tooth to be re-examined by your pediatric dentist.

If a tooth chips or is knocked out, try to find the piece of the tooth or entire tooth to show to the dentist. Should a baby tooth be knocked out, they are not re-implanted like adult teeth; however, there are methods available to restore your child’s smile and reduce space loss. These options can be discussed with your dentist.

Of course, prevention is always the best strategy. Keep in mind your children’s teeth as you “baby proof” your home. When in doubt call your pediatric dentist should your child experience a dental injury.

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