What to do when your child has dental trauma

I recently had a mother come into the surgery with her two-year-old child after they had fallen at the playground and hit their front teeth. As you can imagine both mother and child were very distressed. It made me think about what to do in these situations. What would be useful for parents to turn to a reputable source for what to do and what to expect when their child has dental trauma in their mouth? 

As children go from crawling to walking to bike riding and various other activities, they are bound to have injuries. When a child has dental trauma it is always important to call your family dentist and come in for an exam.

At home, you can perform the following steps:

• Clean the area with a wet face cloth if possible. 
• Give your child some Panadol.
• If the teeth are mobile avoid hard chewy foods.
• If the tooth has come out completely, place it in either your saliva in a container or some milk and bring it to the dentist with you. Do NOT wash the tooth with water- this will kill the periodontal ligament cells around the tooth!
• Use an icepack on a traumatised lip to reduce swelling.
• Call your dentist ASAP and they will fit you in that day.

Your dentist will most likely check for the following:

If they are younger than five, they will most likely do a visual check. X-rays are often too hard to take on a distressed child at this young age. If they are five or older, they will usually take an X-ray of the area. This will allow the dentist to see if there is any root fracture or sign of a developing infection. It provides a baseline for further X-rays at a later date.

• The dentist will check to see if the tooth is chipped/mobile/intruded or avulsed (completely fallen out of the mouth).
• If it is a minor chip the dentist will do nothing and just monitor the tooth. 
• If the chip is severe and the nerve is close to exposure, they may try to seal the tooth with a filling material. 
• If the tooth is mobile, they will advise a soft diet for 2 weeks and review in 1 week. 
• If the tooth is intruded into the gum, they will monitor it over a few weeks. In 90% of cases, a partially intruded tooth will re-erupt. 
• If the tooth is completely avulsed (out of the mouth) and it is a baby tooth, the dentist will likely leave the tooth out. Then recommend a review appointment for a space maintainer for the child (age dependent of course). If it is an adult tooth, they will try to re-implant the tooth back into the socket.
• The dentist will also be checking for any sign of concussion, lacerations to the lips, cheeks, inside of the mouth, signs of an infection and any debris. They will advise a soft diet for 2 weeks. 

Check-ups after the dental trauma

It is important to review your child’s mouth with your dentist one week later. Then again one month later and every six months after that after a dental trauma event.

In mild dental trauma cases, often the teeth can rebound back. In more severe cases the tooth can die. Things to watch out for are tooth discolouration, swelling of the gum around the tooth or a small pimple in the gum above the tooth.

Facial swelling after tooth trauma is a medical emergency and should be addressed ASAP at your nearest hospital. Check-in with your child if they are experiencing pain with this tooth in the first 6 months after trauma. If there has been trauma to a baby tooth sometimes the subsequent adult tooth can be affected. Your dentist will be closely observing for any differences in the adult tooth’s anatomy. They will keep an eye on this when it erupts and if there is any delay to its eruption.

Hopefully, this blog helps you feel more equipped if a dental emergency happens on your watch. If you’d like to explore our amazing purpose build early education centres, you can book a tour or send us a message.