Dental injuries are common in children during their growing up years.
Studies have shown that approximately 35% of children would have
suffered some form of dental injury by the time they are 5 years of age.
In younger children, their coordination and judgement are incompletely
developed and majority of falls happen in and around the house as they
become more inquisitive and start to explore their surroundings. In
older children, most injuries are a result of falls or collisions while
playing and running.
Dental injuries may result in small chips of
the tooth to completely avulsed (knocked out) teeth. It is important to
note that if the child is experiencing any of the following symptoms due
to the accident (loss of consciousness, dizziness, disorientation,
unable to open the mouth, teeth do not fit together properly or bleeding
from the noes or ears), he/she should be sent to the hospital
immediately for management.
Chipped/ Broken Tooth- Hoo Swee Tiang
There
are different levels of severity for chipped teeth, ranging from a
small enamel chip to a fracture involving the nerves of the teeth.
Oftentimes, the chipped tooth will have sharp edges that may cut the
lips or tongue, and cause the situation to seem much worse than it
really is. In such situations, apply gentle pressure to the bleeding
areas with a clean gauze or cloth and try to locate any broken fragments
of the tooth. Do visit your dentist at the earliest time possible.
Generally,
small chips can be repaired, smoothened down or left alone. In cases
where the fractured portion involves the nerve of the tooth, nerve
treatment may be required. Dental x-rays are recommended to check for
other possible injuries and to ensure that no broken tooth fragments are
lodged in the oral soft tissues, eg lips, cheeks and tongue.
Bleeding Gums- Hoo Swee Tiang
Bleeding gums due to dental injury is not uncommon and can have a wide range of causes.
In
many cases, the gum bleeding is due to superficial cuts on the gums or
impact trauma to the supporting tooth ligaments. These can bleed readily
but usually pose no danger to your child. It is important not to panic
in these circumstances and try to render the best possible first aid.
Other causes of gum bleeding can be from deeper lacerations of the gums or injury / fracture of the tooth and surrounding bone.
In
most of the above cases, the immediate concern will be to manage the
bleeding situation. Application of a gentle pressure with clean gauze /
cloth for a few minutes will often significantly reduce or stop the
bleeding. This not only calms the child but also allows a better
assessment of the extent of injury. When the bleeding has stopped, it is
often found that the actual injury is not as bad as initially imagined.
Do consult your dentist as soon as possible for the appropriate follow
up management.
Knocked out permanent teeth- Hoo Swee Tiang
In
the event of accidental trauma, avulsion (knocking out) of the adult
tooth usually causes the most alarm to the child and their loved ones.
While it is understandably disturbing, it is important to remain as calm
as possible and take the following steps to increase the chances of a
successful replantation by your dentist.
1) Hold the tooth by the crown and do not touch the root.
2) If the tooth is dirty, wash the tooth briefly (approximately 10 seconds) under cold running water. Do not scrub the root.
3)
Replace the tooth into the socket, or place it in milk. If replaced in
the socket, bite gently on a handkerchief or cloth to retain it in
place.
4) Attend a dental clinic as quickly as possible.
The critical factors for a successful replantation are:
1) The time interval between the accident and when the tooth is replaced in the socket / placed in milk to protect it.
2)
The transport medium the tooth is placed in. The best medium is the
tooth's own socket.
However, other mediums of similar osmolarity as our
body cells, such as milk and normal saline, are acceptable alternatives.
In the same vein, wrapping the tooth in tissue dries up the cells and
should not be done.
3) The amount of time lapsed between the
accident and when the avulsed tooth is replanted by a dentist. The
sooner a dentist gets to manage the tooth, the better the chances for a
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