We often see children come into the office with trauma to their front baby teeth. Pediatric dental trauma affects 30 to 40% of all children. Whether caused by a fall, or while playing a sport, impact can cause injury to the tooth. How tooth trauma is treated varies upon how severe the injury is.
When bringing your child to the dentist due to trauma, a maxillary radiograph (x-ray to patients front teeth) will need to be obtained to better assess the injury. After the radiograph is obtained the doctor can go over better treatment options and how to care for the injury when you leave the office.
When a baby tooth is bumped and has not shifted position, this is called a dental concussion. With a dental concussion there may not be mobility or bleeding, but there maybe tenderness with eating. With bumping a tooth, just like a bruise to the skin, the tooth may become discolored, tinting the tooth a grey color. Though the tooth is grey this doesn’t always mean this tooth is “dead” the tooth has the ability to heal and become white again. Keep in mind that if this tooth gets hit again it has a higher risk for more trauma.
If a tooth that was bumped appears to be mobile and bleeding is present at the gumline, this is called a subluxation injury. Typically with time this tooth has the ability to harden in place again and can be monitored or can abscess (formation of infection) and would have to be removed.
In some dental trauma situations, the baby tooth may appear to be in a different position, this injury is called luxation injury. This means that the tooth was partially displaced from the dental socket. This type of injury can cause the root of the baby tooth to damage the premature permanent tooth. Treatment options may vary with this type of injury.
At times when a tooth is bumped and a minor chip of the enamel is present, the tooth can be monitored – some doctors may file this down, but in many situations children have the ability to naturally wear small chips down with grinding or eating. If the tooth is severely fractured, the dentist will want to check that there is no root exposure. If root exposure is evident, your doctor will give you treatment options depending on your child’s age and temperament in an office setting. In other cases the tooth is completely knocked out of the dental socket – if so, we do not suggest that the tooth is placed back into the socket.
Regardless of how severe the injury is, it can be traumatic for everyone involved. It’s best to put a cold press (if tolerable) on injured area, and stay on a soft food diet. Keep in mind that treatment may vary and we ultimately want what is best for the development of the permanent tooth 🙂