25% of school children experience dental trauma, and 33% of adults have experienced trauma to the permanent dentition, with the majority of the injuries occurring before adolescent phase. Proper diagnosis, treatment planning, and follow‐up are necessary to assure a favorable outcome.
Traumatic dental injuries frequently occur in children and young adults as they are more involved in sports activity. The other factor for dental injury is the development stage of teeth. So, there is no adequate anchorage to support the tooth in case of trauma or injury. Luxation injuries that are, tooth either knocked out or become mobile are the most common problems in the teeth, and crown fractures are more commonly reported in the permanent teeth.
How to Prevent and Manage Milk Tooth Injury?
A young child is often difficult to be examined and treated due to lack of cooperation and because of fear. The situation is stressful for both the child and the parents. It is important to keep in mind that there is a close relationship between the root of the injured milk or primary tooth and the underlying developing permanent tooth germ. Tooth malformation, impacted teeth, and eruption disturbances in the developing permanent teeth are some of the future problems that can occur following trauma to milk teeth and alveolar bone. A child’s maturity and ability to cope with the emergency situation, the time for the shedding of the injured tooth and the occlusion, are all the important factors that influence treatment. Repeated trauma episodes are frequent in children who have a previous history of trauma. If a child gets an injury, it is vital to get a dental checkup from your dentist or a pediatric dentist so that the dentist will be able to detect the severity of the injury and do timely treatment to prevent future adverse consequences.
Toddler age that is, children between1 to 3 years are very prone to falls as they would have just learned to stand and start walking on their own. So, parents should be very particular in this age to keep the children on observation and keep them away from sharp objects and ladder steps.
Management of Permanent Tooth Injury:
Maxillary teeth or upper front teeth are very much prone to trauma, and there are several other factors which increase the propensity of trauma to the teeth. They include children involved in contact sports, class 2 malocclusion (forwardly placed upper front teeth), children with special healthcare needs like epilepsy and motor function disorders. During regular dental visits, parents should be well informed about these conditions and how to manage dental trauma if it occurs.
Preventive measures like use of protective gears like a mouth guard and helmets should be worn by the children involved in contact sports to decrease the impact of trauma in case of injury. If an injury occurs, then a dentist should be called as soon as possible so that telephonically local measures are conveyed by the dentist and for permanent treatment rush to a dental surgeon for adequate management of the problem. If not managed on time the injuries have a long-term effect like dental developmental defects, discoloration of the tooth, tooth loss, psychological problems, etc.
In conclusion, professional help is always recommended in case of dental injury whether the patient is having pain or not. If managed on time, it decreases the adverse effects that can occur later in the course of dental and psychological development of the child.
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To manage dental trauma, the dentist must reposition the tooth, ensure splinting and check for any occlusal defects. A radiograph must be taken to verify the intra-socket positioning achieved with a splint.
The types of dental trauma are:
- Subluxation: The tooth becomes mobile.
- Avulsion: The tooth gets displaced out of the socket.
- Lateral Luxation: The tooth gets displaced, and the adjacent bone gets fractured.
- Intrusion: The tooth gets pushed into the bone.
- Extrusion: The tooth gets pushed out of the bone.
- Tooth Fracture: Based on the type of tooth fracture, it is classified into nine types.
Pediatric dentists treat children; hence they are trained to understand and practice psychological methods to train the children to have a positive attitude toward dental treatment so that the child may experience pain-free treatments.
Traumatic intrusion of deciduous teeth can be surgically repositioned and splinted. Alternatively, the tooth can be extracted, and space maintainers can be placed till the eruption of permanent teeth.
Dental trauma is one of the most common dental health problems affecting about 20 % to 30 % of individuals worldwide. The prevalence in boys is around 10.2 % and 6.5 % in girls. Approximately 33 % of children and 20 % of adults sustain dental trauma, costing about $2 to $5 million annually in the US.
Tooth injuries present with:
- Bleeding from gums, mouth, or lips.
- Loose or broken tooth.
- Difficulty in jaw movement.
Oral traumas are any injury to the mouth, including teeth, gums, cheek, tongue, and jaw. The most common of them all is dental trauma, where the tooth is broken or avulsed. Soft tissue issues cause significant bleeding and swelling, requiring immediate attention.
Children usually suffer falls and clashes when they begin walking and running. Typically, the upper front teeth are most likely to have a traumatic injury.
The alveolar bone surrounding the primary tooth has large marrow spaces, which is characteristic of growing skeletal bone. This increases the elasticity of the bone, due to which teeth facing a traumatic injury are more likely to dislocate or laterally luxate than get fractured.
Injury to the innervating blood vessels causes bleeding into the pulp. The bloodstains may be taken up by the dentin as well. Both these factors combine to form internal discoloration of the tooth, developing over several days to months.
Trauma to the face or oral cavity can, directly and indirectly, affect the teeth. Any direct traumas can lead to fracture, pulpal necrosis, and even tooth avulsion. Injuries to the bone can affect the developing permanent tooth; either the dental organ (tooth developing structure) or the developing roots of a semi-erupted tooth might get affected. Such injuries may even cause long-term effects by messing up the occlusion.
Broken, untreated teeth are open pathways for the innervation of pathogens directly into the systemic circulation. Fevers along with tooth pain are signs of infection that are a result of tooth trauma.
Tooth subluxation is a result of traumatic injury to the periodontal structure. The tooth becomes mobile within the socket but is not avulsed (fallen out).
If a traumatized discolored tooth remains alive, it is likely to resolve back to its original color within 4 to 10 weeks of trauma. Some discolorations might even take close to six months to regress.
Nerve injuries from dental injections are rare events that may lead to prolonged and permanent neural sensations in the affected region due to nerve injury. The symptoms may subside within a few days, lead to a compressive injury called compressive neuritis, or may even cause permanent sensation loss.
Last reviewed at:
08 Nov 2021 - 2 min read
Query: Hello doctor, I am 19 years old and all of my teeth are baby/milk teeth. Is there a chance that permanent teeth will grow for me? Read Full »
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