Our latest “Dentistry in Focus Article” from February 2017 is by Dr Wilkie and concerns Dental Trauma.
What is dental trauma?
Dental trauma can range from a simple bump of the tooth, broken tooth or even result in the tooth being knocked out of the mouth. It is important to remember that trauma to the facial region not only affects teeth but can also impact on the jaw, gums and facial soft tissues such as the lip and cheeks. If your child experiences any falls or bumps to the facial region it is always best to visit the dentist to reduce the risk of short and long term complications.
What is the best management?
The management for trauma largely depends on the type of injury received. Common dental trauma and management is listed below:
- Concussion: Concussion is when there has been a bump to the tooth that has not caused movement in the tooth. Dental concussion is similar to a ‘bruised tooth’. No treatment is provided but it is best to have a dental visit to ensure we can monitor changes in the nerve of the tooth
- Subluxation: Subluxation is when the tooth becomes mobile due to trauma. Often this injury will have bleeding from the gums. Depending on the degree of tooth movement, a wire may be required to hold the tooth in position (called a flexible splint). Or the tooth may stabilise itself if minor movement.
- Luxation: Luxation injuries may result in the tooth being moved into a new position. This may include the tooth being knocked inwards towards tongue/roof of mouth, or it may result in the tooth appearing longer or shorter. This injury may require the tooth to be re-positioned back into its regular position. Ongoing monitoring is always required to ensure the nerve of the tooth does not die as a result of the trauma. If this occurs, root canal treatment may be required in the future.
- Avulsion: An avulsed tooth refers to a tooth that’s has been dislodged completely from the mouth. If you or your child loses a tooth due to trauma, contact the dentist immediately. It is important to remember that if a baby tooth is lost, do not put it back into the tooth socket as it may cause damage to the developing adult tooth under the gum.
- However, if an adult tooth is lost:
- Firstly pick up tooth by the crown not the root
- If dirty, gently rinse under cold running water but avoid touching the root of the tooth
- Place tooth back into socket (hole where tooth was lost from) and bite gently on a clean handkerchief to hold in place. Note it is important to do this as soon as possible!
- If unable to replace into mouth, the tooth can be stored in a glass of milk (less ideal but a good second option!)
- Attend the dentist immediately
- Fracture: fracture can include a small chip from the tooth which may require a filling to be placed. A deeper fracture may involve the nerve of the tooth, often bleeding can be seen coming from the crown of the tooth. This injury may require the nerve of the tooth to be managed which may involve placing material over the nerve of the tooth (pulp cap), or a root canal procedure.
- A Root fracture is less easy to see at home as the fracture occurs below the gum. There may be bleeding from the area and the tooth may have changed position. Sometimes the tooth can be repositioned by the dentist and held in position with a flexible wire. This injury needs to be closely monitored as root canal treatment or loss of tooth may occur in future.
Whats involved in a dental appointment for trauma?
Each appointment depends on the type of injury that has occurred. An appointment may be as simple as assessing the region and taking an X-ray. Often the dentist will tap the tooth and place a cold stick against the area to monitor the nerve of the tooth. If required, the management discussed above may be necessary during the dental appointment.
It is important for regular monitoring after a dental injury, changes in the nerve of the tooth can lead to infections which may lead to pain and swelling if not addressed. It is important to come to regular recalls to monitor for these changes.
What is the best way to prevent dental trauma?
Mouthguards are a great prevention method when playing sports. Mouthguards are easily made and a very affordable option to prevent tooth injury from occurring. Remember to bring the mouthguard along to check up appointments to ensure it still fits well to provide the best protection for the teeth.
Please note: As we are part of the Dental Care Network, Robertson Dental Innovations can offer it’s patients a free Dental Trauma loyalty program: Dentisure (for more information click here). This program enables patients to claim back for out of pocket expenses for dental trauma treatments, conditions apply.
About the Author
Dr Belinda Wilkie is a local from Bendigo having grown up and now completed her studies here. Based at our Condon Street practice, Dr Wilkie is available 5 days a week. Dr Wilkie is also part of the Bendigo Dental Implants team, helping to assist Dr Robertson with the impressions and 3D X-rays for the implant planing. Dr Wilkie also loves working with our younger patients, helping to establish good oral hygiene practices.