Dental Trauma

Dental Trauma

Pediatric Dental Trauma
Common pediatric trauma can happen during falls, baseball injury, bicycle accidents and more. The trauma can vary from a simple lip laceration to a tooth fracture and even a fracture in the jaw bones. The goal of treatment is to save the permanent (adult) teeth.
 
Types of Dental Trauma of permanent teeth:
  • Subluxation: Mobility of the tooth due to injury to the supporting structures of the tooth.
  • Avulsion: tooth is completely displaced out of the tooth socket
  • Lateral Luxation: the tooth is displaced and a neighboring bone is fractured.
  • Intrusion: the tooth is pushed into the bone
  • Extrusion: The tooth is pushed out of the bone
  • Fracture of the tooth
How do you diagnose the severity and type of fracture? Radiographic and clinical exam is necessary to make the correct diagnosis.

If my tooth gets knocked out what do I do?
A knocked out tooth is a dental emergency and need to be treated in a timely fashion. Periodontal ligaments (PDL) are springs that connect the tooth and the bone. These ligaments can survive for 2 hours if the tooth get knocked out. Please call the office immediately if you have a tooth that is knocked out. The tooth needs to be kept in saliva (spit), milk or Hank’s solution. These solutins give the PDL a chance to survive. 

What is the treatment?

Subluxation:
  • A flexible splint to stabilize the tooth for 14 days
  • Soft diet
  • Monitor the tooth after stabilization
Extrusion:
  • Repositioning of tooth and stabilization with splint for 14 days. The vitality of the tooth has to be monitored. If the tooth is not vital it may need a root canal.
  • Soft diet
  • Monitor the pulp (nerve) of the tooth and if devitalized root canal treatment is recommended.
Lateral luxation:
  • Reposition the tooth and stabilize with splint for 4 weeks
  • Soft diet
  • Monitor the pulp (nerve of the tooth). Possible root canal therapy is the pulp is devitalized.
Intrusion
  • Treatment:
    • Spontaneous eruption –treatment of choice for teeth that are not fully developed
    • Orthodontic repositioning
    • Surgical repositioning for severe intrusions
  • Prognosis: Resorption and or ankylosis is a risk of intruded teeth. Root canal is used to prevent resorption within 3-4 weeks.
Avulsion
  • Reposition the tooth and splint it for 2 weeks.
  • If the tooth was dropped on a dirty surface such as soil a tetanus vaccine coverage needs to be verified.
  • Root canal treatment within 7-10 days is recommended
  • Soft diet
  • Prevention: mouth guard with contact sports
Fracture of Roots of the teeth:
  • Initial Treatment: stabilize fragments with a splint and possible removal of the nerve (pulpectomy) depending on the severity of the fracture.
  • Definitive treatment
    • Crown
    • Orthodontic extrusion
    • Surgical extrusion 
    • Decoronation
    • Extraction
Dr. Song and Dr. Um are experts in treating dental trauma. Please contact our office as these emergencies need to be treated in a timely manner. 

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