Dental Injuries in Children: How to Provide First Aid and When to See a Doctor 0 14

Dental injuries in children are often related to their age. They can affect both primary and permanent teeth. Most often, injuries to primary teeth occur at the age of 1–1.5 years, when children begin to walk and may fall, injuring their front teeth.

As for permanent teeth, injuries most frequently occur between the ages of 6 and 12, when children start riding scooters, skateboards, and rollerblades. These activities are associated with falls, which can lead to injuries of the front teeth and soft tissues. Therefore, using protective gear, including helmets, is extremely important.

Types of Dental Injuries

* Contusions (the tooth remains within normal mobility; this is an internal concussion of the vascular-nerve bundle without damage to the ligament holding the tooth in the socket).

* Tooth luxation, where the tooth is displaced from the socket due to trauma to the periodontal ligament.

* Tooth fractures are divided into uncomplicated and complicated. In uncomplicated fractures, a part of the crown of the tooth chips off, but the nerve remains intact. Complicated fractures involve damage to the tooth cavity and the vascular-nerve bundle, as well as root fractures.

* Avulsion of the tooth — complete loss of the tooth from the socket.

How to Help a Child

If the injury occurred outdoors, it is necessary to wash away dirt from the area of injury. It is sufficient to rinse the mouth with water. Antiseptics such as chlorhexidine or miramistin, which are approved for use on mucous membranes, can be used. If there is severe pain, pain relief medication can be given to the child. The main thing is to see a doctor as soon as possible.

Even if a primary tooth is injured, delays can lead to serious consequences, such as damage to the bud of the permanent tooth located in the area of the roots of the primary tooth. This can result in the loss of both the primary and permanent tooth.

In the dental clinic, the doctor will examine the oral cavity and the damaged soft tissues for contamination and the presence of fragments (especially important in the case of a comminuted fracture). Sometimes antibiotics and a tetanus shot are prescribed. An accurate diagnosis and treatment are determined only after a detailed examination, including X-rays and/or computed tomography for a 3D image.

It is important to remember: the absence of complaints from the child after a visit to the dentist does not mean that a follow-up visit is unnecessary. There is a risk of hidden inflammation that may manifest later and threatens the bud of the permanent tooth. The timing of the next visit to the doctor will be determined by the specialist.

Regarding extraction, injured primary teeth are not always removed. The decision is made based on the type of injury, the degree of root formation, and the presence of the permanent tooth bud. If the doctor notes significant mobility of the primary tooth, it is extracted. The same applies if the tooth has shifted inward toward the bone tissue and threatens the permanent tooth bud.

What to Do if a Permanent Tooth Falls Out

If a tooth falls out, it should be gently reinserted into the socket without touching the root area. The site of injury should not be treated; at most, rinse it to remove visible contaminants.

There is a rule: if the tooth is reinserted into the socket within 2 minutes, the likelihood of healing the ligament that holds the tooth is 99%. If 2–10 minutes have passed, the probability decreases to 50%. If more than an hour has passed, reattachment is likely impossible.

If the tooth has chipped, collect the fragments and bring them to the clinic. Using the fragments, the damaged tooth can be successfully restored. It is recommended to store the fragments in saline solution. If the journey to the clinic takes up to 1 hour, dry fragments can also be brought. Unlike a permanent tooth, a primary tooth cannot be reinserted into the socket and expected to heal.