AT THE DENTIST
It is an unfortunate fact that children of all ages can suffer injuries to their teeth during the course of their daily activities.
Injuries can start as early as the first teeth being present in the mouth. Falls or cot injuries may affect newly erupted teeth by loosening them, intruding them into the gum, losing them entirely or fracturing them. Mild mobility after a fall usually resolves itself with no consequences. Intrusion of the tooth into the gum can, on occasion, result in nerve damage with resulting infection and eventual loss of the tooth. Even if the tooth is not lost, post injury, teeth need to be monitored regularly for evidence of necrosis and infection since this can result in damage to the enamel structure of the underlying permanent tooth.
Fractures of the tooth crown are more common in older children. If the damage is slight, the tooth can be repaired invisibly and painlessly, but more severe damage, with the fracture line close to the nerve chamber, needs to be monitored prior to any repair work being carried out. Should the nerve be exposed, urgent attention is required to preserve some of the nerve tissue in order to allow the immature root to finish developing. Severe injuries may also result in fragments of root remaining embedded in the lips. It is essential to trace all broken fragments and if this is not possible, x-rays of the lips should be taken especially if there is swelling associated with lip laceration.
Very occasionally a tooth may be avulsed completely from its socket. This can occur in contact sports, falls or accidental blows. Here, urgent intervention is imperative. The tooth should be rinsed with fresh milk or even just bottled water and transported to the dentist inside the child's mouth, between the gum and the cheek.
As always, practising prevention is always best. Advising children of the consequences of rough play and respect for fellow players is critical. Children playing contact sports should be fitted with custom-made mouth guards. These have been shown to reduce dental fractures drastically and may be the best prevention for lifelong consequences to a child's smile.