Dental Injuries
Dental trauma is unpredictable and distressing for children and carers. Timely and appropriate advice and management are paramount for a successful outcome.
Dr Maria Kalkani has extensive experience managing dental and facial injuries both in the hospital and in the dental clinic.
Dental Injuries
Children aged 1 to 3 years are at high risk for dental injuries due to falls while learning to walk and run, and while further developing their coordination. Falls are the most common cause of injury in baby (primary) teeth.
Sports-related injuries are the second most common cause of dental injuries of the adult (permanent teeth), affecting 25% of children aged 8 to 14 years. Participation in sports increases the risk for dental trauma due to falls, collisions, contact with hard surfaces, and contact from sports-related equipment. High-risk sports include hockey, lacrosse, rugby, football, basketball and netball, martial arts, and skating.
Facial trauma that results in fractured, displaced, or lost teeth can have significant negative functional, aesthetic, and psychological effects on children and adolescents.
First line assessment includes a thorough medical and dental history, clinical and radiographic (X-rays) examination, and additional tests such as palpation, sensitivity, and mobility evaluation.
Permanent (Adult) Teeth
Treatment of dental trauma varies according to the type of injury involved:
Luxation (tooth Loose or displaced)
A loose or displaced permanent tooth is a paediatric dental injury that needs to be treated as soon as possible. The tooth can usually be restored to its proper place and monitored over time. Local anaesthesia and stitches or splints may be required to preserve the tooth in its socket. Children with loose permanent teeth should be evaluated and treated by a paediatric dentist who has experience in treating dental trauma in children. These teeth should be followed up according to specific protocols and, sometimes, root canal treatment may be necessary, even years after the injury.
Fracture (tooth chipped or broken)
Broken permanent teeth can usually be repaired successfully. For the best possible outcome, the child should see the paediatric dentist for treatment as soon as possible or within a day from the time of the injury. Broken teeth that are sensitive to hot or cold need to be treated urgently. Tooth fragments may be saved, if possible, and stored in water/ milk (for hydration) as they can sometimes be reattached. If tooth fragments cannot be found or cannot be reattached, the tooth may be repaired with a material called composite resin, which is a white tooth filling material. If the nerve of the tooth has been exposed after the injury, the paediatric dentist has the experience to assess the extent of the exposure and the stage of the tooth development and recommend the most appropriate nerve treatment. Sometimes a root canal is necessary to prevent an infection.
Avulsion (tooth knocked out of the mouth)
Avulsion is a dental emergency and professional advice should be sought as soon as possible.
An adult tooth that is avulsed should be reimplanted in its socket as soon as possible.
If the tooth cannot be reimplanted, it should be placed in a protective solution, like cold milk. It should never be allowed to dry.
What About Baby Teeth?
Injury can cause a primary (baby) tooth to become loose with some bleeding from the gums. The tooth can be partially displaced from the dental socket, appear longer than it was before and be excessively loose. A clinical examination and a dental x-ray are recommended as soon as possible. This type of injury may push the baby tooth root into the developing permanent tooth and cause damage to the permanent tooth. Treatment of these conditions depends upon the degree of trauma and the child’s ability to cope with discomfort.
Treatment for a chipped baby tooth depends on the extent of damage.
A fracture that involves the enamel (outer layer of the tooth) may need to be smoothed.
If the fracture involves the enamel and dentin (second layer) and a large portion of the tooth is missing, we may need to restore it with a filling or a crown
A fracture that involves the nerve (pulp exposure), may require nerve treatment to the tooth or possibly a dental extraction
If a baby (primary) tooth is knocked completely out of the dental socket, it should not be reimplanted, because reimplantation of a baby tooth can cause harm to the developing permanent tooth.
What Parents of Our Patients Think
We were very lucky to have Dr Maria Kalkani to treat an emergency incident my daughter had. She gave us excellent treatment while explaining everything in detail. Her positive approach towards children combined with her extensive knowledge made us feel trust and safety. Invaluable feeling. Thank you!
— Mrs M.Z.