dental trauma

‘any trauma to the mouth that may cause bleeding and lacerations to the gums, and dislodge, or fracture teeth, and may require immediate medical attention’

if you have been in an accident and have had any sort of head injury, it is best to go to your nearest accident and emergency department. a traffic accident, falling of a bike, falling down stairs, or sustaining a sports injury can all cause an impact that breaks or loosens teeth, but your most serious injury could be concussion. you may need urgent assessment and observation to make sure that the accident has not caused any bleeding within your brain.

there are many different types of dental trauma, some of which have been highlighted here.

knocked-out (avulsed) tooth.

this is one of the most serious dental traumas for permanent teeth. however, the damage can be fixed. if you act quickly, there’s a good chance the tooth can be saved.

when a tooth has been knocked out, the nerves, blood vessels and supporting tissues are damaged, too. the nerves and blood vessels can’t be repaired. that is why all avulsed teeth will need a root canal. however, the bone can reattach to the root of the tooth once it’s put back into place.

the odds of saving a tooth are highest in young children, but adult teeth can be saved as well. only permanent teeth should be re-implanted.

it is important to get to the dentist as quickly as possible after a tooth has been knocked out. it is also important to avoid damaging the tooth even more.

follow these suggestions to improve the chances of saving your tooth:

handle the tooth carefully. try not to touch the root (the part of the tooth that was under the gum). it can be damaged easily.

if the tooth is dirty, hold it by the upper part (the crown) and rinse it with milk. if you don’t have any milk, rinse it with water. don’t wipe it off with a washcloth, shirt or other fabric. this could damage the tooth.

keep the tooth moist. drop it into a glass of milk. if you can’t do this, place the tooth in your mouth, between the cheek and gum. a young child may not be able to safely “store” the tooth in his or her mouth without swallowing it. instead, have the child spit into a cup. place the tooth in the cup with the saliva. If nothing else is available, place the tooth in a cup of water. the most important thing is to keep the tooth moist.

try slipping the tooth back into its socket. in many cases, it will slip right in. make sure it’s facing the right way. don’t try to force it into the socket. if it doesn’t go back into place easily and without pressure, then just keep it moist (in milk, saliva or water) and get to the dentist as soon as you can.

displaced (extruded) teeth.

this is a similar type of injury, usually caused by impact, but the tooth has not actually come out. It might have been knocked away from its usual position, or it might be hanging in by thin threads of tissue. after pushing the tooth back into position if you can, you need to see an emergency dentist as soon as possible, particularly if you are in a ‘hanging by the thread’ situation.

severe toothache

dental trauma relating to a blow to your mouth or jaw may result in severe pain in your teeth, there may be serious damage even though no teeth are obviously missing or broken. you will need an X-ray or other investigation to find out if you need treatment.

soft-tissue injuries.

injuries to the soft tissues, which include the tongue, cheeks, gums, and lips, can result in bleeding. to control the bleeding, here’s what to do:

rinse your mouth with a mild salt-water solution.
use a moistened piece of gauze or tea bag to apply pressure to the bleeding site. Hold in place for 15 to 20 minutes.
to both control bleeding and relieve pain, hold a cold compress to the outside of the mouth or cheek in the affected area for 5 to 10 minutes.
if the bleeding doesn’t stop, see your dentist right away or go to a hospital emergency room. continue to apply pressure on the bleeding site with the gauze until you can be seen and treated.