Probably one of the most upsetting things – to parent and child – is an accident on which a child’s tooth is fractured, displaced, or knocked out. Tooth trauma can also happen to adults, especially those engaged in active high contact sports.
Approximately one in 11 children in Ireland will have broken one or more of their permanent teeth before they reach the age of 15 years. Damage can range from a small chip off the enamel to a fracture involving the dental pulp. Occasionally, the tooth can also be displaced or, more rarely, knocked out completely. Traumatic injuries to teeth can be complicated to treat and can have long term financial, aesthetic and functional problems for the patient.
Prevention and Management
Most traumatic injuries to teeth arise from accidents during normal everyday activities such as informal play and prevention in these circumstances is difficult.
The wearing of mouthguards or helmets with face shields can reduce the likelihood of fracturing a tooth. It is becoming more commonplace that sports clubs advise the mandatory wearing a mouthguard for all players during matches and training. It is recommended to wear a mouthguard for all high risk sports such as rugby, hockey, martial arts, boxing, mountain biking, horse riding and skateboarding.
There are many different types of mouthguards, ask your Dentist for advice on the one most suitable for you and / or your child. The most important factor is to select one that will be comfortable enough to encourage use. When a tooth is accidentally damaged, it is important that professional advice from a dentist is sought immediately.
What to do if a child's tooth gets knocked out
When children are learning to walk they are especially likely to fall and injure their teeth or mouth. You should bring a child to see a dentist if they hurt their mouth and the bleeding doesn't stop, or if they damage a tooth, or if they fall and drive a tooth back up into their gum. Your dentist will be able to take an x-ray and decide if anything needs to be done. Very often, all that is needed after an injury is to keep a close eye on the child's teeth and gums for a while, but you should check with a dentist to make sure.
Where a primary (baby) tooth that is knocked out completely, parents/carers should not attempt to replant the primary(baby) as they could damage the permanent (adult) tooth that is developing beneath the gum. The child should be brought to a dentist to be checked.
Where a permanent tooth that is knocked out completely, make sure that the tooth knocked out is a permanent tooth - (primary (baby) teeth should not be replanted). Keep the injured person calm. Find the tooth and pick it up by the crown (the white part). Avoid touching the root as this can damage the membrane which is essential to saving the tooth.
If the tooth is dirty, wash it briefly (10 seconds) using milk, saline solution or cold running water. Encourage the injured person/parent to replant the tooth, using the shape of the teeth at either side of the gap as a guide to positioning. Once repositioned, the injured person should bite on a handkerchief to hold the tooth in place until the dentist splints it.
If the tooth cannot be replanted immediately, it can be carried inside the injured person's mouth between the teeth and the inside of the cheek, or in milk or a special storage medium for knocked out teeth, if available. Avoid storage in water. Seek emergency dental treatment immediately; phone ahead to tell your dentist you are on your way.
For further advice on what to do if your child’s tooth gets knocked out see our “Save that Tooth” poster.