Dental trauma most commonly affects the upper front teeth (incisors) and can affect your smile & confidence, ability to chew food and can be costly. Accidents within and around the house are the main cause of injury to baby teeth, while accidents at home, school and sports account for most of the injuries to the adult teeth. Physical activities and contact sports, such as rugby and boxing or any sport involving a fast moving ball can pose a threat to your teeth, unless a mouth guard is worn. When a tooth is accidentally damaged, it is important that professional advice from a dentist is sought immediately.
In this month’s blog the different types of dental trauma and their management will be discussed along with the importance of wearing a custom made mouth guard during contact sports to minimise potential tooth loss or even prevent dental injuries.
Tooth fractures: Part of the tooth may break. Fractures can affect just the enamel of the tooth or the enamel and the dentine. In these cases a composite restoration (filling) will be able to restore the missing piece of tooth. Other options may include a porcelain veneer or a crown; although the latter are more destructive options. If the fracture involves the pulp (nerve of the tooth) a root canal treatment may be required. In some instances the fractures may be more complex and extend to the root of the tooth or the surrounding bone and socket that holds the tooth in place. The long term outlook in this case could be poor.
Subluxation: is an injury to the tooth resulting in the tooth becoming slightly loose but without the tooth changing position. The gum around the tooth can often bleed. Usually there is no need for treatment although a soft diet for a week is recommended. Very occasionally, a flexible splint may be placed on the affected tooth and the teeth either side for a couple of weeks to help keep the tooth comfortable.
Extrusion: is when the injured tooth is partially pushed out of its socket. In this socket the tooth needs to be repositioned in place and splinted to the teeth either side. A soft diet is recommended for a week. The dentist needs to monitor the tooth on a regular basis to check that the nerve is still alive. For extruded baby teeth, repositioning of the tooth, doing nothing or extracting the tooth are the options depending on the severity of the injury.
Intrusion: is where the tooth is pushed into its socket. An intruded baby tooth may cause damage to the permanent adult tooth that hasn’t yet erupted. Spontaneous re-eruption of the tooth may occur or extraction may be needed to minimize the damage to the permanent tooth. Intruded permanent teeth need to be repositioned. This can happen on its own (the tooth erupts to its original place) or if not with the help of braces. In most cases a root canal treatment of the tooth should follow a few weeks after the repositioning has taken place.
Avulsion: In this case the tooth is totally knocked out of its socket. You should not attempt to reposition a baby tooth in its socket. The child should follow a soft diet for a week. The permanent (adult) successor tooth may be affected. On the other hand, a permanent avulsed (knocked-out tooth) should be put back in place as soon as possible.
If this happens to you, your child, or anyone you may know:
Seek emergency dental treatment immediately.
The dental treatment needed varies and depends on the how quickly the tooth was put back in place and the stage of the formation of the root of the tooth. In most cases a root canal treatment will be needed and the tooth will need close monitoring.
In the UK, it is recommended that a mouth guard should be part of the sports kit. The wearing of mouth guards or helmets with face shields during organised contact sports can reduce the likelihood of fracturing a tooth.
There are three main types of mouth guards:
Having a mouth guard will add a dimension of protection to your teeth as it spreads the impact across the mouth meaning individual teeth are less likely to be lost. Although there are several types of guards you can get from shops, we recommend a custom made guard which will fit securely around your teeth. This may cost slightly more than a ready-made mouth guard from a sport shop, but the extra protection you will be giving your teeth could just be priceless. (please note if you require a custom made mouth guard made by your dentist it may take 2-3 weeks at busy times as the dental laboratories have to cope with high demand just before the start of a new term!)
This blog was written by Anastasios Plessas (Associate Dentist) – June 2016
Please complete the form below and we will get back to you as soon as possible.