Dental trauma can happen at any time, and the seriousness of the situation ranges from basic first aid to more complicated dental procedures. Here are answers to some of the most common questions about how to treat dental trauma.
How should I treat a laceration?
If there is a laceration or cut, the first thing to do is apply pressure to the cut to stop bleeding. This can be done with a finger, a clean cloth or gauze or a bandage. Then, go to the emergency room or your physician to see if you need a steri-strip, stitches or special skin glue. For small cuts, if the bleeding stops and the skin appears to close, you may not need to pursue advanced care.
My daughter fell and ripped her lip. She started bleeding from her mouth. What do I do?
This may be due to a torn frenum, which is the flap of tissue that connects the lip to the gum tissue in the mouth. There can be a lot of blood, so applying pressure and then ice will help to stop the blood flow. If the bleeding doesn’t stop, seek medical assistance.
It is important to evaluate the cut to see if it is a through-and-through cut or is self-limited. Sometimes there may be foreign bodies in the cut, like teeth or pieces of tooth, rocks, sand, glass or anything else that was involved in the trauma. So if there is any question, the area needs to be x-rayed, cleaned and dressed in a health care facility.
I got my tooth knocked out, what should I do?
First, find the tooth. Next, do not wipe it off unless it is very dirty and can be gently washed off. You should try to hold the crown of the tooth, not the root! The root has remnants of the periodontal ligament, and this is the key to successfully saving the tooth. If you are comfortable, put it into the socket and gently press it into place. Then, go to the dentist to have x-rays and evaluate the bone and soft tissues in the area.
If I am not comfortable putting my tooth back in, what should I do?
Place it in milk or saline, or get a kit at the drugstore called “Save-A-Tooth.” It has the nutrients necessary to keep the tooth hydrated with some nutrition for the damaged cells in the tooth. The solution in Save-A-Tooth is called Hank’s Balanced Salt Solution, and it contains calcium, phosphate, glucose and calcium, which can help protect the tooth and keep it alive until you can get to the dentist.
What shouldn’t I do to a tooth that was knocked out?
Do not wipe the tooth, scrub it or put it in your mouth or in a glass of water. These will all damage or infect the tooth with bacteria and change the osmotic gradient or fluid flow in the tooth. Don’t wait to go to the dentist. The ability to save the tooth is greatest if it can be reinserted within the first 15 minutes after avulsion. For each hour you wait, the success rate goes down drastically.
While many people have been told to put the tooth in the mouth to protect it, the bacteria present in the mouth that are exposed to the root may contaminate it and the socket. It is important to keep the tooth wet – in saline, milk or Save-A-Tooth – and get to the dentist within an hour.
My child knocked out a baby tooth. Should it be put back it?
No, baby teeth should not be pushed back into the socket.
My child chipped his tooth. What should I do?
Save the fragment as mentioned above and see the dentist. There may be an opportunity to bond the broken fragment back on. Use gauze if there is any bleeding and ice to help decrease swelling to the area. Store the broken chip in cold milk or Save-A-Tooth, but do not transport it dry.
Whenever there is trauma, the tooth may require having the nerve removed, which is called a root canal. The dentist will evaluate the extent of the fracture and evaluate the nerve of the tooth over a period of months to ascertain whether the tooth may remain vital and alive. The dentist can’t use a vitality test (like ice) at the time of fracture, since the tooth will be in shock and such tests won’t be accurate.
If my tooth is loose but not cracked, what will the dentist do?
They will evaluate if the tooth has shifted or the surrounding bone has been fractured. They may adjust your bite by gently removing some enamel on the opposing tooth or they may splint this tooth to other healthy teeth to allow the tooth to stabilize and heal. Then the splint will be removed in 10 days or so, and the tooth will be monitored to see if it will stabilize. Sometimes brackets and braces or bars are used to splint these teeth together for longer periods of time, as determined by your dentist.