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Dental Trauma

Dental Trauma

Dental Trauma

Dental trauma may be inflicted in a number of ways: contact sports, motor vehicle accidents, fights, falls, eating hard foods, drinking hot liquids, and other such mishaps. As oral tissues are highly sensitive, injuries to the mouth are typically very painful. Dental trauma should receive prompt treatment from a dentist. Prompt treatment is essential for the long-term health of an injured tooth. Obtaining dental care within 30 minutes can make the difference between saving or loosing a tooth.

Causes and symptoms:

The cause of dental trauma varies depending on the age of the child. Toddlers are more likely to injure a tooth by falling, while older children are more likely to suffer dental trauma from a sports injury. Teenagers often present with dental trauma as the result of fights. The incisors in the upper jaw are the most commonly injured teeth.

Pain characterizes all dental traumas. The tooth may be knocked out and the socket bleeding or it may be loose. Soft tissue injuries, such as a "fat lip," a burned tongue, or a cut inside the cheek, are characterized by pain, redness, and swelling with or without bleeding. A broken tooth often has a sharp edge that may cut the tongue and cheek. Depending on the position of the fracture, the tooth may or may not cause tooth ache pain. When a tooth is knocked out, the socket is swollen, painful, and bloody. A jawbone may be broken if the upper and lower teeth no longer fit together properly (malocclusion), or if the jaws have pain with limited ability to open and close (mobility), especially around the temporomandibular joint (TMJ).

Types of dental trauma:

Dentoalveolar trauma may be classified into categories based on treatment protocols. These categories include: dental avulsion, dental luxation and extrusion, enamel and crown fracture, dental intrusion, dental concussion and subluxation, root fracture, and alveolar bone fracture.

Diagnosis:

Dental trauma is readily apparent upon examination. Dental x rays may be taken to determine the extent of the damage to fractured teeth. More comprehensive x rays are needed to diagnose a broken jaw.

Treatments:

The type of treatment too depends on the type of injury

For soft tissue injuries: Reduce swelling with cold compresses Control bleeding by putting pressure with a clean gauze Stitches can help deep punctures or lacerations Painkillers such as aspirin or ibuprofen can reduce pain

For broken teeth: Treatment of a broken tooth will vary depending on the severity of the fracture. For immediate first aid, the injured tooth and surrounding area should be rinsed gently with warm water to remove dirt, then covered with a cold compress to reduce swelling and ease pain. A dentist should examine the injury as soon as possible. Any pieces from the broken tooth should be saved and taken to the dentist with the child.

If a piece of the outer tooth has chipped off, but the inner core (pulp) is undisturbed, the dentist may simply smooth the rough edges or replace the missing section with a small composite filling. In some cases, a fragment of broken tooth may be bonded back into place. If enough tooth is missing to compromise the entire tooth structure, but the pulp is not permanently damaged, the tooth will require a protective coverage with a gold or porcelain crown. If the pulp has been seriously damaged, the tooth will require root canal treatment before it receives a crown. A tooth, that is vertically fractured or fractured below the gumline will require root canal treatment and protective restoration. A tooth that no longer has enough remaining structure to retain a crown may have to be extracted (surgically removed).

A broken jaw must be set back into its proper position and stabilized with wires while it heals. This is usually done by an oral surgeon. Healing may take six weeks or longer, depending on the patient's age and the severity of the fracture.


Prognosis:

When dental trauma receives timely attention and proper treatment, the prognosis for healing is good. As with other types of trauma, infection may be a complication, but a course of antibiotics is generally effective.

Prevention:

Dental injuries increase sixfold to eightfold when mouth protection is not used. Education of athletes and coaches may encourage greater use of mouthguards. Educating physicians and the public about first aid for dental injuries may reduce complications later.
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Dental Trauma