The blissful days of summer: mornings spent sleeping in, playing in the summer heat, and splashing into an ice-cold pool. Each day is much the same. It is the time of year where bedtimes are relaxed and catching fireflies is part of the nighttime routine. In my office, it is the season for teeth to get bumped, break, or fall out. Usually these incidents start with the phrase, “Hey, Mom! Watch this!”
These are the questions you need to ask yourself when this happens:
- Is my child okay?
- What is involved? Is it the tooth, gums, lip, or a combination?
- Does the tooth look different? Is it shorter? Is it longer? Is it broken? Is it pushed forward? Or backwards?
- Is the tooth loose? Is there bleeding around the tooth?
In any of these cases, it is a good idea to have your child seen by their dentist to have an exam and dental radiographs (X-ray) to make sure everything is okay and to get a baseline report to monitor the tooth in the future.
I am starting a trauma series due to the influx of cases I see in my office during the summer months. In this segment, I will discuss a tooth that has been bumped but still looks the same as it did before the incident and is not loose.
This is diagnosed as a concussion, and the American Academy of Pediatric Dentistry (AAPD) defines it as an “injury to the tooth-supporting structures without abnormal loosening or displacement of the tooth.” Following a concussion dental injury, the tooth may be tender for a few days. On a radiograph, the tooth will look the same as it normally does. The goal following this type of injury is to allow the tooth to heal and return to its normal state. Whether it be a baby or adult tooth, no treatment is necessary aside from monitoring for signs of pulpal necrosis, aka the tooth dies, may he rest in peace.
“Heavens to Betsy! What would a tooth look like if it does succumb to this injury?” you may ask. Pulpal necrosis may present as pain, crown discoloration, abscess, and tooth mobility. The same symptoms can present for baby and adult teeth. The likelihood of a tooth developing pulpal necrosis increases the more the tooth has been displaced from its socket, so in the case of a concussion injury, pulpal necrosis is unlikely.
“Whew! That is a relief, but my child’s tooth is still tender.” To help with any discomfort your child may be feeling, acetaminophen and/or ibuprofen can be beneficial as well as maintaining a soft diet for a few days until the tenderness subsides.
Dental Trauma Guide:
AAPD Trauma Guidelines: