First Aid: Injury to a permanent tooth

Injury to a permanent tooth, however, is a medical emergency that could have long-term effects if not handled quickly and properly. Follow these steps in the event of an injury:

• If the tooth is still in your child's mouth, that's the best place for it. If the tooth has fallen out, find it.
• When you find the tooth, hold it by the crown (the enamel-covered part of the tooth, the widest part of the tooth).
• Using cool water, rinse the tooth. Don't scrub away or remove any tissue fragments.
• If your child's mouth is injured and you can't put the tooth back, put it in milk or saline solution. The PH level of milk is similar to that of saliva and can help preserve the tooth. Parents can ask their pediatric dentists how to obtain a "tooth saver kit," which has all of the necessary supplies to save a child's tooth for transport to the dentist's office.
• Take your child and the tooth to the dentist immediately. If your dentist is unavailable, go to the emergency room.

source:
http://www.mayoclinic.com/

Injuries to baby teeth

Injuries to child's teeth can occur from falls, during play or during sports activities. Knowing what to do if a child's tooth is injured can be the difference between saving and losing the tooth. It can be cracks or chips, or tooth loss. The child may experience bleeding from the area, pain or increased sensitivity when a tooth is injured.

Injuries to baby teeth and permanent teeth are usually treated differently. Because there is no threat of long-term disability from a missing baby tooth, these injuries are not treated as medical emergencies. In some cases, a temporary partial can be fitted to the child's mouth to replace a missing baby tooth, but it is most common to allow the child's mouth to heal and wait until the permanent tooth grows in.

The good news is that children who have dental injuries can have their teeth repaired and keep them for a lifetime.The parent or caregiver should immediately call the dentist and take the child and the tooth or tooth fragments to the dental office. Because, when it comes to dental injuries, time is a critical factor. The length of time before a tooth is reimplanted and how it is transported to the dentist are crucial in successfully saving and reimplanting the tooth.

When are baby teeth most at risk from injury?

Children are most accident prone between the ages of two and four years. The majority of accidents happen in or around the home. Injuries to baby teeth often result from a fall. Damage can be caused by either a direct blow to the teeth, or by the impact of the lower jaw being forced upwards. The front teeth are the most likely to be affected.

Always consult your dentist after a child's tooth or jaw has been injured.

How to prevent tooth injuries in children?

• Teach them not to walk or run while holding an object in his or her mouth.
• Teach them not to suck or chew on hard, sharp or pointed objects.
• Have them wear a mouthguard for sports activities that could cause injury.
• Always wear seat belts when riding in vehicles.

What can be done if a baby tooth has been chipped or broken?

Loosening or displacement is the most common injury to baby teeth. This is because the bone in which the root is anchored is soft and elastic in a young child.

If a tooth is chipped, and only the enamel is affected, smoothing the sharp or roughened edge is usually all that is needed.

If a front tooth has a chipped biting edge, a tooth-coloured plastic filling can be bonded to the tooth. This will restore its shape and appearance, and protect the edge from further damage. Since the enamel has no nerve supply, these treatments are painless.

When larger piece of tooth has broken off, the tooth can become painful. This is because the dentine layer of tooth under the enamel has become sensitive to hot and cold.

• The tooth can be repaired with a tooth-coloured filling or with an amalgam.
• The injured tooth should be checked regularly for any colour changes.
• A colour change to grey indicates that the nerve and blood vessels have died.

The treatment for a baby tooth that has been knocked out:

• Re-implantation of a baby tooth is not done as it would damage the permanent tooth under it.
• The gap left by the loss of a baby tooth must be kept open for the permanent tooth that will eventually replace it.

A space maintainer can be fitted to prevent other teeth from drifting into the gap.

What happen with Grey discoloured or Fractures tooth?

A colour change to grey indicates that the nerve and blood vessels have died. Should it become painful or infected, the tooth may need to be extracted. This is to preserve the health of the underlying permanent tooth.

• An alternative may be to perform a pulpotomy. This is the removal of the nerves and blood vessels in the crown of the tooth. It is not a difficult procedure and is usually successful.
• Severe fracture of the crown of a baby tooth is not common.

Fractures mean a tooth can be driven into the jawbone by a fall or any impact on the tooth.

• This could damage the permanent tooth growing under it.
• If an x-ray confirms that the permanent tooth is at risk, the baby tooth will have to be

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