As a dentist who has been around the block for a while, I often receive messages from friends and acquaintances seeking some dental advice. It often goes something like this - a chain of WhatsApp messages from someone who's been off the radar for years: "Hi, how are you?", "It's been so long, hope all is well.", swiftly followed by, "Jonny's had a fall and his front tooth is out - we're panicking, what should we do?" I confess, I've done the same to my medic friends (so I'm not really one to grumble), but let's just say it's an occupational hazard.
While my knee-jerk reaction is "see your dentist asap", I often realise that they could use some more immediate useful advice. Sifting through online advice can be pretty overwhelming, with so much information it can be hard to pick out the good advice from bad.
So this post is dedicated to all those concerned parents out there. We'll talk about the most common forms of dental trauma, affecting both deciduous (baby) teeth and permanent teeth. We’ll explore what these injuries entail and the crucial steps to take if they occur.
However even if you have all the information you need and you trust the source of the information it can still be hard to know what information is relevant for you or your child. This is where Ouch can help. The bot at the bottom right of this page is loaded up with trusted information about dental trauma so it should be able to answer any questions you might have. As well as that if you or your child has had an accident you can report your symptoms and our AI will generate a report for you to take to your dentist as well as providing some home care instructions.
IT IS IMPORTANT TO NOTE THAT THE BOT USES ARTIFICIAL INTELLIGENCE. IT IS NOT A REPLACEMENT FOR A DENTAL EXAMINATION AND ANY ADVICE OR GUIDANCE PROVIDED IS FOR INFORMATION PURPOSES ONLY
When teeth suffer a hit without any displacement, it’s akin to sustaining a bruise. This is known as 'tooth concussion'. You may notice sensitivity to touch or temperature changes, or it may just look different. While concussed teeth generally heal on their own, it’s advisable to monitor the tooth closely and maintain impeccable oral hygiene. In children, concussed deciduous teeth may discolor mildly as a natural response to injury, but this isn't always cause for alarm.
Luxation refers to a tooth that has been dislodged from its original position. This could either be extrusive (partially out of the socket), lateral (displaced sideways), or intrusive (pushed into the jawbone).
Pain, misalignment, and bleeding are common signs. If you suspect a tooth has been displaced, prompt dental attention is crucial. Don't attempt to reposition the tooth yourself—this could cause further harm. For baby teeth, the treatment approach is typically more conservative, as improper handling could harm the developing permanent teeth.
Teeth are strong, but not indestructible. A fracture can range from minor chips (uncomplicated fracture) to serious cracks extending to the root (complicated tooth fracture). Symptoms include sharp pain when chewing or sensitivity to hot and cold. It's important to seek dental treatment to prevent infection or further damage. Treatment may involve fillings, crowns, or root canals, depending on the severity. For baby teeth, timely treatment is necessary, even though they're temporary, to prevent pain, infection, and potential damage to the underlying permanent teeth.
Home Care For Uncomplicated Fracture
Keep the area as clean as possible - salty mouth rinses, flossing around the area to prevent any food trapping
Apply sensitive toothpaste to the fractured area to reduce sensitivity. This may also create a protective layer over the dentine.
If pain worsens then try topical anaesthetics
Home Care For Complicated Fracture
Complicated fracture as the name suggests require dental attention ASAP.
Please note it may be possible for the dentist to stick back the fragment of tooth (normally only front teeth). So try to keep the fragment and take it along to your appointment. There is evidence that if the fragment is stored in milk then the resultant strength of the bond when your dentist reattaches it may be stronger
If the nerve is exposed then the tooth is likely to be extremely painful. A dental appointment is advised as soon as possible so prompt treatment will great increase the chance of successfully saving the tooth. In the meantime controlling the pain and keeping the area clean is the order of the day:
Over the counter painkillers such paracetamol, paracetamol with codeine or a non steroidal anti-inflammatory drug (NSAID).Over 16 year olds can combine paracetamol and NSAIDs. CARE MUST BE TAKEN TO CHECK FOR ANY CONTRAINDICATIONS DUE TO EXISTING CONDITIONS, MEDICATIONS OR ALLERGIES.
Gels that anaesthetise (numb) the area. They usually contain either Benzocaine or lidocaine .
Clove oil can be applied using a small piece of cotton wool soaked in it for 10 sec.
Warm salt water rinses to keep the area clean
If it is not possible to see a dentist try to use a DIY temporary filling material to cover the nerve. This may not be possible especially in front teeth as it is unlikely to stick. If it is possible clean the area with a chlorhexidine mouthwash before applying
It may be more comfortable to sleep with your head raised
An avulsed tooth is one that has been entirely knocked out of the mouth – a scenario that requires immediate action. For an adult tooth
Keep calm and find the tooth.
Pick it up by the crown (the white part) and avoid touching the root.
Clean the tooth gently with milk (tap water if milk isn't available)
If the tooth is dirty, gently rinse it in milk, saline, or saliva (of the patient!)
Attempt to replant or return it to its original position in the jaw.
Bite down softly on a cloth to keep it in place and go straight to your dentist.
If you can't reinsert it, keep the tooth moist in milk or saliva and get to a dentist urgently.
For children's avulsed baby teeth, the advice differs. Reinsertion isn't advised as it could jeopardise the developing permanent tooth. Instead, focus on keeping the child calm and controlling bleeding until professional care is available.
The handling of dental trauma varies significantly between permanent and deciduous teeth. Permanent teeth have a greater potential for being saved and restored, so the actions taken immediately following a traumatic event are critical. The goal with permanent teeth is to ensure they can function properly for as long as possible. On the other hand, deciduous teeth are naturally meant to fall out, so the strategies involve mitigating any immediate discomfort and ensuring there's no damage to the incoming permanent teeth.
In both cases, prevention is key. Encourage the use of mouth guards during sports and activities, foster a safe environment for children, and maintain regular dental checkups to mitigate potential damage and promote oral health.
Dental trauma is unsettling, but knowing how to respond can make a significant difference. Remember, time is of the essence, especially with permanent teeth. Your response could mean the difference between saving and losing a tooth. Even if an injury seems mild, it's always safer to consult with your dentist. And while this blog post and our bot is a great starting point, it's no substitute for professional dental advice tailored to your specific situation.
If you're in a predicament, don’t hesitate to use our bot for immediate guidance and download the report it generates. However always follow up with a dental visit as soon as possible. Your smile is priceless, and your dentist and we are here to help you protect it—every step of the way.
If you are a dentist and want to see what Ouch can do for you then get in touch. Our AI Platform will effortlessly help you triage patients, generate, qualify and convert leads for elective treatments, streamline administrative tasks and delight your patients.
Email us to find out more on admin@ouch.ai
International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations https://onlinelibrary.wiley.com/doi/full/10.1111/edt.12578
International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth https://onlinelibrary.wiley.com/doi/full/10.1111/edt.12573
International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition https://onlinelibrary.wiley.com/doi/full/10.1111/edt.12576