Dental Trauma in Children

by Eric Dixon DDS

Summer time is here!

It is time for skateboards and scooters, baseball and bicycles, pool parties and pinatas…and unfortunately an increase in tooth trauma. Our office has seen fractured teeth in the past year in all of the above activities. While we can’t completely protect our children from every potential accident, an ounce of prevention in this case is definitely worth a pound of cure.

The number one cause of non-auto related facial trauma in children is bicycle and scooter accidents. One of the easiest and most effective trauma prevention tools is the proper use of a well fitting helmet. These days there are not only an amazing selection of fun designs that make helmets more acceptable to our children, but since 1993 they have been required by law for all children in the state of California under the age of 18 when riding bikes, scooters or skateboards. I always test my children’s helmet by snapping it snuggly under their chin (watch not to pinch!) and hitting the front of the helmet with the palm of my hand. The helmet should stay in place. If it does, then it will protect not just the skull, but also the face if there is a face forward fall on the pavement. My own children have both had full face plants that resulted in scrapped up chins and tips of noses, but no significant face/tooth trauma.

If an unavoidable accident does happen, and the mouth is injured, there a few things you can do to help your child recover more quickly and completely. Most importantly, please verify that your child is otherwise healthy after the accident and that their mouth or teeth are the only areas involved. If after the accident your child suffered a loss of consciousness, nausea, dizziness or vomiting please call your pediatrician at Coast Pediatrics Del Mar or 911 immediately. Also, if you feel your child has a broken jaw or their mouth moves to one side or the other when they open, please take them directly to the emergency room.

The most time critical situation involving a tooth trauma is when a permanent tooth is knocked out of the mouth. If this happens to your child, grab the tooth by the crown (tip of the tooth) and rinse it off under clean running water and place it in some cool milk. Do not scrub the tooth! The tissue that is still alive on the root of the tooth is the most important thing in determining the success of the tooth’s survival. Minutes do matter in this situation, and getting the tooth back in the socket within 30 minutes will give the tooth the best chance of survival.

Your dentist can place the tooth back in the socket, and on young permanent teeth the nerve of the tooth can sometimes reattach and remain healthy. On older children, a knocked out tooth will often need a root canal to remain healthy, but the dentist will evaluate each situation individually. Knocked out primary (baby) teeth are almost never re-implanted in the socket, but it is still important to call your dentist soon after the trauma to evaluate if any follow up care is needed. If a baby tooth is lost, your dentist can make a retainer like appliance that can replace the missing tooth for cosmetic reasons if it is desired by the parents.

A broken permanent front tooth is probably the most likely dental trauma your child may suffer this summer. First, if a tooth is broken, try to find the pieces. If the tooth fractured cleanly, and in a large enough piece, it can often be re-bonded back together. Do not be overly concerned if you can not find the pieces though, your dentist can use the amazing materials we have today to replace the missing portion of the tooth with color matched resin reinforced porcelain filling material. When done correctly, most people have a hard time recognizing a tooth has been fractured and repaired. If the nerve of the tooth is exposed during a trauma, your dentist can often prevent the need for a root canal by placing a special material over the nerve called MTA. This has been an amazing advancement in dentistry, children who would have needed a root canal just 10 years ago can avoid it now with the use of modern materials and techniques.

Hopefully you will not need to use any of this information this summer, and these wonderful sunny months in San Diego pass without incident. Please use every preventative measure you can to keep your children safe and out of harms way. However, if a trauma does occur, please use this information to help improve your child’s chances of a full and healthy recovery.

Dixon.photoDr. Eric Dixon is a pediatric dentist in private practice.  He received his DDS degree from University of the Pacific in 2001, and then spent 2 years at UCLA completing a pediatric residency program.   Upon completion of his training, he joined the pediatric dental practice of his father Dr. Howard R. Dixon along with his wife Dr. Stephanie Dixon, and has been treating the children of San Diego ever since.  He and his wife Stephanie have two young sons, Tyler and Austin.  Drs. Eric and Stephanie are available to treat children of Coast Families living throughout San Diego County in their two offices, one in Sorrento Valley and the other in the Kensington area of San Diego.  See their websites and for more information.


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