Dental Emergencies

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Dental Emergencies

  • Client: Pediatric Dentistry Goodyear, Avondale, Surprise, PVPD
  • Date: Tuesday, 09 October 2012
  • Info: Dental Emergencies
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Although dental injuries and dental emergencies are often distressing for both children and parents, they are also extremely common, where handling time is of the essence.

Approximately one third of children have experienced some type of dental trauma, and more have experienced a dental emergency.

There are two peak risk periods for dental trauma - the first being toddler-hood (18-40 months) when environmental exploration begins, and the second being the per-adolescent/adolescent period, when sporting injuries become commonplace.

Detailed below are some of the most common childhood dental emergencies, in addition to helpful advise on how to deal with them.

Toothache, common in children of all ages and rarely occurs without cause. Impacted food can cause discomfort in young children, and can be dislodged using a toothbrush, a clean finger, or dental floss. If pain persists, contact our pediatric dentist, Dr. Olga Dolghier. Some common causes of toothache include: tooth fractures, toot decay, tooth trauma, and wisdom teeth eruption (adolescence).

How you can help:

1. Cleanse the area using warm water. Do not medicate or warm the affected tooth or adjacent gum area.

2. Check for impacted food and remove it as necessary.

3. Apply a cold compress to the affected area to reduce swelling.

4. Contact our pediatric dentist to seek advice.

Dental avulsion (knocked-out tooth) - If a tooth has been knocked-out of the child's mouth completely, it is important to contact the pediatric dentist immediately. In general, pediatric dentists do not attempt to replant avulsed primary (baby) teeth, because the reimplantation procedure itself can cause damage to the tooth bud, and thereby damage the emerging permanent tooth.

Pediatric dentists always attempt to replant avulsed permanent teeth, unless the trauma has caused irreparable damage. The reimplantation procedure is almost always more successful if it is performed within one hour of the avulsion, so time is of the essence!

How you can help:

1. Recover the tooth. Do not touch the tooth roots! Handle the crown only.

2. Rinse off dirt and debris with water without scrubbing or scraping the tooth.

3. For older children, insert the tooth into its original socket using gentle pressure, or encourage the child to place the tooth in the chick pouch. For younger children, submerge the tooth in a glass of milk or saliva do not attempt to reinsert the tooth in case the child swallows it).

4. Do not allow the tooth to dry during transportation. Moisture is critically important for reimplantation success.

5. Visit our pediatric dentist, Dr. Olga Dolghier (where possible) or take the child to the Emergency Room immediately -t time is critical in saving the tooth.

Dental intrusion (tooth pushed into jawbone). Sometimes, dental trauma forces a tooth (or several teeth) upwards into the jawbone. The prognosis is better for teeth that have been pushed up to a lesser extent (less than 3mm), but every situation is unique. Oftentimes, the force of the trauma is great enough to injure the tooth's ligament and fracture its socket.

If dental intrusion of either the primary or permanent teeth is suspected, it is important to contact the pediatric dentist immediately. Depending on the nature and depth of the intrusion, our pediatric dentist, Dr. Olga Dolghier will either wait for the tooth to descend naturally, or perform root canal therapy to preserve the structure of the tooth.

How you can help:

1. Rinse the child's mouth with cold water

2. Place ice packs around affected areas to reduce swelling

3. Offer Tylenol for pain relief

4. Contact he pediatric dentist where possible, or proceed to the Emergency Room

Tooth luxation/extrusion/lateral displacement (tooth displacement), is generally classified as "luxation," "extrusion," or "lateral displacement," depending on the orientation of the tooth following trauma. A luxated tooth remains in the socket - with the pulp intact about half of the time. However, the tooth protrudes at an unnatural angle and the underlying jawbone is oftentimes fractured.

The term "extrusion" refers to a tooth that has become partly removed from its socket. In young children, primary tooth extrusions tend to heal themselves without medial treatment. However, dental treatment should be sought for permanent teeth that have been displaced in any manner in order to save the tooth and prevent infection. It is important to contact our pediatric dentist, Dr. Olga Dolghier if displacement is suspected.

How you can help:

1. Place a cold, moist compress on the affected area

2. Offer pain relief (for example, Children's Tylenol)

3. Contact our pediatric dentist, Dr. Olga Dolghier immediately

Crown fracture. The crown is the largest, most visible part of the tooth. In most cases, the crown is the part of the toot that sustains trauma. There are several classifications of crown fracture, ranging from minor enamel cracks (not an emergency) to pulp exposure (requiring immediate treatment).

Our pediatric dentist, Dr. Olga Dolghier can readily assess the severity of the fracture using dental x-rays, but any change in tooth color (for example, pinkish or yellowish tinges inside the tooth) is an emergency warning sign. Minor crown fractures often warrant the application of dental sealant, whereas more severe crown fractures sometimes require pulp treatments. In the case of crown fracture, the pediatric dentist should be contacted. Jagged enamel can irritate and inflame soft oral tissues, causing infection.

How you can help:

1. Rinse the child's mouth with warm water.

2. Place a cold, moist compress on the affected area

3. Offer strong pain relief (for example, Children's Tylenol)

4. Visit our pediatric dentist, Dr. Olga Dolghier or Emergency Room depending on availability and the severity of the injury.

Root fracture, is caused by direct trauma, and isn't noticeable to the naked eye. If a root fracture is suspected, dental x-rays need to be taken. Depending on the exact positioning of the fracture and the child's level of discomfort, the tooth can be monitored, treated, or extracted as a worse case scenario.

How you can help:

1. Place a cold, moist compress on the affected aea

2. Offer pain relief (for example, Children's Tylenol)

3. Contact our pediatric dental office

Dental concussion. A tooth that has been displaced from its socket or fractured, but has received a bang or knock, can be described as "concussed." Typically occurring in toddlers, dental concussion can cause the tooth to discolor permanently or temporarily. Unless the tooth turns black or dark (indicating that the tooth is dying and may require root canal therapy), dental concussion does not require emergency treatment.

Injured cheek, lip or tongue. If the child's cheek, lip or tongue is bleeding due to an accidental cut or bite, apply firm direct, pressure to the area using a clean cloth or gauze. To reduce swelling, apply ice to the affected areas. If the bleeding becomes uncontrollable, proceed to the Emergency Room or call a medical professional immediately.

Fracture jaw. If a broken or fractured jaw is suspected, proceed immediately to the Emergency Room. In the meantime, encourage the child not to move the jaw. In the case of a very young child, gently tie a scarf lengthways around the head and jaw to prevent movement.

Head injury/head trauma. If the child has received trauma to the head, proceed immediately to the Emergency Room. Even if consciousnesses has not been lost, it is important for pediatric doctor to rule out delayed concussion and internal bleeding.

Should you have questions or need additional information about dental emergencies, please ask our pediatric dentist, Dr. Olga Dolghier.