June 23, 2017 - Roland Chong

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Welcome to issue Twenty of YOUR DENTAL CARE News. In our nineteenth issue we discussed about Oral Cancer…. If you missed this issue please visit our website http://www.procarefamilydental.com.au/articles.
In this issue we will discuss Dental trauma.
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Dental trauma-what to do?

A sporting or recreational accident involving the face and mouth area is quite common.  When the facial area is involved in an accident many things can go wrong. Bone fractures, cuts to lips or cheeks, broken teeth, dislodged teeth, and concussion are some of the common facial injuries.

First responder.

The most important step in any emergency setting is to ensure that everyone in the immediate area is safe. Remove any immediate danger or if not possible, wait for an emergency professional to attend the scene. Any danger to the person in the immediate vicinity needs to be dealt with first. The next most important step is to ensure the injured person is conscious, breathing and all vital signs accounted for. If the injured individual has a facial injury and unconscious they need to go to a hospital.

What to do with broken and dislodged teeth?

Any broken tooth fragments at the site of injury should be collected if possible. These should be stored in milk or saline preferably not in water. Broken parts of teeth can be reattached to the existing tooth so don’t discard them!

If adult teeth are knocked out completely the tooth should be replanted immediately.  The tooth must be washed under running tap water first, if sterile saline is not available, for no more than 10 seconds. Always hold the tooth by the crown (Figure 1), this is the part of the tooth which is visible past the gum, and never by the root. Position the tooth the right way in the socket by looking at the adjacent teeth, and gently push it into the socket. Have the person bite gently on the tooth with some gauze or towel between the teeth. Seek dental management immediately. Aluminium foil can also act as a good temporary splint to hold the tooth in place.

The less time the tooth is out of the socket the better. The long term prognosis for the tooth improves with immediate dental management. If  the tooth cannot be re-positioned into the socket transport the tooth in milk or saline to a dentist immediately. In the event neither is available then place the tooth beside the cheek and back molar. Having the tooth in the mouth during transport is not advisable if the patient is young or having trouble staying conscious.

The tooth should not be replanted into the bony socket if it is a baby tooth. The developing adult tooth in the bone can be damaged if the baby tooth is pushed into the socket. Baby teeth which are knocked out are best kept out for the tooth fairy.

Summary.

What to do after dental trauma:
1) DRABC (Danger, Response, Airway, Breathing, Circulation.)
2) Locate any missing tooth parts or teeth.
3) Store tooth parts or whole tooth in appropriate medium for transport to dentist. Re-position knocked out adult tooth immediately if possible.
4) See dentist ASAP.

Figure 1. Correct way to hold a knocked out tooth.

I hope this helps you manage any future trauma to teeth. In the meantime keep smiling.

Roland Chong

Roland has over 18 years experience as a general dentist. Roland does all aspects of general dentistry with a special interest in prosthodontics (crown and bridge work) and cosmetic dentistry. A member of the International Team of Implantology, Roland is constantly developing his skills by collaborating with international experts.