While 14-month-old Amy was playing in the bath water, her mother turned away to retrieve a towel from the linen closet. That was all the time it took for Amy to slip and injure her mouth on the side of the tub. Her mother, shocked at what had just happened, had to quickly decide if the injury was to the lip, gums, and/or teeth. In most cases, it is good news if the injury involves the lip or gum tissue, as they quickly heal, while the outcome for injured teeth may be more uncertain.
If the injury involves the teeth, the parent should check for any fractures, looseness, change of position, or missing teeth. If any of these are discovered, it should prompt a call to the child’s dentist. In cases where the baby tooth is totally “knocked out,” the parent should try to find the tooth and present it to the dentist. This will assist the dentist in confirming that the baby tooth was not fractured or pushed up under the gum tissue. In most cases, a dentist will not re-implant a baby tooth. The main concern of the dentist will be the developing permanent tooth.
The treatment options will be based on the degree of injury and the compliance of the child. Let’s face it, most 6-month to 3-year-olds probably have not even experienced their first trip to the dentist. Meeting a stranger in a new setting who wants to look in their injured mouth may not place them in the best of moods! What to expect on your emergency trip to the dentist:
- Examination of the trauma to the lips, gums and/or teeth
- Possible x-ray to diagnose the extent of injury
- Treatment options such as the following:
- Observation
- Smoothing or sealing fractured teeth
- Repositioning teeth that are out of position
- Baby tooth “root canal” (pulpectomy)
- Extraction of injured tooth
Prevention is the best approach for protecting against baby tooth trauma. Bathtubs are the most common site for tooth trauma, while coffee tables and steps run a close second. Something as simple as placing a non-slip pad or similar device in the bathtub, or padding the edges of tables, can be highly effective in preventing injuries. Toddlers learning to walk should be monitored closely and always have a parental hand to hold.
When oral trauma does occur, parents should not harbor guilt. Children, by their nature, are very active and fall frequently. Parents must accept the fact that oral trauma can and will occur, regardless of their best preparations and natural caring.
Dr. Glenn V. Hemberger, D.D.S., M.S. specializes in dental care from baby’s first check-up (12-18 months) to preventative care including orthodontics.