Parents with young children are well versed in the situation called : EMERGENCY. Every other day parents face situations that need urgent attention in children. Some may be simple causing alittle panic while others may lead to extended hospital stay. The dental problems in children are not emergency proof. The tooth canbe the cause of a panic situation in a child. When such situations arise, we rush to the nearest medical centre, buta medical centre equipped with the dental facility would benefit the long term results of the treatment.
- A fall on the ground, from the bed, from a bike
- Push or pull causing a bang during play
- Fall with an object placed in the mouth
- Road traffic accidents
Most trauma occur during school hours in older children or at home when the child is left unattended in younger children.The immediate appearance of the child after injury to the teeth may cause a lot of apprehension to the parents.
TYPES OF INJURIES :
Fractured teeth (broken teeth):The broken can be simple, involving only the top layer (enamel or dentin) of the teeth and require only a filling. At times the break may involve the pulp and require a root canal treatment followed by a filling or even a crown. Furthermore, if the tooth has lost a major portion or is broken at the root, it may need an extraction. The treatment needed will be decided by the dentist based on the X-rays and other investigations and the long term results.
Mobile teeth:Sometimes after a trauma, the teeth may not break , but be mobile to a certain degree. The treatment of mobile teeth consists of making the teeth immobile by using splints for around 2 weeks and soft diet. If the mobility is high or in the case of milk teeth, the dentist may decide to remove the tooth.
Teeth out of position:If the tooth has moved out of position in any direction, then the dentist will reposition it and make it immobile with splsints but again in milk teeth the decision may vary with either repositioning or removal of teeth.
Tooth out of the socket (avulsion):if the entire tooth has fallen out of the socket there are certain guidelines to follow:
First the tooth should be located and brought to the dentist and if the tooth cannot be located then a chest x-ray may be advised. In case of permanent teeth:
- Try to place the tooth back in its position or
- Hold it in the mouth (if it cannot be done in young children) or
- Put it in milk or coconut water and immediately rush to the nearest dentist.
- Do not hold the tooth by the root or wash o manipulate it
- The dentist will replace it in the socket and immobilize it for some weeks.
- The earlier you reach the dentist the better will be the treatment result. A milk tooth will not be replaced back to the socket.
Lip tear / cut:cuts and bruises in children heal more easily than in adults. If the cut is small the child may not require stitches, but a deep wound may need to be stitched.
Jaw fracture:In case the jaw has fractured then the child may show swelling of regions of the face associated with the fractured bone. They need to be treated by a specialist consisting of simple treatment or even surgery in case the injury is severe.
In all the cases the child may:
- Be given tetanus injections (based on the need)
- Antibiotics as well as pain relievers
- Advised a soft diet
- Asked to come for follow up which is important.
- X-rays may be needed during the follow up visit.
INSTRUCTIONS THAT MAY HELP:
- Be calm. The child will be more fearful if the parents are tensed therefore the parents need to be calm.
- Do not rush to the nearest pharmacy and ask for a pain relieving medicine (common practice in Nepal)
- Rush to the nearest health care centre and if the centre does not have a dental facility then, ask to be referred to one.
- If the injury occurs at night, go to a center with 24 hours emergency services
PREVENTION OF INJURIES: preventing an injury is the best option:
- Make the house/ school child safe: cushioning flooring, corners of furnitures should have rounded edges, high railings should be constructed.
- Keep sharps or injurious objects like knives, scissors out of reach of the child.
- Use helmets, knee and arm pads as well as mouth guards during sports and other activities.
- Do not leave young children unattended.
- In case the child has tooth decay or hypomineralized teeth (makes teeth weak) or proclined front teeth get it treated.