Click on these links to view posts related to Accidents and Dental Trauma:
Fractured Teeth, Knocked out Teeth, and other Pediatric Dental Accidents Basics of pediatric dental trauma.
When to Call the Dentist, When to Go to the Emergency Room Not all accidents need to be a visit to the ER.
My Child's Tooth is Turning Dark! I know you're wondering how that has happened and what to do about it.
After hours on call--the pager! Adventures of a rresident being on call for emergencies.
Torn Maxillary Frenum in a Child Very common injury in preschoolers.
APDA First Aid for Dental Emergencies Overall "how to" for basic dental emergencies. This will take you to our APDA website.
If you want more, go back to the home page or click here:Pediatric Dentistry
Saturday, April 01, 2006
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22 comments:
My three year old kncoked out his front upper tooth. I rushed him to our pediatric dentist. She said she had to pull his two other teeth right next to his knocked out one. He already has speech problems do you recommend getting replacement teeth?
I don't know in regards to your child, but usually I do not recommend the "fake" teeth. However, sometimes I have done a "pedo partial" for some patients -mainly for looks. I do not see any problems with having missing baby teeth as far as speech development. I will say the partials look better with several fake teeth than just one. One tends to stand out too much. Ask your dentist.
Hi Dr. Brandon,
I am a Pedo resident from UNC Chapel Hill. I am preparing a lecture to MD's about dental emergencies and while searching for material on the web, I came across your webpages. They are well organized and informative. I am wondering if you wouldn't mind letting me use them?
Also, in the Knocked Out Teeth section, you stated that if milk is not available, teeth can be stored in water. From my training here, the endo department believes that storage in water is no different than dry storage because water is too hypotonic and the live cells around the PDL would explode, leaving you no better than dry storage. Do you think that is the case? If so, perhaps your web pages and your first aid instructions would need to be updated.
Thanks for your informative webpages.
Ronald H. Hsu, DDS
Resident
Pediatric Dentistry
UNC Chapel Hill
hsur@dentistry.unc.edu
Dr. Hsu,
You are welcome to use my web site material. It's in the public domain. It's not a peer reviewed journal, just my opinions and experience.
On the water/milk thing. Most all the parents I see in this situation use milk. That's what I prefer, as it is easily available. I did have one parent scrub the tooth and use alcohol!..Ouch!
I read, in Andraesen's text you could rinse with water and store up to about 20 minutes after that then there might be problems. (again milk is much better) I wonder if a tooth left totally dry with a blunderbus root would dry out too much to the point it wouldn't revascularize where otherwise it might? In an article by Dr. Joe Camp(from UNC!)(Pediatric Dentistry 1995) says "the tooth must not get dry" with water being the least preferable medium. Well, things are changing all the time. If you have more up to date info, let me know. Thanks for the comment, and good luck!
Dr. Brandon,
My 7 1/2 year old caught her permanent front upper incisors on the outside of the trampoline enclosure (netting) and the teeth were moved and loosened. The next morning I took her to a general dentist who said that her roots weren't completely formed and she needed to be splinted by orthodontics. Within the hour, an orthodontist had two bracketts on her front teeth.
Initially I was told that she had a 50% chance of loosing her permanent teeth, and a 95% chance of them dying, and that she would need root canals.
Almost four weeks have gone by, and the front top incisors are straight and have not changed color, and she is still wearing the little braces (spint). However, this week I was at our Pediatric Dentist, with a different child, and she said that the splint should not be worn more that 48-72 hours due to permanent damage to the roots that would require root canals, and told me to contact an endodontist immediately to discuss. The Pediatric dentist said that there is new research that says not to keep wearing the splint.
I'm a little confused now, because the 7 1/2 year old is wearing a splint to keep her permanent teeth in her mouth while she heels from her trama to her teeth and gums.
I cannot find research that confirms that my daughters treatment is not the current and best treatment for trama and loose permanent teeth in a child. What is your experience with type of trama, and do you think that we have had the splint on to long?
I cannot comment on your particular case or give advice, because... well, for one thing every case can be different.
In general, a 7 year old will have less root development and a greater chance of tooth survival after a trauma say than an adult. Another child, (even of the same age) may have a more mature root. Most people will not benefit from a splint after the first week or so... depends on the amount of displacement, avulsion, or root damage as well. I wouldn't get overly concerned with percentages, because, as I mentioned, each case is different.
I do agree an Endodontist would be a good person to consult.
my 4 1/2 year old son has 4 cavities in his 4 upper front teeth. We saw a pediatric dentist and she told us we can either have the teeth filled along with 4 baby root canals and then cap the teeth OR have the teeth extracted and fitted for a baby partial or we can have the teeth removed and leave it at that no partial. I am not sure what to do. Root canals on a child seem a bit drastic but then so does pulling the teeth and having a partial. I guess my questions are...do root canals on baby teeth work or can we be setting him up for pain in the future. 2. the dentist told us the partial would be cemented in place...how does this work with his adult coming in in a few years? 3. if we dont get the partial how would this affect his mouth growth, speech and adult teeth coming in? we are prepared to pay for what ever the insurance does not cover and realize they (insurance) may not even cover the partial if we go that way. He will be asleep to have all this done. Not sure if this helps you answer my questions but his abby teeth came in very early about 3 to 4 months old he had a full set of teeth.
Thank you so much.
My son loosened his teeth from a fall 2weeks and 3 days ago..they are still loose and also displaced a little bit.The dentist said that if they are slightly displaced it shouldnt be a problem,but would that have any reason to why they are not tightning back up? Can his displaced teeth be fixed? What are the chances of a good outcome? Im very concerned.My son is only 1.
Seems like the dentist just wants to follow it for a bit. Probably a good course of action unless something else turns up symptom wise.
Thank You for your fast responce!
One more wuestion..please forgive me :-] Can a displaced tooth correct itself if its slightly displaced?
A slightly displaced/loose tooth can go back close to its original position--baby teeth more likely , but not if it is in crossbites or too displaced.
Thanks for your responce again!!:-]Its been 3 weeks since the accident and I do notice his teeth are a little tighter,but they do seem to have a cross bite with his upper teeth.Also,the surroundings have some discoloration to them,not much..slightly yellow.Doesnt this mean the nerve is dead? Is there anything that we can do if there is a cross bite?
My child knocked his tooth loose 4weeks ago. I checked and it still seems a little loose. :-[ It has not really changed colors,but I heard that wasnt a hopeful sign. Is there a chance that the tooth can still heal after 4weeks?
Usually they tighten back up, but get it looked at to make sure.
My son chipped his top tooth 2 months ago..no color change and no infection and dentist wants to see him back in 6 months,two bottom teeth have seemed to tighten back up more. I am concerned because thise are his only two bottom teeth at this point and when his other teeth come through is there a chance it can loosen again? And also,if no clor change in 2 months,is that a hopeful sign? His tooth is pointy but dentist never mentioned filing it down,could I get it done?
My 13 month old son has an under bite.I noticed that his bottom teeth go over his top teeth??
Well, at 13 months you can't really tell much about underbites---also, after a trauma if there is no color change in 2 months that is good, but still needs to be watched I think.
teeth still loose after 7 weeks.no color change.
That message didnt seem clear.LOL.
My son bumped his teeth about 7 weeks ago and knocked two teeth loose.They have tigtened back up,but are still slightly loose when I touch them but not as much as they we're.He is young and cant seem to keep ANYTHING out of his mouth and I dont think the daycare keeps hard toys out of his mouth.Any advise? The tooth has had no color change.
Okay a few questions...My son has two top and two bottom and is now getting another tooth on the bottom? Is that normal? My older son got his top first.
Another question,My oldest son was complaining when I brished his teeth. I looked and saw nothing.He showed me where it was hurting and it was his comes,they look blistery and swollen and in patches.
Teeth come in an odd order sometimes. Have your dentist check out any odd spots like that. Might be nothing, but good to check.
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