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Traumatic dental injuries (TDI) are relatively common among children (WHO 2019). Epidemiological studies reveal that 25 percent of toddlers can be expected to sustain dental injury most often between age 2 and 4 years of age.4 Tooth and mouth injuries often occur after a fall (for young children, especially when they have an object in their mouth).4
FIRST AID FOR DENTAL (TOOTH) INJURIES1
- Minimize emotional trauma: If the child has not injured himself seriously, start by comforting him while assessing the injury.
- Control bleeding: If a child is bleeding, use a clean cloth to apply and maintain pressure till the bleeding stops.
- Relief pain: Apply an ice pack to reduce swelling and relieve pain and if not enough give a pain relief medication (dose prescribed by your child’s doctor according to child’s weight rather than age).
- Check the teeth: If a child tooth is knocked out.
1. Place it in milk immediately to keep it moist and visit the dentist immediately.
2. When handling the tooth, only touch the crown (the part that is visible in the child’s mouth) and not the root (the part that sits in the child’s gum).
3. If the tooth is dirty, it should be rinsed in milk. The tooth should not be scrubbed or sterilized.
4. Fragments of tissue and gum that remain attached to the tooth should not be removed.
5. The tooth should not be allowed to dry out or be in contact with water for more than 2 seconds.
6. The tooth should be taken to the emergency dental appointment.
7. NEVER try to push a dislodged or knocked out tooth back into its socket. It may cause infection or damage the permanent teeth that are sitting beneath the child’s gum, waiting to emerge at around 6 years of age.
8. Because of the risk of damage to the socket and permanent tooth, primary teeth are never re-inserted, even at the emergency dental visit.
9. PS: Primary teeth (n=20 milky teeth): small, very white, bulbous crowns, often worn, flat edges
Permanent teeth (n=32 permanent teeth): larger, creamier in color, jagged edges on newly erupted teeth. Permanent incisors usually erupt sometime between the ages of 6 and 8 years.2,3
- Call a dentist immediately: visiting a dentist is important for all tooth injuries, including when a tooth has been displaced (moved) but not knocked out. A displaced tooth that remains in the child’s mouth may cause damage to the permanent teeth. The dentist will assess the likelihood of a permanent tooth being damaged and may need to remove the displaced primary tooth (milk tooth).
Dr. Nisrine Makki
Pediatrician
1https://healthengine.com.au/info/first-aid-oral-trauma-children
2https://www.rch.org.au/clinicalguide/guideline_index/Dental_Injuries/
3https://www.rch.org.au/clinicalguide/guideline_index/Burns
4https://pediatrics.aappublications.org/content/133/2/e466
