Dental Trauma

Tooth accidents happen and can be life changing – I am regularly asked after hours, what I should do. Where can I get help?

If a dental injury occurs, it is often important that you know what to do and where to seek advice.

So here’s an overview of some dental injuries (I am updating a guide at present).

Dental trauma refers to injuries to the teeth, gums, or other oral tissues. The types of dental trauma can range from minor chips or cracks in the teeth to severe damage that requires immediate emergency care.

According to the International Association of Dental Traumatology (IADT) &lt: www.iadt-dentaltrauma.org, there are several types of dental trauma:

1. Fractures: refer to any break or crack in the tooth or its root. Different types of fractures include enamel-only, enamel-dentin, and root fractures.
2. Luxation: injuries involve the tooth being pushed or pulled out of its normal position. Luxation injuries can be classified as subluxation (tooth is loose but still in position), lateral luxation (tooth is pushed to one side), intrusion (tooth is pushed into the jawbone), or extrusion (tooth is partially pushed out of the socket).
3. Avulsion: is when the tooth is completely knocked out of the mouth.
4. Soft tissue injuries: include injuries to the gums, tongue, and cheeks.

The Dental Institute of Dental Trauma provides guidelines for the management of dental trauma based on the severity of the injury.

These guidelines take into account factors such as the type and extent of the injury, the age of the patient, and the time elapsed since the injury occurred.

The guidelines provide recommendations for the immediate treatment of dental trauma and long-term management to ensure the best possible outcome for the patient.

It is important to seek immediate dental care if you or someone you know experiences dental trauma.

Prompt treatment can help prevent further damage to the teeth and gums and may improve the chances of saving a knocked-out tooth.

Enamel or Dentine Fractures (FRACTURED TOOTH) 

The Protocol for a fracture in enamel or dentin in a tooth depends on the severity of the injury. Here are some general guidelines:

1. Enamel-only fractures: are the most minor type of dental fracture and usually do not require any treatment. However, if the fracture is deep or causes sensitivity, a dentist may recommend filling the area with a tooth-coloured composite material.
2. Enamel-dentin fractures: involve both the enamel and dentin layers of the tooth. If the fracture is small and does not extend to the tooth’s nerve, the dentist may recommend a filling or bonding material to restore the tooth. A crown or root canal treatment may be necessary if the fracture is large or close to the nerve.
3. Cracked tooth: A cracked tooth can be more difficult to diagnose and treat than a simple fracture. Treatment may involve a crown, root canal treatment, or extraction, depending on the extent of the crack and the location of the tooth.

It is important to see a dentist as soon as possible if you experience any dental trauma. The dentist can evaluate the injury and recommend appropriate treatment to restore the tooth and prevent further damage.

What is the Protocol for luxation and the types? (Pushed in or out of position)

The Protocol for luxation injuries in teeth depends on the type and severity of the injury. Luxation injuries involve the tooth being pushed or pulled out of its normal position. There are different types of luxation injuries, including:

1. Subluxation: This is a minor injury where the tooth is loosened but still in its original position. Treatment may not be necessary, but the tooth should be monitored to ensure it heals properly.
2. Lateral Luxation: This is when the tooth is pushed to one side or the other. Treatment involves repositioning the tooth back into its original position and stabilizing it with a splint for a period of time to allow the tooth to heal.
3. Intrusion: This is when the tooth is pushed into the jawbone. Treatment involves repositioning the tooth back into its original position and stabilizing it with a splint. In some cases, root canal treatment may be necessary.
4. Extrusion: is when the tooth is partially pushed out of the socket. Treatment involves repositioning the tooth back into its original position and stabilizing it with a splint. In some cases, the tooth may require root canal treatment.

5. Avulsion: is when the tooth is completely knocked out of the mouth. It is important to seek immediate dental care as time is critical to save the tooth. Treatment may involve re-implanting the tooth into the socket and stabilizing it with a splint. A dental implant or bridge may be necessary if the tooth cannot be saved.

Overall, it is important to seek immediate dental care if you experience any type of luxation injury. A dentist can evaluate the injury and recommend appropriate treatment to ensure the best possible outcome for the tooth.

What is Avulsion of a tooth? (KNOCKED OUT)

When a tooth is avulsed, meaning it has been completely knocked out of its socket, it can result in a number of issues. Here are some of the potential problems that may occur following the allusion of a tooth:

1. Tooth Loss: The most obvious issue following an avulsion is tooth loss. This can be a significant cosmetic issue, especially if the missing tooth is in the front of the mouth.
2. Pain and Discomfort: Avulsed teeth can be painful and uncomfortable, particularly during healing.
3. Bleeding: The avulsed tooth can cause bleeding in the mouth, which can be difficult to control.
4. Infection: There is a risk of infection following an avulsion if the tooth was not handled properly or if it was exposed to bacteria outside the mouth.
5. Bone Loss: If the tooth is not replaced in the socket quickly enough, bone loss can occur in the area where the tooth was once located.
6. Bite Problems: An avulsed tooth can cause bite problems, especially if the missing tooth was located in the front of the mouth.
7. Speech Difficulties: The loss of a front tooth can also affect speech, causing difficulty with pronunciation and diction.
8. Misalignment: If an avulsed tooth is not replaced or restored, the surrounding teeth may shift and become misaligned.

It is important to seek immediate dental care if you experience an avulsed tooth. A dentist can help minimize these issues and re-implant the tooth back into the socket to improve the chances of saving the tooth.

When should a root canal be performed after dental trauma?

A root canal procedure may be necessary after dental trauma when the injury causes damage or infection to the tooth’s pulp, which contains the tooth’s nerves and blood vessels. The pulp can become inflamed or infected, leading to pain and potentially further damage to the tooth.

The timing of the root canal procedure after dental trauma will depend on the severity of the injury and the symptoms experienced by the patient. Here are some general guidelines:

1. Acute symptoms: If the patient is experiencing acute symptoms such as severe pain, swelling, or an abscess, a root canal may need to be performed immediately to alleviate the pain and prevent further damage or infection.
2. Delayed symptoms: If symptoms do not appear immediately following the dental trauma, a root canal may still be necessary if the tooth becomes discoloured, sensitive to temperature, or painful in the weeks or months following the injury.
3. Evaluation by a dentist: It is essential to see a dentist as soon as possible after dental trauma to evaluate the injury and determine if a root canal is necessary. The dentist will examine the tooth and may take X-rays to assess the extent of the damage and determine if the pulp has been affected.
4. Timing of the root canal: The timing of the root canal procedure will depend on the severity of the injury and the patient’s overall oral health. In some cases, the root canal may be performed immediately, while in other cases, it may be necessary to wait until the swelling and inflammation have subsided before performing the procedure.

Overall, seeking prompt dental care after dental trauma is important to minimize the risk of further damage and determine if a root canal is necessary. The timing of the procedure will depend on the severity of the injury and the patient’s symptoms and oral health.

Always try and contact your dentist first – photographs are beneficial and may be able to be sent to them to gain advice and obtain urgent treatment if deemed necessary.

If you haven’t got a dentist on the Island, the Community Clinic on 01624624785 – may be able to help.

Out of Hours – call us on 07624 494327 or, failing that, your local accident and emergency.

An Avulsed or Luxated Tooth often requires urgent treatment, so it’s essential to seek advice.

The Tooth App ToothSOS is also invaluable – this can be downloaded via the app store on your mobile device