Dental Trauma

Any type of dental trauma can be scary and often very painful, so it’s always helpful to know a little bit about what damage has been done and how you can help yourself if you have an accident or need to see the emergency dentist. Don’t rely on home remedies if you’re experiencing a lot of pain, and whatever you do, don’t try and perform any surgery on yourself, leave the complicated procedures to your dentist.

What kinds of injuries are classed as ‘dental trauma’?

There is a long list of injuries that can be labelled traumatic, from chips to fractures and much more besides. Most dental trauma’s are quite painful, but treatable. Staff at the Pearl Dental Clinic, London, are experienced with all types of dental problems and can restore your smile with minimal stress. They also run a twenty-four emergency dental service, for patients who are involved in accidents or who need immediate assistance.

Chipped teeth are probably the most common dental injury, but emergency dentists are equipped to deal with traumas as severe as dislodged teeth or lacerations to the soft tissue in the mouth. In some cases, the injury might not be extremely painful, but it’s important that it is assessed by a healthcare professional, as there could be some problems that aren’t immediately obvious but may need subsequent treatment.

What can they do to help?

Treatment of dental traumas varies depending on the situation at hand, i.e. what sort of trauma has occurred and how severe it is.

Chipped teeth -With superficial chips or fractures there is generally not a lot of discomfort unless the crack breaks through the enamel and exposes the inner pulp of the tooth. It’s much easier to fix a cosmetic problem rather than a medical one, and if there’s no need for fillers or bonding, your dentist should be able reattach any broken pieces or rebuild the tooth using dental cement, without the need for anaesthetic. If a large portion of the tooth has been lost, you may need a crown to protect the remainder against infection or further damage.

However, if the fracture has penetrated deeper into the structure of the tooth there is a danger of infection and a metal or composite filling will probably have to be applied to seal the pulp and keep it functional. If this happens to you, don’t place any painkillers directly onto the affected area, just rinse your mouth out with warm water and bite on a small piece of gauze to relieve the pain until you can be seen by the dentist.

Seeking help for a cracked or split tooth is vital in the early stages, if it’s left untreated, bacteria can get to the central nerves and destroy them, this will lead a root canal procedure – something you want to avoid if possible.

Knocked out teeth – Teeth that have been completely removed from their socket have to be saved as soon as possible, before the root dies and the tooth cannot reattach to the soft tissue. While you wait to see the dentist, carefully wash the tooth in warm water without brushing or scraping it, then try and put it back in the socket if you can. If this is too painful or it won’t hold at all, carry it in a cup of milk – this is good for the enamel and keeps the roots alive until it can be reattached. It’s important to get to a dentist within an hour if you want to save your natural teeth. If you dentists manages to cement the tooth back in place, it has to be stabilised with a splint for several weeks, this stops it becoming dislodged and allows the gums to grow around it. Over the next few weeks you will be able to tell if the tooth was reattached in time or if it has to be fully removed, it’s likely that you will need a root canal treatment if there has been serious damage to the nerve centre.

Dislodged teeth – Not all injured teeth with fall out of the mouth upon impact, sometimes they can be pushed further into the socket or become twisted into a different position. Dental surgeons should be able to reposition the teeth in the ruptured tissue, but there’s likely to be more pressing problems with the roots. In the same way as knocked-out teeth, you will probably need a root canal procedure to prevent infection, and a filling at a later date. Again, time is a factor with dislodged teeth, if the tooth isn’t returned to it’s proper position and cemented into place, bacteria can cause the area to become infected, this is to be avoided at all costs as it can lead to decay, gum disease and tooth abscesses.

Fractured roots – Dental traumas that involve damage down to the root are more serious and are usually very painful. There are lots of things that can go wrong with the healing of fractured roots; this is because they are very delicate and vulnerable to infection if they are not protected by the hard tooth. A fracture that is closer to the tip of the root has a better chance at healing properly, but if it’s closer to the gum line, chances are the dentist won’t be able to save your tooth. Normal course of action is to splint or bond the tooth to the surrounding dentures, this stabilises it for a period of time, until it can be determined whether the pulp is still active and can be saved. If the tooth is still loose after about six months, it can either be removed or permanently fixed to the teeth next to it to keep it stable.

What are the long-term effects?

That all depends on the nature of the injury, the length of treatment, and the healing process. The best results are usually seen in patients who have seen a dentist immediately after the trauma occurred, time is the biggest factor in almost all dental emergencies. It’s possible that some people could be experiencing problems for years after the initial injury.

If you feel that your teeth are not healing properly, make another appointment to see your dentist and have your condition assessed.