Sometimes it happens quickly. When cycling, sledging or in football training. A child falls, collides with the opponent or gets the ball directly in the face. Often an incisor is out or broken or the jaw is injured. Teenagers and children today lose more teeth to injury than to decay. In school or recreational sports alone, 1 in 3 children suffer an injury to their teeth. What to do in such situations? Can the tooth be saved and what precautions can be taken? We have met with the renowned dentist Dr. med. dent. Jürgen Pink(www.max34.de) and have compiled the most important rules of conduct as well as information on further care in the following.
The right first aid is crucial!
In the event of an accident, the first thing to do is to remain calm. The tissue in the mouth and facial area is very well supplied with blood, which is why injuries in this region can cause heavy bleeding, but this usually stops quickly. The following steps should then be taken:
- The child must first be examined for injuries to the teeth or jaw. Above all, it should be quickly determined whether a tooth has been knocked out.
- If a tooth is missing, it must be searched for immediately. In the case of children or unconscious people, there is a risk of swallowing or inhaling the tooth; this can be life-threatening! In parallel, a tooth rescue box should be organized immediately, which are available in pharmacies. We at Child Care already have such boxes for emergencies.
- Once the tooth has been found, the most important thing is how it is stored. Every minute counts here! Knocked out teeth dry out within minutes without proper precautions, the roots of the tooth die and it is impossible for the tooth to heal.
- Important: The tooth may only be touched at the crown, the root surface must not be touched, otherwise the roots will die immediately.
- Do not clean tooth, disinfect, keep under tongue or place in water.
- A tooth rescue box is the ultimate here, as it contains a special tooth nutrient solution and keeps the tooth alive. In such a box, teeth can even be successfully reinserted and preserved 24-48 hours later.
- Sometimes the knocked out tooth can be pressed directly into the tooth space (alveolus). Here, the tooth is also well taken care of. However, this can only be done in responsive patients who cannot swallow the tooth. This option is not recommended for children.
- Alternatively, as a short-term interim solution, the tooth or tooth piece can also be kept in UHT milk for a maximum of 1-2 hours or in an iostonic saline solution for a maximum of 30 minutes. Also suitable for the first few minutes is a plastic bag. With these variants, however, significantly worse healing results are to be expected.
- Calming and caring for the injured. Stop the bleeding with sterile compresses. Cool the pine if necessary.
- In case of any dental injury, consult the dentist or a dental clinic immediately. Teeth can also be shaken or loosened, which is not testable by the layperson, but can lead to long-term problems in the jaw.
- Beware of accidents in swimming pools: If children hit the edge of the pool with their jaws or incisors, the milk teeth can be pushed onto the incisors. See the dentist as soon as possible!
- Visiting the dentist is important for meaningful documentation and therefore for any insurance claims.
The second step: A quick and optimal restoration at the dentist
If the above steps have been taken and the tooth with the complete root has been lost, the chances are very good that the knocked out tooth or the piece of tooth can be reinserted into the jaw and preserved in the long term. If a part of a tooth is broken off, it can often be cemented back in place with a special solution if it is stored optimally. Alternatively, the tooth shape and structure can be built up with a filling.
When the tooth is reinserted, there is a difference between the milk teeth and the second teeth. The latter can be replanted very well by the dentist, if they are completely lost with the root and found again. Also, the milk teeth can be reinserted relatively well up to about the age of 4 years. Here, the dentist must decide whether this makes sense. The reason: At about 6 years of age, the milk teeth gradually fall out. In this process, the roots of the milk teeth are slowly degraded and the so-called “wobbly teeth” develop. These milk teeth can then no longer grow without a root.
If the jaw is affected, an x-ray should be taken first to determine the degree of injury. In the event of a fracture of the jaw, treatment by an oral surgeon must be carried out as soon as possible.
Precautions & Prevention:
If youplay action-packed sports or have kids who love to move, be sure to get a dental rescue box and carry it with you! These are available in pharmacies for about 20 € and have a closed shelf life of about 3 years.
Preventively there is the possibility to wear a mouth guard. There are different variants. The ready-made mouthguard is available in sports shops. It is inexpensive, but cannot be individually adjusted and therefore does not offer optimal protection. The second option is a custom-fitted mouthguard made of thermoplastic material, which is softened in a water bath and then adapted to the shape of the teeth. It offers good but not optimal protection. The Mercedes among mouthguards is a mouthguard made individually by a dentist. The exact anatomy of the jaw is determined by taking an impression of the jaw, which can be done digitally at Dr. Pink’s dental practice if desired. Based on the impressions or digital images, the dental laboratory then produces a perfectly fitting mouthguard with a high level of comfort and protection.