Dental Trauma to Adult Teeth
There are many different forms of trauma that can occur to damage the teeth, and it is important to be aware of the first action procedures upon encountering such an injury. I have limited the discussion to primary care when an adult tooth is displaced, fractured, or when the whole tooth, root and crown, is forced out of its surrounding bone.
Complete Avulsion (The tooth is completely removed)
Complete avulsion is most common in boys aged 7-10 years. Immediate first action procedures upon such an injury are as follows:
- Find the tooth.
- Do not touch the root with your hands and do not let it dry out!
- Implantation in the first 60 mins is essential for a chance at long term success.
- Re-implantation at the time of injury is best. Remove any dirt from the root of the tooth with milk, saline solution or saliva from the injured person.
- Hold the tooth by the crown and orientate correctly. Push slowly into the socket.
- Apply ice packs to lip to reduce swelling.
- Attend a dental surgery as soon as possible and feel free to call me for step by step live instructions on 0425 203 187.
- Offer some panadol and check tetanus immunity status
The tooth will need to be splinted into place, x-rays taken, and further advice given depending on the situation.
The tooth can be pushed forward, back or intruded. With any of these scenarios, the tooth needs to be seen by a dentist quickly. Repositioning of the tooth is very important. An intrusion injury (where the tooth is pushed up into the bone) can sometimes look like the tooth has been knocked out. Intrusion is the most serious injury and the long term success is very guarded. In most scenarios, the tooth that has been re-positioned needs to be splinted in to place.
These can be just the enamel, the enamel and dentine, or involve the nerve of the tooth or/and the root structure.
- Just the enamel - Not an emergency situation but needs to be checked by a dentist in due course.
- Enamel and dentine - When the nerve is visible or fractures involving more than 50% of the crown. Find the fractured bits of tooth. See a dentist soon but emergency treatment is not essential. Protection of the nerve of the tooth is advised as soon as possible for increased chance of long term success.
- Root fractures - These can sometimes appear as the tooth being slightly mobile and can be confused with displacement. An x-ray is needed to establish the cause of the mobility. Treatment depends very much on the developmental age of the root.