What to do if you get hit in the teeth

DENTAL TRAUMA

If you need to contact us outside normal working hours, please phone the practice number - 01482 642736

Most people have been hit in the teeth by the time they reach their late teens. Some get away with no damage at all. Others break, loosen or even knock teeth out. This page is aimed to be a simple guide to what to do if it happens to you, or if it happens to somebody else whilst you're about.

Broken front tooth, stitched lip 

 

HAVE A LOOK~ HAVE ANY TEETH BEEN MOVED OR BROKEN OR ARE ANY MISSING?

If any teeth are missing FIND THEM. If teeth have been knocked out you need to find where they are. Teeth that cannot be found may have been inhaled, especially if the casualty has been knocked unconscious. If you cannot find all the teeth then the casualty will need X-rays to locate the teeth if they are inside them. A swallowed tooth isn't usually a problem but a whole tooth, or part of one inhaled into a lung is extremely important as it will become infected and would need to be removed.

IF A TOOTH HAS BEEN KNOCKED OUT AND THE CASUALTY IS WELL ENOUGH THEN PUT THE TOOTH BACK IN.  

If it's too dirty then wash it with cold TAP WATER first and then push it back in. Don't worry if it's the wrong way round, we can turn it round. If you don't feel confident enough to do this, or if things are a mess, then put the tooth in MlLK. If the casualty is well and confident enough they can keep the tooth in their own mouth in the cheek.

Avulsed tooth, missing tooth, teeth 

We have about an hour to get the tooth back in properly - so get on the phone!

 

IF TEETH ARE LOOSE OR HAVE MOVED BUT NOT FALLEN OUT, DON'T TRY TO MOVE THEM, YOU MAY DO SERIOUS DAMAGE.

 

Get on the 'phone immediately. We stop all other jobs for a trauma case.

 

When you arrive at the surgery, we'll clean things up, x-ray things and temporarily splint the tooth in place. After a few days the splint comes off and then we monitor the tooth. We'll check it regularly after that with either something called a pulp tester (a gadget that tests how easily the tooth can feel electricity), or by touching the tooth with cotton wool soaked in an icy fluid to see if the teeth can feel cold. If the tooth is dying, the response is less or non-existent. In which case we root fill the tooth. If teeth are very young, the root may have not finished growing, in which case we pack the root with chemicals that can make the root grow as if by magic!

 

BROKEN TEETH

Are usually surprisingly easy to repair with adhesive materials and even large fractures of the crown of a tooth are repairable to a very high standard by "bonding" tooth coloured material onto the remaining tooth. Early, high quality repair often allows these teeth to go on for decades with no problems at all.

Broken tooth, fractured tooth, teeth 

 

Teeth that are repaired quickly do a lot better than those that are left.

 

TEETH CAN DIE AFTER TRAUMA

  • Some will die within days - these are often the teeth that get bashed but don't break. The energy of the blow would have been dissipated by breaking the tooth, but if the tooth is merely jolted in the socket, the blood supply can be nipped off at the tip of the root. The tooth will go grey due to blood pigment being sucked out into the tooth, just like a bruise. So, if you get hit in the teeth but things look okay, watch for a change in colour. If these teeth are left, they will eventually become infected because there's a space full of dead material inside the tooth - every time we brush our teeth, scratch ourselves or go to the loo we scatter bacteria into our bloodstream. Usually, our white blood cells target them and kill them, but if the blood can't get to an area, they can't do their job - resulting eventually in an abscess.

These teeth are usually quite simple to root fill and then bleach back to their original colour by packing the inside of the tooth with peroxide based chemicals.

  • Some teeth die many years after being traumatised. They gradually fill themselves in, a process called sclerosis. They also change in colour, but to a colour varying from cream to brown. If you think about it, we all know someone with a brown front tooth - it's sclerosed, and if you ask them, they've often fallen off a bike 30 years ago. When x-rayed the root canal looks to have disappeared. Note how one of these teeth is subtly different in colour.  

 Brown tooth, sclerosed tooth

Because the tooth is solid, these teeth are very difficult to bleach back to the original colour.Brown tooth, sclerosed tooth

 

 

RESORPTION

There's another long term drawback to trauma. Occasionally, teeth that are traumatised are eaten away (resorbed) by cells called osteoclasts that are supposed to help in bone metabolism. Once resorption starts it's all but impossible to stop.

 

 

Basically, teeth that suffer trauma need looking at - and sooner rather than later.

 

 

 Click this link to download a condensed version of the above as an advice sheet.

 

 

IF IN DOUBT, RING FOR ADVICE

 

Practice number: 01482 642736

 

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© Hesslewood Lodge Dental Practice, 16 Nov 2015