Management of sports injuries
The most common injury to the primary teeth is dislocation of the front
teeth. A primary tooth that is loose may be left in place or, if interfering with the bite, it may be removed. In
many cases, a loose tooth will heal without treatment. Injured teeth that are very loose may need to be
removed if there is a possibility that the tooth could fall out easily or cause the child to choke (eg, while
sleeping).
Anyone who participates in sport should wear appropriate safety equipment to prevent tooth (crown)
fractures, tooth intrusion, extrusion, and avulsion and temporomandibular joint dislocation. The treatment or
management of dental injuries depends upon the type of injury and whether the injured tooth is a primary
(baby) or permanent (adult) tooth.
Dislocated or loose primary tooth — The most common injury to the primary teeth is dislocation of the front
teeth. A primary tooth that is loose may be left in place or, if interfering with the bite, it may be removed. In
many cases, a loose tooth will heal without treatment. Injured teeth that are very loose may need to be
removed if there is a possibility that the tooth could fall out easily or cause the child to choke (eg, while
sleeping). If the primary tooth was knocked out completely, it should not be placed back into the gums
because of the risk of damage to the permanent tooth to follow.
Broken primary tooth —Treatment may include smoothing the rough edges of the tooth, repairing it with a
tooth-coloured resin material, leaving the tooth in place, or removing it.
Dislocated permanent tooth — A permanent tooth that is knocked out is a dental emergency that requires
prompt treatment. The tooth should be placed back into the tooth socket as soon as possible, ideally within 15
minutes and up to one hour (or longer if stored in cold milk). At least 85 percent of teeth that are put back in
the tooth socket within five minutes survive.
The following steps are recommended:
? Handle the tooth carefully by the top (crown).
? Remove any debris by gentle rinsing the tooth with saline or tap water; the tooth should not be scrubbed or
sterilized.
?Place the tooth by hand back into the socket.
?Keep the tooth in place by having the child bite on a clean towel or handkerchief.
?The child should see a dentist for treatment as soon as possible.
If it is not possible to replace the tooth in the gums, the tooth should be stored in a container of cold milk or in
a container of the child's saliva. Do not store the tooth in water, because this reduces the chances of successful
healing of the reimplanted tooth. The child should see a dentist as soon as possible. The likelihood that the
tooth will survive is reduced the longer the tooth is out of the mouth.
Loose permanent tooth — A loose permanent tooth that is interfering with the child’s bite is also a dental
emergency that requires prompt treatment. It may be necessary to use anesthesia (to prevent pain) and
stitches or splints (to hold the tooth in place).
Broken permanent tooth — The child should see a dentist within two days from the time of the injury. Broken
teeth that are sensitive to hot or cold must be treated on urgent basis. The tooth may be repaired with a
material called composite resin, which can be matched to the colour of the natural tooth.
Mouth injuries
The evaluation and management of mouth injuries depends upon how the injury happened, what areas are
injured, and the severity of the injury.
Tears — Small wounds or tears inside the mouth usually do not require stitches. Tears of the flap of skin under
the upper lip (the frenulum) also heal without stitches. Cuts to the tongue that are large, especially if near the
tip of the tongue require stitches. Wounds that involve the outer part of the lips and extend into the skin also
frequently require stitches.
Puncture wounds — Wounds to the back of the throat can occur if a child falls while holding a pencil,
toothbrush, or other object. If the object penetrates the side of the back of the throat, near the tonsils, there is
a risk of injury to the carotid artery (a large blood vessel). A child with this type of injury may require an
imaging test and/or evaluation by a surgeon, and will sometimes require hospitalization or surgery.
Home management of minor mouth injuries — To stop bleeding inside the lip, press the area against the
teeth and hold for several minutes. To stop bleeding of the tongue, hold the injured area between the fingers
with a piece of gauze or a clean cloth. Applying pressure should control the bleeding within 10 minutes. It is
normal to have small amounts of blood-tinged saliva afterwards. Small mouth wounds usually heal within
three days.
Pain relief — If a child has pain related to a mouth or tooth injury, the child may apply a piece of ice or frozen
popsicle to the area. A non-prescription pain medication, such as ibuprofen (Advil, Motrin) or acetaminophen
(Tylenol) may also be given. These medications should be dosed according to the child's weight rather than
age.
Antibiotics — Antibiotics are not often required for children with dental or mouth injuries. However, children
with complicated mouth wounds, including those that require stitches, may be treated with five to seven days
of antibiotics to prevent infection. Also, children with heart conditions that require antibiotics to prevent a
heart infection (endocarditis) after dental work should receive antibiotics.
Tetanus prevention — A dose of tetanus vaccine may be necessary depending upon the child’s tetanus
immunization status.
Hygiene and diet — After a tooth or mouth injury, it is important to keep the teeth clean. This includes
brushing twice per day with a soft bristled toothbrush. Occasionally, a mouthwash will be prescribed to
prevent swelling and infection. If a child's tooth is loose or the mouth is sore, a soft diet is recommended for
several days. Sucking on a pacifier or a finger should be restricted for the first 10 days following a tooth injury.
Children who have stitches in the mouth should avoid spicy or salty food, popcorn, and straws for
approximately one week.
Comments
Post a Comment