Fall is finally here, which means back to school and back to sports. Many kids today participate in sports, and parents know that injuries are always a part of the game. No injury is more devastating to a parent than a fractured or lost permanent tooth. Knowing how to handle an emergency like this can help save a child’s tooth. A blow to the mouth can result in one of three conditions: a fractured, displaced or avulsed (lost) tooth.

The fractured tooth – Many blows to the mouth result in fractures, which although damaging, usually do not result in loss of the tooth. Most fractures do not require immediate dental attention; however, if you see a red spot at the center of the tooth this could indicate exposure of the nerve. Your dentist will explain the appropriate treatment option for your child. Those could range from repairing the tooth with a white filling (bonding), a porcelain veneer or a crown. Some teeth may actually need root canal treatment. The good news is that most of these teeth can survive in the patient’s mouth for many years.

The displaced tooth – Sometimes the force is so great that the tooth can be moved out of its position. If this occurs, a dentist should be consulted with urgency. Sometimes the tooth can be gently moved back into position. This is done under local anesthesia for the patient’s comfort. On other occasions, an orthodontist may be required in order to help reposition the tooth. Your dentist will have to closely monitor the tooth with x-rays and a special diagnostic test to determine the life of the tooth. Displaced teeth may get dark, often a sign that the nerve has died. Root canal and whitening procedures can be done to bring these back to their original esthetic state.

The lost tooth – In these situations, you will most often see more blood. The first thing to remember is not to panic. If at first you do not see a tooth on the ground, have the child rinse with water and look into the mouth for displaced or fractured teeth. Remember, the child will be very agitated so it is important for adults to remain calm. If the tooth is found on the ground, DO NOT grab the tooth by its root. Carefully grasp the crown portion (the portion that is normally seen when one smiles) to pick it up. If the tooth is free of dirt, the best treatment is to replant it immediately into its socket, call your dentist and hold the tooth in place until you have reached the dentist’s office. The chances of preserving your child’s tooth without long-term damage are very good when the tooth is replaced in its socket within 15 minutes. If someone on the scene cannot replant the tooth, the tooth should be stored in a special tooth-preserving solution. Examples of these are Hanks’ Balanced Salt Solutions (HBSS) and Save-A-Tooth Never store the tooth in tap water, saliva or even milk as these will permanently damage the tooth’s root.

The cost of replacing a missing tooth can be upwards of $3,000. A mouth guard is the best preventative measure. Your dentist can help discuss the different options available. It is important that parents, coaches, athletic trainers, school nurses, police, emergency medical personnel and others have a plan in place for the treatment of lost teeth and include the special tooth-preserving solution as part of all first aid kits. Traumatic injuries to the face may cause other damage such as bone fractures or facial lacerations that need immediate medical attention. In these cases, first responders will transport and treat the patient, but someone at the scene of the accident must take charge and locate, preserve and transport lost teeth. With a proactive approach, years of frustration can be avoided.

Jorge R. Blanco, D.D.S. is an expert in the field of cosmetic dentistry.  In practice for more than twenty four years, he is currently the only dentist accredited with the American Academy of Cosmetic Dentistry (AACD) south of Palm Beach.  Since 2004, Dr. Blanco has been a clinical instructor with the Rosenthal Aesthetic Advantage Program at NYU and taught the General Dental residents at Mount Sinai Medical Center in Miami Beach.  Active in community affairs, his practice, which is under the name of Images Dentistry since 2004, is located on Red Road in South Miami.


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