Dental Advice: What to do after a fall?


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Question: Oh dear, my little one chipped his front tooth. What do I do?

Dr Rashid: Ideally, a chipped tooth should be filled to prevent infection. However, in a young child, this may be impossible. So you may have to leave it alone until it drops off, or when he is more cooperative for a filling. However, if the chipped tooth is sharp and causes soft tissue injuries such as ulcers, your dentist can smooth it quite easily with a sandpaper disc.

If a baby tooth is knocked out, it should not be replanted. Please remember that this is very different from a knocked-out adult tooth. Replanting Baby’s teeth may cause damage to the adult tooth that is still forming underneath.

Question: My baby’s front tooth turned dark after he bumped it. I heard that it will lighten after a while. Is that true?

Dr Rashid: The most common complication of such injuries is tooth discolouration, where the tooth turns grey or black. This often occurs if the child suffers from a displacement type of injury. Imagine a tooth being chipped, displaced or having internal bleeding. It’s like the skin turning blue-black. If the displacement is mild and the blood vessels of the tooth is not severed, the “bruising” will clear up and the colour lightens. If the displacement is severe and the blood vessels are severed, then the dark colour remains. There is no treatment; just leave it alone.

Question: My kid took a tumble and bit his tongue, ending up with a bloody mouth. What do I do?

Dr Rashid: Bleeding is common after mouth and face injuries because of cuts to the soft tissues. Most of the time, they are superficial nicks. But when the blood mixes with saliva, resulting in what looks like a lot of blood, it makes the wound seem worse than it is. However, there are rare instances where the wounds are deep and may require stitches.

The best way to stop bleeding is to use a clean towel to apply continuous pressure for 10 minutes. Time yourself – do not keep removing the pressure. Check only after 10 minutes. Don’t use tissue because the paper may have to be teased off the cut areas, which may start the bleeding again. Don’t rinse away the blood – this is the worst thing to do because it will prevent the blood from clotting.

To stop bleeding in the mouth, I don’t think using a cold compress is very practical because it is too bulky and will not fit into the oral cavity. Using ice cubes won’t help either because when the ice melts, it may delay the blood from clotting.

Question: Why Should I bother about getting my tots teeth checked after a minor injury? Won’t his milk teeth all drop off anyway?

Dr Rashid: Injuries to primary teeth can cause infections that may harm the child. They may even disturb the development of the underlying forming adult teeth and will require long-term follow-up to check on those teeth.

I remember a young girl who injured herself in an accident and suffered bad cuts on her gums. Amazingly, there were no tooth fractures and the parents didn’t think it was important enough to see a dentist.

A few days later, the lacerated soft tissues got infected. She ended up with facial swelling and fever as a result of the complication of the injury.

By the time I saw her, she had developed a bad infection. The poor girl then had to be admitted to the hospital for intravenous antibiotics for the infection. I encourage parents to bring their child in for examination with a dentist after an injury, so that the child gets proper medical care.

Question: My toddler fell on his face and now says chewing is painful. What's wrong?

Dr Rashid: Any mouth and face trauma should be examined by a dentist. Three types of tooth injuries could have happened:

=Tooth and root fractures Such fractures may expose the nerves, and cause the tooth to be wobbly and painful when chewing. Worse, the upper part of the tooth may be dislodged and cause a choking hazard to children below three years old. An X-ray may be required.

=Tooth displacement injuries Most mouth injuries can cause the teeth to become wobbly or, in severe cases, fall out. In this case, it can be a choking hazard.

=Soft tissue injuries He may be suffering from pain caused by mild bruising to lacerations in the soft tissues like lips or gums. It isn’t easy getting kids to keep their mouths open when they’re very young. I find this is the best way: Have the child lay on the bed or sofa, with his head near the edge of the bed or on Mummy’s lap. Get Daddy to distract him by playing with his hands. That would prevent him from pulling away Mum’s hands when she’s examining him.

Dr Rashid Tahir is a specialist paediatric dentist at The Kids Dentist, Camden Medical Centre.

From Young Parents issue

Dental Advice: What to do after a fall?

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