Info to Public
All tooth traumatic injuries require periodic follow up once in 3 months after the treatment is carried out. In the follow up visit an x-ray will be taken for assessment of the healing phase, eruption phase in children. If it is satisfactory then it is at the discretion of the pediatric dentist to see you at a less frequent interval maybe once in six months or once a year. An another important point to be noted is that many tooth traumas do not give trouble immediately. They only manifest after one year or even later. So follow up is mandatory in any tooth trauma for that matter. Also to be noted is that some traumatic injuries do not give problem at all and heal well when given time. So a good dentist knowledge is also mandatory in this aspect to assess the problem precisely. The after effects of tooth trauma has to be discussed with each and every person who suffers tooth trauma.
Tooth trauma - immediate first AID management
- Ice cold pack compression as long as possible to arrest bleeding and reduce the facial swelling associated with the trauma.
- If tooth is loosened out stabilize it in the same position and report to the nearby emergency center.
- If tooth is completely out of the socket place it back inside. If not possible wash it in running tap water without scrubbing it and place it in contact lens solution (or) tender coconut water (or) cold milk and rush to the nearby dental center for management. The golden hour is 60 minutes More the time lesser the survival chance of the tooth. Each and every minute counts
Tip to the public
How to assess a good dentist /pediatric dentist for tooth trauma management?
A good dentist /pediatric dentist will take xray and will perform heat or cold sensation test. Added diagnostics like EPT-Electric pulp tester, Diagnodent may be used to assess the life of the tooth.
Most importantly before starting the treatment he/she will give a detailed outlook of the present scenario of the problem and the future course of action (sequelae of the problem). A dentist who explains the sequelae means his/her knowledge on tooth trauma is good. If knowledge is good automatically clinical skill will fall in place.
Points to ponder
- Loosened tooth will require splinting
- Completely dislodged permanent tooth will require reimplantation if reported immediately
- Broken crown will require reattachment of the broken fragment or tooth coloured composite filling
- Root damage if it is closed will require root canal treatment. If it is not fully developed in young children will require two stage root canal treatment (i. e) Apexification (or) Apexogenesis followed by root canal treatment. Duration of the treatment process in this scenario is longer. But with recent developments like MTA (Mineral trioxide aggregate), biodentine has fastened the healing time and success of treatment to a great extent
Common terminologies used while discussing tooth trauma
- Tooth splinting
- Root canal treatment
- Composite build up
- Apexification, Apexogenesis
- Mineral trioxide aggregate
- Fiber posts (or) tooth posts
- Crown lengthening
- Nitrous oxide inhalational sedation, GA
- Pulpal herniation, pulp exposure
- Non-vital tooth(tooth discolouration)
- Dilacerated tooth
- Delayed or early eruption of tooth
- Deviated path of eruption
- Intraradicular splinting
- Periapical surgery, (etc)
- Soft tissue trauma, sutures, (etc)
- Root fractures will require RCT followed by intraradicular post stabilisation
Take home message:
Most of the tooth traumas after the treatment is done may require long term follow-ups to assess the success and outcome of the treatment. So patience and confidence with the treating dentist is mandatory with an added salt of strong trust.