Tooth trauma damaged, how to do?

[Are you looking for what? ]

[Looking for my teeth! ]

When Xiong Haizi ran all over the ground, it was inevitable to fall down. Just skin injuries, parents are already dizzy. If they suddenly find that their children’s teeth are half missing or even their front teeth are missing, they are not allowed to turn on the radar and look for teeth all over the ground?

The International Association of Dental Trauma’s Clinical Guidelines for Dental Trauma point out that oral injuries account for 5% of all kinds of trauma, while 18% of all kinds of trauma in preschool children occur in oral cavity, including the most common maxillofacial injuries and dental injuries.

“Lost tooth” refers to the complete avulsion of the tooth and its complete separation from the alveolar socket. This is the most serious condition of dental trauma, but it is not uncommon, accounting for about one tenth of dental trauma cases.

After this happens, it is very important to take appropriate emergency measures and treatment measures, which are related to whether the fallen tooth can regain its function. When a tooth falls off completely, everyone hopes to be able to put it back in its original position, and so do dentists. Of course, there are many places to pay attention to.

Before you go to the hospital, what you can do

First of all, we need to make sure whether the lost teeth are permanent teeth and deciduous teeth are not necessary and should not be treated for tooth replantation. If Xiong Haizi is at the age of tooth change, and the original deciduous teeth are tottering and falling, the deciduous teeth fall off, then congratulations to the children! I have solved the problem by myself, so I don’t have to go to the hospital to have my teeth extracted.

After confirming that the lost tooth is a permanent tooth, of course, if you can’t be sure, you can also follow the steps to prepare:

1. Keep the injured quiet: Especially children, they must try their best to appease and be quiet. Cooperation is the key to successful treatment.

2. Find the tooth and don’t touch the root: pick it up gently, hold the white crown part, and be careful not to touch the red root part;

3. If the teeth are dirty, rinse with flowing cold water for about 10 seconds. If the injured cooperate, put/plug back into the alveolar socket again; And provide clean handkerchiefs and gauze for patients to bite and keep fixed;

4. If the third step cannot be done, rinse the teeth and immerse them in normal saline, milk and other media, which can even be contained in the oral cavity of the injured person. It is recommended to include the gap between the lower posterior teeth and buccal mucosa. However, be careful not to immerse the teeth in water.

5. It is a very important step to find a nearby hospital or clinic that can carry out dental treatment.

What will the doctor do after arriving at the hospital?

Usually, doctors will first carry out some routine inquiries and examinations, including asking the basic condition of the injured person, the time and cause of tooth loss, simple treatment before seeing a doctor, and giving X-rays, relevant tooth viability tests, etc. These are very useful for subsequent treatment.

In the following professional treatment, the dentist will first judge whether the lost permanent teeth have developed and matured. Considering that many Xiong Haizi have just changed their new teeth-we call them “young permanent teeth”, which is slightly different from the mature permanent teeth of adults.

For mature permanent teeth of adults

1. If the affected tooth has been relocated/inserted back into the alveolar socket before seeing a doctor, It is not recommended to pull out again when it is confirmed that there is no wrong direction or position. Rinse the tissues around the teeth with water, normal saline or other disinfectant liquid. Use splints to connect the affected teeth with the surrounding healthy teeth and fix them, and return to the clinic after 2 weeks. During this period, take antibiotics orally to reduce the possibility of infection and promote periodontal healing.

2. If the teeth are stored in saline water and milk, the doctor will clean and disinfect the surface of the root and apical foramen. And carefully check the alveolar fossa, reduce the broken alveolar bone, and then replant the teeth back to the alveolar fossa. The subsequent operation is similar to that already installed for treatment.

3. Before removing the splint, root canal treatment of the affected tooth should be carried out at an early stage. Because the pulp of the developed permanent teeth is broken after falling off, there is basically no possibility of survival.

For Xiong Haizi’s Young Permanent Teeth

The basic treatment measures are similar to those of mature permanent teeth.

However, it is worth noting that, Because the pulp of young permanent teeth is not fully developed, Some root apical foramen has not been closed, blood supply is abundant, which is of great significance for preserving tooth vitality. Young permanent teeth are vigorous and very likely to restore all the functions of a tooth, so root canal therapy is not needed in advance. However, the tooth should be examined regularly. Once the symptoms of pulp necrosis occur, root canal therapy is not too late.

It should be noted that after the doctor treats, the injured should pay attention to eating soft food, keeping oral hygiene, brushing teeth correctly and using mouthwash.

The best results versus the worst results

When both doctors and patients do their best, there is great hope that the teeth will recover completely, that is, the teeth will not ache, maintain the same physiological mobility as normal teeth, and the abnormal root will not be seen in imaging.

However, any improper operation may lead to unsatisfactory results. Even if everything is carried out step by step, the results will not be so satisfactory.

For example, when the teeth fall off and are dry outside the oral cavity for more than 60 minutes, The periodontal ligament on the surface of the root will be necrotic. At this time, the target of treatment will be reduced to bone adhesion of teeth and alveolar bone (without any mobility), and of course root absorption (root shortening) will also occur. Therefore, once an accident occurs, after finding the teeth, it should be decided immediately and handled correctly. Never think you are clean and wrap it with toilet paper.

Other possible adverse outcomes include tooth pain, loosening, or teeth [motionless] due to bony healing, imaging manifestations of apical inflammation, and root resorption and shortening.

In fact, it is king to be careful not to fall when walking.

Responsible Editor: Fei Fei

References: