A tooth injury is a bruise, dislocation or fracture as a result of a blow, fall or other mechanical impact. Most typical:
- Injury to the front milk teeth in children aged 1-2 years, when children are just starting to walk, but still have poor coordination of movements, often fall and hurt themselves, and run into hard objects.
- Dental trauma at the age of 7-10 years, when children learn to rollerblade and skateboard, play ball, climb, and sometimes fight.
Chronic injury is also possible when a child constantly chews hard objects, and chips of enamel and microcracks appear on the teeth.
IMPORTANT! Information from the article cannot be used for self-diagnosis and self-medication! Only a doctor can prescribe the necessary examinations, establish a diagnosis and draw up a treatment plan during a consultation!
Bruised baby tooth in a child
Most often, bruises occur in preschool children with baby teeth. In appearance, the bruised tooth may not be in an arch with the rest of the teeth, it may look slightly raised above the other teeth due to swelling of the gums. The tooth hurts when chewing and pressing. If a child’s tooth is bruised, what should parents do? The best thing to do in this case is to apply cold to the area of swelling on the face and take the child to the dentist, and if he has determined for sure that this is indeed a bruise, treatment will most likely not be required. It is enough to avoid hard foods for a month to give the tooth the opportunity to “grow” back. In some cases, an incomplete dislocation of the tooth is added to the bruise, and the dentist, under local anesthesia, will set the tooth in place and fix it with a splint.
The gum has moved away from the tooth: treatment
If the gum has moved away from the tooth, treatment will largely depend on the severity of the inflammation. For example, if a patient seeks help at a fairly early stage of inflammation (when the depth of periodontal pockets does not yet reach 3 mm and there is no tooth mobility), significant success can be achieved in the treatment of periodontitis and the process can be completely stopped. Advanced cases of gum inflammation will require much more complex treatment and serious financial costs. Next we list the main stages of treatment.
1) Consultation and x-ray diagnostics –
It is necessary to begin treatment with a consultation with a periodontist and a panoramic photograph of the teeth, which will allow you to create an optimal treatment plan taking into account the condition of your teeth and gums. The image will allow you to determine the amount of destruction of bone tissue around each tooth, the location and depth of periodontal pockets, and will help guide the patient in the need for splinting of mobile teeth, the need for prosthetic replacement of missing teeth, and make the correct diagnosis.
An example of a panoramic image of a patient with periodontitis –
Looking closely at the image, you may notice that the level of bone tissue (the bone looks in the image as fine-mesh looped tissue and normally should reach the necks of the teeth) is reduced in different teeth by 1/4 to 4/5 of the length of their roots. The patient has decayed teeth that need to be removed, as well as carious teeth that require treatment (24stoma.ru). The level of bone tissue is most reduced in the front teeth of the upper and lower jaw, which in this case was the result of not only inflammation of the gums, but also the absence of the chewing group of teeth.
To treat gums, it is best to contact not ordinary dental therapists or hygienists, but periodontists. These are the dentists who specialize in gum treatment. The first and most important stage of treatment will be ultrasonic teeth cleaning. Next, a course of anti-inflammatory therapy is carried out, which in most cases can be successfully carried out at home.
2) Removal of dental plaque –
First of all, it is necessary to remove the cause of inflammation - microbial plaque and dental deposits. They are removed from the teeth using an ultrasonic scaler (Fig. 15), usually over several visits. It is simply impossible to remove all dental deposits in just 1 visit in a patient with periodontitis, because... It takes a lot of time to remove subgingival dental plaque, which is localized in periodontal pockets below the gum level.
It is subgingival dental plaque that poses the main danger for further progression of inflammation, so sometimes it is necessary to prescribe the patient even 3-5 times. Learn that without professional cleaning, all other stages (for example, anti-inflammatory therapy, splinting) will be completely meaningless.
Most dentists and hygienists won't bother with finding and removing subgingival calculus...as experience has shown. Therefore, it is very important to find a competent specialist. Anti-inflammatory therapy is prescribed immediately after 1 session of removing tartar, and within the first 24 hours you will be able to notice changes in the appearance of the gums. In parallel with the reduction in gum swelling, their volume will also decrease, which will allow you to see new portions of dental plaque and remove them during subsequent visits.
Removing dental plaque with ultrasound: video
You can see in the following photos what happens when subgingival tartar is removed poorly. The first photograph shows that the gums are visually in good condition, although a periodontal probe revealed the presence of a periodontal pocket about 5 mm deep. The second photograph was taken after the gums were detached from the teeth, and it shows a very large amount of destruction of bone tissue, which arose due to the presence of small subgingival tartar on the surface of the tooth root.
3) Anti-inflammatory therapy –
The course of anti-inflammatory therapy usually lasts 10 days. In most cases, it is carried out by the patient himself at home, after doctor’s prescriptions and patient education. However, if the patient has deep periodontal pockets with purulent discharge, the doctor may additionally prescribe washing the periodontal pockets, which is done using a syringe and antiseptic solutions. In some cases, antibiotic therapy may also be prescribed for periodontitis.
Anti-inflammatory treatment regimen - usually a complex is prescribed, consisting of an antiseptic mouth rinse and application of gel to the gums. The procedures are carried out 2 times a day (morning and evening, after meals and subsequent oral hygiene), for 10 days. Most often, a complex of the following drugs is prescribed:
- rinsing with Chlorhexidine (instructions)
- “Cholisal-gel” applications (instructions)
In patients with periodontitis, the correct choice of treatment agents is very important. For example, a standard 0.05% solution of chlorhexidine, sold in pharmacies for 40 rubles, is advisable to use only for superficial inflammation of the gums (gingivitis), but for periodontitis it is better to use a 0.2-0.25% concentration of this antiseptic. It is a big plus when such a solution contains not only a good concentration of chlorhexidine, but also other active ingredients (for example, aluminum lactate for bleeding gums or extracts of medicinal plants).
Antiseptic mouth rinse is carried out after breakfast and oral hygiene, rinse your mouth for 1 minute. After this, the gums need to be dried with a dry gauze pad to remove excess saliva, and an anti-inflammatory gel should be applied to the gum edge. The gel is applied in front of a mirror using a finger, and usually only on the front side of the teeth. After such treatment, it is not recommended to eat for 2-3 hours, and also not to drink for 30 minutes. There are a lot of remedies for treating gums, and we hope that our next articles will help you understand their diversity -
→ The best antiseptics for mouth rinsing, → Rating of the best gels for treating gums.
4) Oral hygiene training –
If you have not yet forgotten the beginning of the article, then remember that the cause of periodontitis and destruction of the dental-gingival attachment is unsatisfactory oral hygiene, which leads to the accumulation of microbial plaque and tartar on the teeth. Therefore, in addition to the basic treatment that we described above, it is very important to constantly maintain high-quality oral hygiene.
Good hygiene doesn't mean just brushing your teeth twice a day, that's not enough. Good oral hygiene includes brushing your teeth after every meal, not snacking on cookies or candy between meals, and regularly using dental floss. You can read about absolutely all the recommendations in the article at the link above. Below, you can watch the video on how to properly use a toothbrush and dental floss.
How to use dental floss and brush correctly -
In the presence of periodontal pockets and mobile gingival margins, it is important to carry out hygiene below the gum level. This can be done using special devices - home irrigators. Special attachments allow you to rinse at home not only areas of the oral cavity that are difficult to reach for hygiene, but also periodontal pockets below the level of the gingival margin. Irrigators can use both ordinary boiled water and special medicinal solutions.
Tooth dislocation in a child
A tooth is said to be dislocated if the tooth falls out completely as a result of an impact or is turned out of its socket and is supported only by soft tissues. A dislocated baby tooth in a child is usually not treated; the dentist simply removes it permanently. A permanent tooth can be saved if it is dislocated, but only if the roots of the tooth are not broken, and if it is possible to deliver the tooth to a dental clinic within two hours after the injury, and until that moment keep it in water (it is best in mineral water or in milk) so that the pulp does not have time to die. The dentist carefully sets the tooth into place and applies a splint.
Impacted dislocation of a baby tooth also occurs in children. With this injury, the tooth seems to go inside the gum. In this case, the dentist may recommend not to intervene and simply wait until the injured tooth begins to “erupt” again. Do not try to remove it from the socket yourself; this may damage the buds of the permanent tooth under the injured milk tooth.
Causes of suppuration
If you have purulent discharge from your gums, there is a pimple in which pus accumulates, you feel pain, your teeth ache, then you should not hesitate, but immediately go to the doctor. If you start a purulent inflammation that has formed in the gum, serious consequences can occur. All this can even lead to blood poisoning.
As for a purulent pimple, it can be of any size. For some, it may resemble a pea in shape, and sometimes it can reach the size of half a walnut. But it is worth knowing that you cannot judge the severity of the problem by the size of this pimple. If there is a purulent pimple and it is small, then if left untreated, it can increase significantly within a day.
Suppuration can occur for the following reasons:
- The gum was injured by a fragment of a tooth that was broken. A poor quality crown that hangs over the edge of the gum can also scratch the gums;
- hygiene procedures were performed using a very hard toothbrush;
- a man carelessly picked his teeth with a toothpick.
You should know and understand that every manipulation that relates to teeth must be carried out carefully and carefully so as not to touch the gums. If pus appears, a person must realize that there is already an inflammatory process. And it needs to be treated without delay.
What to do if a child has a dental injury
- If the injury is combined with a fall or a strong blow, you should immediately visit the emergency room and make sure that the child does not have a concussion or fractures, including facial bones - jaw, nose, etc.
- If other injuries are excluded or you are sure that it was the tooth that was damaged, you can immediately go to an urgent appointment with the dentist. If you have a tooth injury, we will see you immediately, since the speed of action often determines whether the tooth can be saved.
- The dentist numbs the area of the injury, determines the type of injury and prescribes treatment. In some cases it starts immediately, sometimes you need to wait a little. Treatment of a tooth injury can last up to a month.
It is important to correctly diagnose and treat an injured tooth to prevent complications. Meet our tooth fairies and check prices.
What to do?
The main thing is never to heat the place that hurts. Once upon a time, grandmothers said that you need to bandage your cheek with a warm scarf, but you shouldn’t do this. Inflammation cannot be heated. If the temperature rises, the process becomes even stronger. If there is pus, you should apply a piece of ice to the area that hurts.
If the pus comes out of the gums, you shouldn’t think that everything is gone. Drug treatment is necessary to stop the process. But antibiotics must be prescribed by a doctor.
Prevention of dental injuries
There are typical situations in which children injure their teeth. For example, a quarter of front tooth injuries between the ages of 1 and 3 years occur in the bathtub when a child slips and hits the edge of the bathtub, so try not to leave your baby unattended in the bathtub. Pay attention to protecting your teeth with a mouthguard when your child plays sports, especially hard and contact sports (hockey, various types of wrestling, basketball), rollerblading or skateboarding. Contact your orthodontist in a timely manner, because... a large percentage of injuries to permanent teeth are associated with their incorrect position, i.e. existing bite pathology, which means an additional risk.
At the same time, you should not blame yourself for not looking after your child and causing dental injury. Children are restless, they love to explore the world and take risks, and we cannot always protect them from such accidents.
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