Dental Trauma: Treatment
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More about Dental Trauma:
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Soft tissue injuries may require only cold compresses to reduce swelling. Bleeding may be controlled with direct pressure applied with clean gauze. Deep lacerations and punctures may require stitches. Pain may be managed with aspirin or acetaminophen (Tylenol, Aspirin Free Excedrin) or ibuprofen (Motrin, Advil).
Treatment of a broken tooth will vary depending on the severity of the fracture. For immediate first aid, the injured tooth and surrounding area should be rinsed gently with warm water to remove dirt, then covered with a cold compress to reduce swelling and ease pain. A dentist should examine the injury as soon as possible. Any pieces from the broken tooth should be saved and brought along.
If a piece of the outer tooth has chipped off, but the inner core (pulp) is undisturbed, the dentist may simply smooth the rough edges or replace the missing section with a small composite filling. In some cases, a fragment of broken tooth may be bonded back into place. If enough tooth is missing to compromise the entire tooth structure, but the pulp is not permanently damaged, the tooth will require a protective coverage with a gold or porcelain crown. If the pulp has been seriously damaged, the tooth will require root canal treatment before it receives a crown. A tooth that is vertically fractured or fractured below the gumline will require root canal treatment and protective restoration. A tooth which no longer has enough remaining structure to retain a crown may have to be extracted (surgically removed).
When a permanent tooth has been knocked out, it may be saved with prompt action. The tooth must be found immediately after it has been lost. It should be picked up by the natural crown (the top part covered by hard enamel). It must not be handled by the root. If the tooth is dirty, it may be gently rinsed under running water. It should never be scrubbed, and it should never be washed with soap, toothpaste, mouthwash, or other chemicals. The tooth should not be dried or wrapped in a tissue or cloth. It must be kept moist at all times.
The tooth may be placed in a clean container of milk, cool water with or without a pinch of salt, or in saliva. If possible, the patient and the tooth should be brought to the dentist within 30 minutes of the tooth loss. Rapid action improves the chances of successful re-implantation; however, it is possible to save a tooth after 30 minutes, if the tooth has been kept moist and handled properly.
The body usually rejects re-implantation of a primary (baby) tooth. In this case, the empty socket is treated as a soft tissue injury and monitored until the permanent tooth erupts.
A broken jaw must be set back into its proper position and stabilized with wires while it heals. Healing may take six weeks or longer, depending on the patient's age and the severity of the fracture.
— Donald Gardner Barstow
