Definition & Overview
A paediatric dentistry emergency is a situation wherein a child’s tooth or teeth sustain an injury, displacement, or fracture due to a number of causes and require immediate medical attention. The early childhood years, particularly the toddler stage, are a peak period for paediatric dental emergencies because this is the time for environmental exploration and experimentation. Toddlers run around, jump around, bumping into everything and often, these activities result in dental injuries.
Another peak period for paediatric dental emergencies starts when children begin to get involved in sports. As children grow into puberty and their teenage years, the risk grows greater because sports also become rough.
Though dental injuries can be worrisome for both parents and children, most of them are easily treated and only a minor part of them can be considered serious emergencies. Nonetheless, it is still best to err on the side of caution and consult a paediatric dentist as soon as the emergency arises.
Who Should Undergo and Expected Results
Common dental injuries can seem like dental emergencies when they first happen. For instance, a toothache can be painful and uncomfortable for children and can have numerous causes. If the pain persists, despite the application of cold compress (when there’s swelling), or when the swelling doesn’t die down, then a visit to the dentist may be in order.
Another common injury is when the tongue, lip or cheek is cut or bitten or when a baby tooth falls out. The immediate thing to do is to stop the bleeding with a sterile gauze or clean cloth. If the bleeding continues after 15 minutes, this situation calls for a paediatric dentist.
More serious injuries (discussed in the next section) require the immediate attention of a paediatric dentist and with these cases, time is of the essence. These conditions usually involve teeth that have to be re-implanted and teeth that have to be surgically corrected. The faster these conditions get resolved, the better prognosis for the tooth and the patient too.
How Does the Procedure Work?
This section will detail the more serious dental injuries that kids can face. These are not nearly as common as the ones previously discussed but they do require immediate medical attention.
- Dental avulsion
Dental avulsion is another term for a knocked-out tooth. Permanent teeth that get knocked out can be saved and re-implanted successfully within one hour of the avulsion so it is imperative that the child and the tooth (handled by the crown and not the root) be taken to a paediatric dentist immediately. To preserve the tooth prior to re-implantation, it is important to keep it moisturized by reinserting it into its original socket (for older children) or keeping it submerged in a glass of milk (for younger children, so they don’t swallow the tooth by mistake).
- Dental intrusion
Dental intrusion results from serious dental trauma that causes the tooth or teeth to be pushed into the jawbone. Teeth that have been pushed less than 3mm usually have a better chance of recovery, like they can descend back to their original position on their own, but one never knows the actual extent of the damage which is the reason why a condition like this needs to be treated as an emergency. Ice packs may be placed around the affected areas to minimize swelling and painkillers can be administered to manage the pain before consulting a paediatric dentist or going directly to a hospital’s emergency department.
- Tooth displacement
Tooth displacement refers to the condition wherein a tooth suffers enough trauma that it is dislocated from its original position. The tooth can either remain in its socket but in an awkward angle or become partly removed from the socket. These two conditions both require emergency attention because they may be symptoms of a fractured jawbone or may be at risk of infection due to the exposed area.
- Fractured jaw
A broken or fractured jaw is another serious paediatric dentistry emergency case. When this happens or when it is suspected, a trip to the ER is imperative. To protect the jaw from further movement, a soft scarf may be tied around the child’s head and jaw.
Possible Complications and Risks
Parents are generally proactive when they see that their child is in pain, and this is the best way to avoid possible complications of dental emergencies. If a toothache, for instance, is dismissed as just a toothache since it’s a common complaint and nothing is done to examine its cause, then parents run the risk of worsening the seemingly harmless toothache. It could be the symptom of a more serious condition like an infection or tooth trauma or wisdom teeth eruption.
On the other hand, there are also parents who are too eager to dispense medical advice and that too can worsen an innocuous concern. These parents may lean toward exaggerated solutions because they believe that more is better. One possible complication, not necessarily connected to the emergency itself, is that some dental clinics only offer emergency services to regular and established clients. Some will even charge higher for after-hours calls. If that is the case, a trip to the emergency room is the next best thing.
Risks also multiply when the teeth that have been knocked out were mishandled improperly, in the case of dental avulsion. If the teeth were not cleaned properly prior to reinsertion, the teeth may cause an infection. If the teeth were not kept moisturized, the teeth may be damaged and cannot be reinstalled.
- American Dental Association