Handling Dental Accidents

Urgent action after injury to permanent teeth (second teeth):

Remain calm and reassure the victim.

Wash the areas of injury with plenty of water.

Apply a cold compress of damp cotton, gauze, clean cloth or tissue, with pressure, for five minutes to stop the bleeding.

Locate any pieces of broken tooth and put the fragments in water. These may be able to be used to repair the broken tooth with special dental adhesive and filling material.

If a whole tooth has been knocked out (avulsed) pick up the tooth by the crown (top). Do not touch or scrub the root. If it has been soiled, it can be gently washed for about 10 seconds under a cool tap. Hold the tooth by the crown and gently insert it into its socket then ask the casualty to bite on a damp cloth while they are taken to a dentist.

If it is not possible to insert the tooth, put it in some milk, or ask the victim to place the tooth in their mouth between their teeth and cheek. Seek immediate dental assistance.

Long-term follow-up

Patients who have had an accident to either first or second teeth need to be monitored by a dentist. Teeth may appear fine at first, but some teeth can show reaction to damage months, or even years, after the event. A dentist will be able to advise on the necessary follow-up period.

Prevention

Toddlers and young children, when they begin to explore their surroundings, are often unsteady on their feet. Furniture is used to support awkward first steps, and falling on to a coffee table is common. Making the home as safe as is possible before a child begins to walk (9-12 months) and not allowing children to walk with cups or bottles (or other objects) in their mouths can prevent many injuries.

Sport results in many injuries to the teeth. A thorough check-up at the beginning of each season to identify teeth at risk and the provision of a mouthguard, fitted by a dentist, provide the best protection possible. Anyone involved in contact sports (eg football, rugby, hockey, boxing and wrestling) should have mouthguard protection. Even non-contact sports (eg basketball, squash, skateboarding, and cycling) can cause damage to the teeth and participants would benefit from the use of mouthguards.

Patients with physical disabilities or conditions that may cause them to fall (eg epilepsy) are more prone to accidents that involve the teeth. A dentist can give advice in these cases.

Prominent front teeth (anterior), especially if not covered by the lips, are much more likely to be fractured. Orthodontic treatment (aligning the teeth with braces) reduces this risk.

Seat belts, appropriate child restraints, and car seats all prevent trauma to teeth, mouth and face, as well as the rest of the body in the event of a car accident or sudden stop.