Milnes, Farquhar: Teeth damage often sustained when kids hit the ground

So often while children are running around just being kids, they will fall and inevitably bump their mouth.

So often while children are running around just being kids, they will fall and inevitably bump their mouth.

The injuries that they sustain can vary from mild to severe and involve either the soft tissues of their lips and gums and/or their teeth.

Most often, if an injury occurs to a child’s mouth, it is the front teeth that are affected.

Regardless of how the injury happens, there are a few different responses from a dental standpoint.

If the injury to the mouth is on the outside of the lips or the cheeks, and if it is more than just a scratch, has persistent bleeding, or might be considered dirty (eg: animal wound, rusty object) assessment by a medical professional is recommended.

Often if the inside of the lips and gums are affected by a fall, healing will be uneventful.

Other than the initial discomfort and bleeding, there is little intervention required.

Occasionally, the injury requires stitches and should be looked at by your child’s doctor, either medical or dental.

When in doubt, it is always best to have a medical/dental professional assess your child. Generally this will help with parental peace-of-mind.

When an injury affects a child’s front primary (baby) teeth, there are a number of considerations which help a dentist determine what treatment, if any, is necessary.

Initial injuries can range from a simple injury of the tooth with no displacement, to an injury that initially displaces the tooth but the tooth then returns to its normal position, an injury that displaces the tooth but does not return to its normal position, or loss of the tooth from the socket entirely. In addition to these, the tooth may or may not be broken through the enamel, dentin, pulp/nerve, or root.

Most commonly, the baby tooth injury involves mild displacement which may or may not return to its normal position.

Following these types of injuries, often the teeth involved will show varying levels of discoloration from a slight darkening, to grey, to yellow.

Many of these injuries go undiagnosed until a parent learns of the injury following tooth discolouration.

The colour change indicates that the tooth has been injured, but does not mean that it will not heal.

In approximately 50 per cent of cases, the discoloured tooth will remain in function, remain asymptomatic, and come out naturally when it is supposed to.

The other 50 per cent of the time, the nerve of the tooth has died resulting in infection.

In these cases, the tooth may be recommended for removal.

Initial and continued follow up including  dental x-rays (if possible) is recommended to determine the health status of the tooth.

If the dental injury that your child experiences involves a bump with no displacement, a little bit of bleeding around the gums, and a tiny bit of mobility/looseness, likely everything will be OK, but a visit to the dentist would be beneficial.

Discolouration of the tooth often happens but follow-up with your dentist will determine what, if anything, needs to be done.

If the injury is more severe, with displacement interfering with his/her bite, the tooth is very loose, the tooth has been broken and is causing pain for longer than 15 to 30 minutes, or some of the root is visible, it is best to see your dentist within 24 hours if possible.

Regardless of what the injury is, for peace of mind, give your dentist a call.

He/she would be happy to speak with you about what has happened and what to expect in the future.

Alan Milnes and Terry Farquhar are certified specialists in pediatric dentistry at 101-180 Cooper Rd.


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