Trauma to Baby Teeth: What Parents Need to Know

DISCLOSURE: Noelle Copeland RDH is the oral care specialist and dental consultant to the Brilliant and Baby Buddy oral care lines through Compac Industries. See terms below

Baby teeth are important! However, there’s an assumption made by many that, because baby teeth eventually fall out, they are disposable and more like “training wheel teeth” that are meant to take a beating, rather than teeth with a defined purpose.

Oral trauma to baby teeth can cause issues that stretch into adolescence and beyond. Trauma can occur at any time, from a small slip and fall at home where a child bumps their mouth accidently, to a more traumatic accident that needs immediate remediation.

If small incidences are happening and a parent isn't always aware, say a child bumps their face on the playground equipment slightly fracturing a front tooth but not enough to break it? That small fracture can grow larger and cause sensitivity and even decay.

Any injury to the mouth where a tooth is broken and tissue trauma occurs will cause sensitivity and pain and more than likely needs to be evaluated by a dental professional as soon as possible.

Cracks, breaks and tooth decay forever alter the natural structure of the teeth and possibly the bones those teeth sit in. Even with the best reconstructive care, it is still a procedure that attempts to recreate what was there naturally.

So what's the big deal if we know all the baby teeth will eventually come out anyways? Why are baby teeth so important?

• They support the progressive eating stages throughout childhood. Liquids to semi solids, semi solids to first foods and, finally and hopefully, a well rounded and healthy diet.

• Baby teeth are intricately connected to the process of learning to speak first words and adapting to proper diction. Thereafter, adult teeth continue in this process.

• They hold the space for the developing adult tooth underneath the gums. If the baby tooth is lost prematurely, it can cause drifting and spacing issues in the surrounding teeth. This can also affect speaking and chewing.

• Baby teeth will be in your child's mouth a pretty long time so they need to be healthy and not infected with cavities. Front baby teeth start shedding between 6-8 years of age but back molar baby teeth need to stay in place and healthy until ages 10-13 years old when the adult molars come in.

• If an infection does occur in a baby tooth, called a cavity or caries, it needs to be addressed. The same blood supply that goes to each tooth also moves throughout the rest of the mouth and body. Infections in teeth move outward and downward, spreading deeper and to other teeth and their supporting tissues in the mouth. This will eventually cause pain and swelling and warrant immediate attention.

Types of Trauma that affect Baby Teeth

Cavities

Decay is the primary cause of chronic tooth sensitivity in children. And even though you might not think of decay as "Trauma", it is.

Decay is an active infection in a tooth, that will continue to grow and traumatize the enamel, dentin and eventually the pulp if it is left unaddressed.

When a tooth has a cavity in it, this creates a hole, this hole continues to grow if left alone, and as it grows, it gets closer and closer to the pulp/nerve of the tooth, creating sensitivity to temperatures and chewing. There are instances where children can have cavities and have no sensitivity or pain at all, this is why it's important for children to see the dentist regularly.

So what can you do to help prevent cavities in baby teeth?

Before baby teeth erupt

• 0-3 months age- wipe baby's mouth with a sterile cloth, at least once a day to remove milk residue and bacteria.

• 3-6 months age- perform an evening brushing routine on baby’s gums to remove biofilms and bacteria. Use a silicone based toothbrush for this.

After baby teeth erupt

• 6 months and up- once the first tooth erupts into the mouth, start to use a bristle toothbrush on the teeth and continue to use a silicone toothbrush on the gums.

• Use a xylitol based tooth gel for children 3 months and older. Xylitol helps protect the teeth and the gums .

• Don't allow a child to go to sleep with a bottle that contains a sweetened liquid.

• Don't dip pacifiers in sweet syrups to coax a child to sleep.

• Don’t use your saliva to clean a pacifier, bottle nipple or around a baby’s mouth. Pathogenic bacteria can be transferred from an adult to a child, including the bacteria that cause oral decay.

• Visit the dentist within 6 months of the first tooth erupting or by the first birthday, whichever comes first.

Chipped Teeth

If your little one escapes childhood without any chipped teeth or mouth trauma, consider it a blessing. Chipped baby teeth can happen very easily and often are harmless rights of passage to waddling, toddling and becoming mobile little humans.

One day we're encouraging them to take their first steps and before we know it, we're designating corralled "safe spaces" for play and padding every corner, sharp edge or coffee table to help prevent a major accident, or a minor accident for that matter.

So if your child chips a tooth, it will most likely be a front tooth but molars can chip too. If a tooth is chipped, assess the following:

• Is it painful? If so, a dental visit may be necessary. This is a great time to remind you that finding a pediatric dentist in the midst of trauma is not the best way to "Visit The Dentist" for the first time. So establish this relationship beforehand.

• Is there tissue damage, like bleeding or an open mouth wound? If yes, then see your dentist as soon as possible. The tooth could be chipped and loosened in the bone socket, which is a more serious type of mouth issue to deal with.
• If the "chipped tooth” goes underneath the gum line, try to find the chipped piece, clean it, and see if you can slide the piece back into place, underneath the gum and hold it in place, as you call your dentist. If you can't do this, place the chipped piece of tooth into a cup of milk and get to the dentist as soon as possible.
• A chipped piece of tooth on a molar chewing tooth is suspicious of having a cavity. Although this can also happen from biting or chewing on non food items, or biting a piece of hard candy, even grinding the teeth ( yes, children sometimes grind their teeth) can cause molars to chip and break.

Loosened Teeth

Teeth that get completely knocked out or traumatically loosened can oftentimes be put right back into the socket. Believe it or not, tiny fibers of tissue and blood vessels will reattach and hold the tooth in place. Oftentimes the tooth will become darker if this happens, because parts of the tooth become filled with blood and dead tissue. However, it's better to have the natural tooth in place and in the tissue than to have a prematurely lost baby tooth and open space. This also can be applied to permanent teeth.

If you have a young child who accidently has a permanent tooth knocked out. It's better to get the natural tooth back in the mouth to heal. It will change color some, but as long as infection is not a concern, the tooth will be ok. And eventually, in the future, a more permanent solution can be applied to address the look and color of the tooth.

Trauma to baby teeth, or just teeth in general, is no fun. But there are so many resources to utilize for help and treatment these days. Honestly, I don't know how parents knew what to do before the internet and the all mighty “Google Search” took shape. There is so much information at our fingertips nowadays.

As always if you have questions about oral care and would like to reach out, my email is Noelle@compacind.com. If you want to try out the best toothbrush for kids, or test drive an upgrade and want to explore the best electric toothbrush for kids, then  look for our NEW DINOSAUR SONIC toothbrush.

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