Traumatic dental injuries in children

Traumatic dental injuries in children

If your child has sustained a dental injury the following information will help you and your child progress through this treatment journey.

Generally, dental injuries in children peak around 7-9 years of age. At this age, the teeth are newly erupted and the roots of these teeth are not fully formed. The endodontic management of these teeth is therefore different to that for an adult.

Injured teeth can heal differently to the rest of the body. This physiological difference means there is a structured approach to review and management.

Does my child need endodontic treatment?

Whether your child needs endodontic treatment or not is determined by a number of factors

  1. Severity of injury
  2. The age of the child
  3. Pre-existing conditions

Each injury is different, so your Endodontist will discuss your child’s needs at the initial consultation appointment.

How do you treat a young child for endodontic treatment?

Endodontic treatment is a complex procedure and patient co-operation is essential. Usually by 12 years of age, children are comfortable with such procedures. Because most dental injuries occur in younger patients, an Endodontist will generally carry out minimal treatment to stabilise the injured tooth or teeth. When the patient is older more complex treatment can be undertaken.

Are there any psychological effects of dental treatment?

Studies have shown that dental injuries have a significant psychological impact on children.  It is beneficial to be positive with the child at all times. Talk to them how the Endodontist will repair their teeth and make them look like they were before the accident. Try to get them back into normal activities as soon as possible. For instance, if the accident happened while riding a bicycle, allow the child to resume riding their bicycle when they feel confident.

Will my child need to see someone else?*

Repairs to fractured teeth – this is based on the complexity of the fracture. Cosmetic and restorative repairs to fractured teeth is usually undertaken by your  general dentist and occasionally by a Prosthodontist (Specialist in restorative dentistry).

What are the long-term effects of dental injuries?

Even when more than one tooth has been injured, the prognosis for each injured tooth can be different. This is because the intensity of trauma sustained by each tooth varies.

For teeth with a poor or uncertain long-term prognosis, our hope is to retain the tooth until the patient finishes growing after which dental implants may have to placed.

How often do we need to see the Dentist/Endodontist?

Young injured teeth can undergo rapid changes (for the better or worse) following dental trauma. The majority of these changes occur in the first 5 years. For this reason, we follow the recommendations of the International Association of Dental Traumatology and recommend regular reviews of injured teeth. Generally reviews are after 1 week, 1 month, 3 months, 6 months and then yearly reviews for up to 5 years.  At each review, vitality tests are performed, and radiographs are taken

Do we need a dento-legal report?

Depending on the circumstances of the injury, you may need a report from your dentist or Endodontist. Third parties such as Crimes Compensation, Lawyers and Insurance companies are well aware that they must formally request a dento-legal report in writing with appropriate signatures covering privacy legislation requirements.

Dento-legal reports can be admissible in court therefore an appropriate amount of time needs to be allowed for the preparation of such reports. There is a fee for dento-legal reports which reflects the time allocated in preparation of these reports and potentially defending the report in court.

Can we carry on with our orthodontic treatment?

If a patient is undergoing fixed orthodontic treatment and sustains a dental injury the orthodontist may slow the pace of the orthodontic treatment to reduce forces on the injured teeth.

It may be advised to leave the tooth with a dressing in the root canal system until the orthodontic treatment is completed as some changes in the root length can occur during orthodontic movement.

Also, the presence of orthodontic brackets and arch wires on teeth can make mandatory placement of rubber dam difficult.

How do we help young patients get over the anxiety of dental treatment?

Fear of dentistry is usually learned from peers, siblings and parents. Today endodontic treatment, including anaesthesia is virtually a painless procedure.

The use of topical anaesthetics prior to administering local anaesthetic means most teeth can be anaesthetized painlessly. Dental visits should be treated without emotion and statements like “its not going to hurt” should be avoided.

Negative statements promote anxiety which can make children more worried about their upcoming visits. It is a good idea to bring headphones with music to keep children distracted and calm.

This information is a guide only. Specific details regarding your child’s treatment will be discussed with you by your Endodontist.