Save your "face": coping strategies for front teeth damaged by trauma

Because children are in the growth and development period and are highly active, they are prone to traumatic accidents, especially during the school age stage, when they are prone to collisions and falls during strenuous exercise and play, resulting in dental trauma, especially the maxillary central incisor, which is most vulnerable.

Dental trauma is unexpected and unpredictable. The purpose of studying dental trauma is to correctly treat traumatized teeth, avoid complications, and take effective preventive measures to avoid and reduce the impact of dental trauma on children's dental and jaw development and physical and mental development.

"Doctor, my child's front teeth are broken." This is the most common description when most parents bring their children with dental injuries to the hospital for treatment. The Pediatric Stomatology Department of Hunan Women and Children's Hospital also often sees similar patients.

The following is the image data of a 13-year-old patient with right upper front tooth trauma who was admitted to the Department of Stomatology. The patient complained of pain in the right upper front tooth for 2 hours. After admission, the patient underwent root canal treatment and aesthetic resin restoration in several sessions. After the operation, the patient and his family members unanimously recognized it, which provided a better foundation for the patient's future physical and mental health.

Depending on the magnitude of the external force, the clinical manifestations of young permanent teeth after trauma are also different. Some are just a defect of the crown tissue without involving the pulp nerve, while more serious cases will involve the pulp nerve. According to the different clinical manifestations of dental trauma, the treatment principles are also different, as follows:

1. Home treatment: After a teenager has a tooth injury, hold the crown of the fallen tooth, rinse it with water, and then put the tooth back into the alveolar socket. You can also hold the fallen tooth under the tongue or soak it in saline, and go to the hospital for further diagnosis and treatment as soon as possible.

2. Observation and treatment: After dental trauma occurs in adolescents, if it is a simple enamel crack, usually no special treatment is required. When enamel cracks are combined with periodontal tissue damage, pulp necrosis is likely to occur, and close follow-up observation is required.

3. Indirect pulp capping therapy: If the dentin is exposed, calcium hydroxide and glass ionomer can be used to repair the dentin section, which can play a good role in protecting the dental pulp.

4. Root canal treatment: If the crown of the tooth is broken and the pulp is exposed, it is easy to cause pulp contamination. In this case, the pulp should be removed and root canal treatment should be performed.

5. Treatment with dental arch splinting: If tooth displacement injury occurs, dental arch splinting can be performed to fix the affected teeth.

In short, the principle of treating young permanent teeth is to preserve the vital pulp as much as possible, and to preserve the root pulp when the coronal pulp cannot be preserved. When neither the root pulp nor the coronal pulp can be preserved, we will try our best to preserve the tooth.

Hunan Medical Chat Special Author: Yu Minjie, Department of Stomatology, Hunan Women and Children's Hospital

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(Edited by YH)