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Section Questions and Answers

Injury to Baby Teeth

  1. When are baby teeth most at risk from injury?
  2. What is the most common injury to baby teeth?
  3. What can be done if a baby tooth has been chipped or broken?
  4. What other injuries can affect baby teeth?
  5. What treatment is there for a baby tooth that has been knocked out?

1. When are baby teeth most at risk from injury?

  • Children are most accident prone between the ages of two and four years.
    • The majority of accidents happen in or around the home. Injuries to baby teeth often result from a fall.
    • Damage can be caused by either a direct blow to the teeth, or by the impact of the lower jaw being forced upwards.
    • The front teeth are the most likely to be affected.
    • Always consult your dentist after a child's tooth or jaw has been injured.

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2. What is the most common injury to baby teeth?

  • Loosening or displacement is the most common injury to baby teeth.
  • This is because the bone in which the root is anchored is soft and elastic in a young child.

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3. What can be done if a baby tooth has been chipped or broken?

  • If a tooth is chipped, and only the enamel is affected, smoothing the sharp or roughened edge is usually all that is needed.
  • If a front tooth has a chipped biting edge, a tooth-coloured plastic filling can be bonded to the tooth.
    • This will restore its shape and appearance, and protect the edge from further damage.
    • Since the enamel has no nerve supply, these treatments are painless.
  • When larger piece of tooth has broken off, the tooth can become painful.
    This is because the dentine layer of tooth under the enamel has become sensitive to hot and cold.
    • The tooth can be repaired with a tooth-coloured filling or with an amalgam.
    • The injured tooth should be checked regularly for any colour changes.
    • A colour change to grey indicates that the nerve and blood vessels have died.

Click to enlarge
Grey discoloured
non-vital tooth
  • Should it become painful or infected, the tooth may need to be extracted.
    This is to preserve the health of the underlying permanent tooth.
    • An alternative may be to perform a pulpotomy.
      This is the removal of the nerves and blood vessels in the crown of the tooth.
      It is not a difficult procedure and is usually successful.
    • Severe fracture of the crown of a baby tooth is not common.

Click to enlarge
Click to enlarge
Repaired teeth

See Repair of Teeth.

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4. What other injuries can affect baby teeth?

  • A tooth can be driven into the jawbone by a fall or any impact on the tooth.
    • This could damage the permanent tooth growing under it.
    • If an x-ray confirms that the permanent tooth is at risk, the baby tooth will have to be extracted.

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5. What treatment is there for a baby tooth that has been knocked out?

  • It is rare for a baby tooth to be knocked out.
    • Re-implantation of a baby tooth is not done as it would damage the permanent tooth under it.
    • The gap left by the loss of a baby tooth must be kept open for the permanent tooth that will eventually replace it.
    • A space maintainer can be fitted to prevent other teeth from drifting into the gap.

See Injury to Teeth in the adult section for injury to permanent teeth.

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