Health & WellnessLifestyles

Management of dental trauma

Dental trauma is a public health concern. The impact of dental trauma is not only physical but also has psycho-social and economic consequences.

In preschool children, oral trauma makes up 17 percent of all bodily injuries. The prevalence is approximately 30 percent.

Oral injuries are most frequent during the first 10 years of life, decreasing gradually with age.

This week, I will address dental trauma and the importance of your dentist in its management, as well as specific home remedies in managing a dental crisis.

Dental trauma

Dental trauma is injury to the mouth, teeth, lips, gums, tongue and jawbones. Soft tissue injuries to the mouth along with dental trauma are typically very painful and should receive prompt treatment. The most common dental trauma is a broken or lost tooth.

Teeth have a hard outer layer called the enamel, and the dentin is the part of a tooth between the enamel and the pulp. The pulp is the living center of the tooth and is made up of delicate blood vessels, nerve tissue and cells.


Most people probably grind and clench their teeth from time to time. The dental term for grinding is called bruxism. It can be harmless, however many times it can be destructive, especially if done in excess. Bruxism causes your teeth to lose its enamel and it sometimes damages the underlying pulp.

Also, grinding may cause pain and soreness to your muscles used to chew, called muscles of mastication. Further, clenching can cause severe pain in your teeth and their attachment to your bone resulting in swelling and shaky teeth.

Teeth grinding and clenching are usually caused by stress or anxiety. In many cases, patients are unconscious of this habit because it is often a reflex or habitual action sometimes even occurring while sleeping. Other reasons for grinding/clenching are crooked teeth, periodontal disease and a sleep disorder such as sleep apnea.

How you know you grind your teeth

Many persons suffer a dull headache or soreness in their jaw when they awake. This is a common symptom of bruxism. Also, many people also learn that they grind their teeth by their loved one who hears the grinding while asleep.

If you are concerned, you should speak to your dentist. An examination will determine signs of bruxism, such as jaw tenderness and excessive wear on your teeth.

In some cases, chronic teeth grinding can result in the fracturing, loosening or loss of teeth. Excessive grinding may wear teeth down to stumps. This sometimes results in extensive dental treatment to correct and restore.

Broken teeth or fractures

Superficial fractures refers to fractures that stop only to the enamel. These are usually not serious unless the fracture leaves the tooth with a sharp edge.

More serious fractures result in teeth becoming sensitive to touch, heat or cold. If the fractures cause an exposure of the inner more sensitive parts of the teeth such as the dentin or nerve pulp, then this can increase the risk of further complications.

Also, some teeth are fractured or broken due to a large cavity that undermines the tooth leaving just a shell. Eventually, that shell of the tooth’s crown collapses perhaps during normal chewing or biting into something hard.

Tooth knocked out or displaced

A more severe trauma may displace the tooth causing it to sink deeper into the socket or hang loosely out of it. If the blow is very severe, it may knock the tooth out completely or fracture the supporting bone. Common causes of knocked out teeth are sporting injuries, violence or an accident. In most of these cases of tooth displacement, the tooth will require a root canal treatment.

Managing severe dental trauma

If your tooth has been knocked out, loosened or fractured, you should visit the dentist as soon as possible. Seeing a dentist within 30 minutes can make the difference between saving or losing a tooth.

If your tooth has been knocked out, do the following:

• Find the tooth if you can and replant it immediately. If a baby tooth has been knocked out, it may not be replanted. You may try to replace the tooth in the socket and keep it down by biting on gauze. This will protect the periodontal ligament fibers surrounding the tooth.

• Always handle the tooth by the crown – do not touch the root; that is the part of the tooth below the gum. Touching the root can damage cells necessary for bone reattachment. If there is any dirt on the tooth, do not try to scrape the tooth to remove it. Rinse gently with water.

• Apply a cold compress to your cheek to relieve any pain or swelling (within 30 minutes).

• Visit your dentist immediately, so that the tooth can be replanted. Remember, the longer you wait, the less likely it is for your tooth to be replanted successfully.

• If the tooth cannot be replaced in the socket and you have to bring the tooth to a dentist, do not allow it to dry out. Keep it moist by putting it in a small amount of cold milk or even your own saliva.

Most dental trauma is preventable and controllable. All depend on your choices. If you or someone you know suffers from a form of dental trauma, see a dentist as soon as possible. If the trauma is caused by violence, consult your local authorities or police. Be alert! Protect your teeth and gums by good hygiene practices. For sporting activities, use protective mouth guards. Arm yourself with the facts. Good decisions save you money and engender good health and wellness.

• Dr. Kendal V.O. Major is the founder and CEO of the Center for Specialized Dentistry, which is a comprehensive family dental practice operating in New Providence and Grand Bahama. He is the first Bahamian specialist in gum diseases and dental implants since 1989. He is also a certified fast braces provider. His practice is located at 89 Collins Avenue, New Providence. He can be contacted at (242) 325-5165 or

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