Dental trauma comes in many different forms whether intentional, as in the case of assault, or accidental, as in the case of a stumbling toddler.
Sadly, Glasgow sees more than its fair share of dental trauma, often inflicted by rowdy patrons of pubs and clubs.
The maxillofacial surgeons often bemoan the incidence of assault-induced dental and facial trauma. Many campaign passionately against domestic violence in Scotland and injuries such as broken teeth don’t always present early.
Our teeth are precious and can’t be replaced.
The next best option to your own teeth may be dental implants but this involves more complex treatment and expense. Partial dentures are rarely favoured.
Research shows that preparing teeth for cosmetic dentistry, such as dental crowns and bridges incurs a considerable risk if there is nerve damage to underlying teeth.
There’s a lot to be said for staying out of trouble and wearing a sports mouthguard where required. Look after your teeth! That said, accidents do happen….
Dr Brendan Murphy, who works closely with our friends at Braehead Clan and Partick thistle, simplified some of the treatments he has employed in the case of trauma:
“Initially, our priority is to stabilise the affected teeth and on examination we will check for injuries, X-ray teeth and place temporary fillings where required. Loose teeth may be splinted to adjacent teeth in order to stabilise them temporarily.
If fractures encroach upon root canal structures then root treatment may be indicated. Bonding with composite resin is one of the least invasive techniques used to rebuild teeth. When done well, this may be difficult to distinguish from adjacent enamel, even on close scrutiny.
Other options may be to use porcelain veneers or laminates, ceramic porcelain crowns and in the case of tooth loss, partial dentures, porcelain bridgework or implants.
Occasionally a tooth will be completely knocked out or avulsed. I’ve seen this happen during a school hockey match and my friend was quite devastated at the time.
When possible, a dentist or receiving surgeon can replant a complete tooth if the patient is seen immediately. One of our patients will describe his experience of this later.
If tooth avulsion occurs, the patient or parent should store the tooth inside their cheek or buccal pouch. Don’t try to wipe or clean it as this will damage some of the cells which help it to reintegrate. The dentist may gently wash it in saline if required, prior to repositioning.
In the case of permanent tooth loss, an immediate, temporary denture will be fabricated in order to facilitate healing and maintain aesthetics.
Replacement with a dental implant or bridge may be considered after approximately six weeks.”