An injury to one or more front teeth caused by a mechanical force is referred to as anterior tooth trauma. Most anterior tooth trauma is the result of an accident. It affects children and adolescents most frequently. In many cases it is possible to preserve the injured front teeth.
What is anterior tooth trauma?
According to PSYKNOWHOW, an anterior tooth trauma occurs as a result of mechanical force, usually in the event of an accident. The injuries to the teeth can arise in different ways. The front teeth include the upper and lower incisors and canines.
In the event of an injury, either one or more teeth can break off. But the bone compartment and the surrounding gums can also be affected by the injury. In the worst case, it can lead to the complete loss of the tooth or teeth.
Anterior tooth trauma is quite common. Canines and incisors in the upper jaw are more often affected than the anterior teeth in the lower jaw due to their location and size. It is often possible to preserve the teeth affected by an anterior tooth trauma.
Causes
An anterior tooth trauma always results from the effects of mechanical forces. Most of these are accidental injuries. They can be caused by a shock or impact. But a fall can also cause the injury.
Sports activities and, in the case of children, accidents while playing are often the reason for the injuries to the front teeth. Statistics show that every second person is affected by anterior tooth trauma by mid-life at the latest.
Children and adolescents are even more likely to injure their front teeth. Anterior tooth trauma occurs particularly often when falling from climbing frames and trees.
But modern trend sports such as skateboarding, rollerblading and parkour also lead to numerous injuries to the dental system. In this age group, anterior tooth trauma is almost as common as tooth decay.
Symptoms, ailments & signs
As a rule, the complaints and symptoms of an anterior tooth trauma are relatively clear, so that an early diagnosis and treatment can take place. Those affected primarily suffer from very severe toothache. In many cases, these cannot be satisfied with painkillers either and must therefore be treated by a doctor.
The pain often spreads to the neighboring regions, so that pain can also occur in the ears or head. The quality of life of the person affected is considerably restricted and reduced by the anterior tooth trauma. Also bleeding in the mouth can be encountered. Due to the pain, it is no longer possible to take food and liquids without further ado, so that some patients suffer from deficiency symptoms or dehydration.
If the anterior trauma is not treated, the teeth are often left crooked or broken. A regrowth of the teeth does not occur.
As a rule, the anterior tooth trauma can be treated well, although surgical interventions may also be necessary. Without treatment, the anterior tooth trauma can also lead to speech defects. The life expectancy of the person affected is usually not negatively influenced by the disease.
Diagnosis
After the occurrence of an anterior tooth trauma, the dentist’s diagnosis essentially refers to the assessment of the damage to the affected canine or incisor teeth. Depending on the type and severity of the injury, a distinction is made between peripheral and central tilts and broken teeth.
The type of injury is determined by carefully palpating the damaged tooth and performing an X-ray examination. Peripheral tilt occurs when the tooth or teeth are loosened and tilted. There can be all degrees of loosening and tilting of the tooth, up to and including complete tooth loss. If the front tooth is tilted inwards and thus knocked into the jawbone, it is a central tilt.
Tooth fractures are divided into cracks, enamel, root or crown fractures, as well as longitudinal, transverse or oblique fractures, depending on the extent of the fracture. The less the tooth is loosened or tilted, the more likely it is that a tooth will break. The course of an anterior tooth trauma always depends on the individual case. The incident that led to the trauma and the subsequent treatment are always decisive for the course of the injury.
In most cases, both the function and the appearance of the affected teeth can be restored after an anterior tooth trauma.
Complications
An anterior tooth trauma usually results in severe pain and bleeding in the patient’s anterior teeth. Therefore, immediate treatment by the doctor is necessary so that there are no consequential damages. If the teeth are not treated, crooked front teeth can remain. Broken teeth also occur.
The pain and bleeding make it impossible to eat and drink normally. This reduces the quality of life and can lead to underweight. If the anterior tooth trauma occurs in children, there are usually no complications.
In children, the milk teeth can be extracted so that the new teeth grow back later. If a tooth is broken or cracked, the affected areas can be straightened with fillings or crowns. If the anterior tooth trauma affects the tooth root, this is removed in most cases. The treatments at the dentist are carried out under anesthesia so that there are no pain or complications.
If the tooth root is removed, the affected tooth no longer feels any stimuli. If the tooth is knocked out completely in an anterior tooth trauma, a gap is created. This looks unattractive and can reduce the patient’s self-esteem. Gaps are filled with implants. Again, there are no further complications.
When should you go to the doctor?
See a doctor after a fall, accident, or impact on the mouth or face area. An anterior tooth trauma can also be present without pain or obvious damage, which should be examined and clarified by a dentist. In some patients, fractures form on the tooth or below the gums. These can only be found and corrected in a dental examination. Damage to the roots of the teeth or displacements of the teeth must be treated and treated by a doctor.
Without a visit to the dentist, the slow process can lead to impairment and permanent problems of the jaw. If the jaw can no longer be moved as usual or if the gums bleed, it is advisable to consult a doctor. If a denture was worn in the accident, it should be checked for integrity by a dentist. Loosening of the teeth, pain or a feeling of pressure in the mouth should be presented to a doctor.
If the person concerned hardly consumes any food or if there is a loss of weight, a doctor is needed. Consult a doctor if you have a headache, difficulty swallowing or if you are unusually sensitive to temperature influences. If there are problems with the chewing process, if there is a change in voice or if there is a speech impediment, a doctor should be consulted.
Treatment & Therapy
Treatment of anterior tooth trauma depends on the type of injury and the type of tooth affected. If milk teeth are affected, the injured teeth are usually pulled. If permanent teeth are affected, different therapies are used depending on the type of injury. Tooth cracks are treated by applying a protective film to the tooth.
In some cases, tooth fractures can be remedied with fillings or crowns. Sometimes, however, the front tooth can no longer be saved and has to be pulled. This is usually the case with a broken tooth in the middle or upper root area. Teeth loosened by an anterior tooth trauma are splinted. In this way, the affected teeth are spared and fixed and can grow back on.
If there are gums injuries in addition to the tooth damage, the cracks are treated with ointments or rinses after initial dental care. If the anterior tooth trauma has resulted in tooth loss, it may be possible to reimplant the knocked out tooth.
However, it depends on the individual case whether this is possible. If reimplantation is no longer possible, the resulting tooth gap must be filled with a denture. Implants or bridge constructions are used after a tooth loss in an anterior tooth trauma.
Outlook & forecast
The prognosis for an anterior tooth trauma depends on how badly the tooth structure or the jawbone has been damaged. Anterior tooth trauma can only affect the hard tooth substance. But they can also affect the tooth-supporting apparatus or the alveolar bone, as well as both together.
If permanent teeth are affected in an anterior tooth trauma, the procedure depends on the severity of the damage. Preservation of the tooth substance is in the foreground. The more carefully the emergency medical measures are carried out, the better the prognosis. If the tooth has been completely knocked out, it can only be re-implanted after a very short interim storage. The prognosis here is poor because the doctor’s visit is usually too late.
With an enamel fracture, the prognosis is good, provided that the anterior tooth trauma is identified and observed. If there is a crown fracture with loss of tooth structure, the prognosis depends on whether the tooth nerve is exposed or not. With professional immediate treatment of an anterior tooth trauma affecting the tooth nerve, the tooth can usually be saved. In the case of root fractures, the prognosis depends on the x-ray findings. Root fractures that injure the oral cavity can be affected by inflammation or bacterial colonization. There is a risk of tooth loss if the anterior tooth trauma is not treated immediately.
The prognosis for tooth dislocation due to anterior tooth trauma is similar. If the wobbling tooth is not stressed, it can grow in again. If necessary, it must be judged.
Prevention
An anterior tooth trauma can only be prevented to a limited extent, as it usually occurs as a result of an accident. Especially with children and adolescents, it is difficult to avoid accidents through controlled caution. If an anterior tooth trauma occurs with tooth loss, the knocked out tooth should be collected and properly stored until it arrives at the dentist, in order to enable reimplantation under certain circumstances. For this purpose, the tooth lost in an anterior tooth trauma should be stored moist.
Aftercare
An anterior tooth trauma can lead to a loose or knocked out tooth or the breaking off of a large part of the tooth substance in the visible area. Injuries to the hard substance of the teeth are by no means only relevant to beauty. In addition to the aesthetic problem, biting or jaw problems can also arise. A distinction must be made between anterior tooth trauma in concussions, subluxations, extrusions, dislocations, avulsions and intrusions.
Dental therapy depends on the severity of the damage caused. Follow-up care also depends on how the anterior tooth trauma was treated and whether the jawbone was affected when the tooth was injured. Professional treatment and careful aftercare ensure healthy teeth for years to come.
If the tooth is knocked out completely and must therefore be re-implanted, follow-up care must be carried out particularly carefully. It must be ensured that the reimplanted tooth is firmly attached to the jaw again. Since adolescents are often affected by anterior tooth trauma, follow-up care must also take into account the growth of the adolescents and the duration of the durability of tooth repairs.
The repaired area may differ in color. From now on, it can remain more susceptible to further repairs. If necessary, a decision must be made during the follow-up to crown the repaired anterior tooth. In addition, follow-up care must ensure that there are no sequelae after an anterior tooth trauma through sensitivity tests of the anterior teeth at certain intervals.
You can do that yourself
In the event of an anterior tooth trauma, the teeth in the anterior region should not be exposed to any further stresses if possible. The biting of food is to healing or medical treatment should be avoided. Biting down on soft foods is also not recommended.
If possible, existing dentures should be temporarily removed if they cause pain. It can only be used again after consulting the dentist and clarifying the symptoms. In order not to cause any further complaints, vibrations of the mouth, jaw and head must be reduced or completely eliminated.
Sports activities or situations with potential hazards are to be avoided. In everyday life this means that martial arts or ball sports are to be restricted or refrained from. If there is no alternative to these situations, an individually adapted face mask must be worn. Clashing the jaws and chewing with the front teeth should be avoided.
When eating, the chopping of the food is to be done with the middle or back teeth. To ensure that no further diseases occur despite the anterior tooth trauma, the teeth should be cleaned thoroughly every day. Care should be taken to ensure that they are cleaned gently. Depending on the symptoms, the use of a soft toothbrush and mouthwash can be helpful. Do not use force when cleaning your teeth.
