Oral trauma is a physical injury affecting the mouth, including the teeth, gums, jaw, and soft tissues of the lips and tongue. These injuries often result from accidents like falls or sports-related incidents. The severity can vary from minor cuts or chipped teeth to a dislodged tooth or fractured jaw. Understanding these injuries is the first step toward proper care and preventing long-term complications.
Common Types of Oral Injuries
Injuries to Teeth
Tooth damage is a frequent outcome of oral trauma. A common injury is a fracture, where a tooth is chipped or cracked. These fractures can be minor, affecting only the outer enamel, or more severe, extending into the sensitive inner dentin and sometimes exposing the tooth’s nerve-filled pulp, which can lead to pain.
Another tooth injury is luxation, where a tooth is pushed from its normal position but remains in the socket. This can be an extrusive luxation, where the tooth appears longer, or a lateral luxation, where it is pushed sideways. An intrusive luxation occurs when the tooth is driven into the jawbone, making it look shorter. The most severe injury is an avulsion, the complete displacement of a tooth from its socket.
Soft Tissue Injuries
The soft tissues of the mouth, including the lips, cheeks, tongue, and gums, are also susceptible to injury. Lacerations, or cuts, are common and can result in significant bleeding due to the rich blood supply in these areas. Puncture wounds can also occur, particularly on the lips or cheeks, and may happen with or without damage to the teeth.
Jaw Injuries
Trauma to the jaw can lead to a fracture or a dislocation. A fractured jaw is a break in the jawbone that can affect the ability to speak or eat. A dislocated jaw occurs when the lower jawbone is pulled from its joints at the base of the skull. Both are serious injuries that cause considerable pain and swelling.
Immediate First Aid Measures
For a chipped or fractured tooth, rinse your mouth with warm water and collect any broken pieces to bring to the dentist. Applying a cold compress to the outside of the mouth can help reduce swelling.
For a dislodged (luxated) tooth, gently attempt to reposition it with your finger, but do not force it. Biting down on a soft cloth can help hold the tooth in place until you see a dentist.
For a completely knocked-out (avulsed) adult tooth, immediate action is necessary. Handle the tooth by the crown, not the root. If it’s dirty, rinse it briefly with milk or water for a few seconds; do not scrub it.
Try to reinsert the tooth into its socket, ensuring it faces the correct way. Once in place, bite down on a clean cloth to secure it. If you cannot replant the tooth, keep it moist in a container of milk or saliva, but not in water.
For bleeding from a soft tissue injury, apply firm, direct pressure with a clean cloth for 15 to 30 minutes. If bleeding is severe and does not stop, or if you suspect a jaw fracture, go to an emergency room.
Professional Medical and Dental Treatments
After first aid, professional treatment is often required. For fractured teeth, a dentist may use dental bonding to repair minor chips. For more significant fractures, a crown may be needed to protect the damaged tooth. If the fracture has exposed the tooth’s pulp, root canal therapy may be performed to remove the damaged nerve tissue.
When a tooth is dislodged, a dentist will reposition it and may stabilize it by splinting it to the adjacent teeth to allow the ligaments to heal. For an avulsed tooth that has been correctly preserved and replanted, a dentist will also use a splint. The long-term success of reimplantation depends on how quickly the tooth was returned to its socket.
Soft tissue lacerations are often cleaned and may require sutures to facilitate healing and minimize scarring. Jaw fractures require medical attention from an oral and maxillofacial surgeon. Treatment may involve wiring the jaws shut or using surgical plates and screws to stabilize the fracture.
Preventing Future Oral Injuries
Preventative measures can significantly reduce the risk of oral trauma. Wearing a custom-fitted mouthguard during sports and recreational activities is an effective strategy. Mouthguards absorb and distribute the force of an impact, protecting the teeth and soft tissues.
General safety practices also play a role in preventing oral injuries. Using seatbelts in vehicles can protect against facial trauma in an accident. For young children, childproofing the home by securing furniture and installing safety gates can help prevent falls that could lead to oral injuries.
Certain personal habits can also increase the risk of tooth damage. It is advisable to avoid chewing on hard objects like ice, pens, or hard candies, as this can cause teeth to crack or fracture. Incorporating these preventative strategies can diminish the likelihood of experiencing oral trauma.