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Primary Tooth Trauma

Acute injuries to deciduous teeth (0-6 years) and protection of permanent tooth germs

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ağız ve Diş Sağlığı department. Book Appointment →

What is Primary Tooth Trauma?

The primary dentition begins to erupt around 6 months of age and is completed by 30 months. The peak age for trauma is 1-3 years, when motor control is developing and the toddler is exploring; the most commonly affected teeth are the maxillary central incisors. According to Andreasen classification, primary tooth injuries are categorized into: enamel infraction, enamel fracture, enamel-dentin fracture, complicated crown fracture, root fracture, concussion, subluxation, lateral luxation, intrusion, extrusion, and avulsion.

The closeness of the apices of primary teeth to the developing permanent tooth germs makes treatment decisions critical. Intrusion injury is the most concerning because the primary tooth tip can damage permanent tooth germs (enamel hypoplasia, dilaceration, eruption disturbance). The incidence of permanent tooth germ damage may reach 12-69%.

Avulsed (knocked-out) primary teeth are NOT replanted because of the risk of damage to the permanent germ; this differs from the management of permanent teeth. Most cases require clinical/radiographic follow-up; conservative approach is preferred.

Symptoms

Tooth fracture or fragment loss
Tooth displacement (intrusion, extrusion)
Gingival bleeding and swelling
Pain and tooth sensitivity
Tooth color change (gray, pink)
Lip and intraoral wounds

Risk Factors

Age 1-3 (gross motor skills development)
Class II malocclusion (anterior projection)
Hyperactivity
Outdoor activities (playground, bicycle)
Anterior open bite
Suspicion of child abuse

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Tooth fracture (any size)
  • Tooth displacement and intrusion
  • Tooth color change after trauma
  • Persistent pain and chewing problems
  • Apically displaced tooth (intrusion suspicion)

Treatment Methods

01
Detailed history and tetanus status
02
Periapical X-ray and panoramic radiograph
03
Conservative approach (no replantation)
04
Pulpectomy/extraction (in fracture/displacement)
05
Antibiotic and chlorhexidine mouthwash (when needed)
06
Long-term follow-up (permanent tooth germ damage)

Which Department to Visit?

You can visit our Ağız ve Diş Sağlığı department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ağız ve Diş Sağlığı Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.