Written by Dr. Yahya Radwan, DDS
Kids have accidents. My kids are no different, of course. It was a Sunday morning and my daughter’s second birthday. She and her four-year-old brother were in the bathtub having a bath.
As she got up to step over her brother, she slipped and fell onto the edge of the bathtub. Of course, it happened so fast—instant chaos: crying, bleeding, wet kids. My wife brought her out right away and we had a look. Yep, my daughter’s front tooth had been hit so hard when she fell that it was pushed inside toward the back of her mouth. It was basically at a 90-angle to the teeth next to it. Great news: the tooth wasn’t fractured, her lip was fine, and her head had not been injured.
No parent wants to be in this situation: A weekend, at 10:00 am, their two-year old daughter is crying hysterically, and a significant amount of blood is coming from her mouth. So, what did we do?
Well, first we needed to put the tooth back to where it was supposed to be. Which we did together while my daughter was sitting in my wife’s lap. She cried so hard, but they both handled it like champions.
The we waited. We put her on a soft food diet for a few days while we waited for the tooth to heal. X-rays weeks later revealed that the tooth was not able to heal itself from the inside and as a result, the nerve tissue died – and the area around the tooth had an infection. We attempted a dental procedure with the help of sedation to clean the inside of the tooth and we gave her antibiotics and waited a few more months for results, but the infection was too stubborn.
At this point we had two options:
Here are the pros and cons for the option of saving the baby tooth that we considered while trying to decide what to do:
Keeping an infection in that area of the face is where things could possibly get more serious. Having a chronic infection could negatively affect the adult tooth as it developed inside the jaw. But that’s not the most serious concern…most people don’t realize how close that area of the face is to the brain. Having an infection in that area has a (albeit very minimal) chance of moving up into the brain with devastating consequences.
When I went through this analysis in my mind, the decision wasn’t difficult to make. After another round of antibiotics and x-rays to confirm that the infection was still there, we decided to remove the tooth.
If faced with the same situation and decision, I’m not sure how much I would have changed my approach. Putting a two-year-old through two dental procedures isn’t ideal, so I might have been a bit more aggressive as soon as we saw the infection and removed the tooth the first time.
Our daughter grew up healthy and adjusted. Although in most pictures she looks like a hockey player who didn’t wear a mouth guard. Her adult tooth came in looking perfect with no developmental abnormalities. As I write this, she’s a beautiful 16-year-old girl with an amazing smile.
So, what do you do if this happens to you?
Mouth trauma is always difficult, but at the very least: