Dental injuries in children are more common than in adults. Infants often fall when learning to walk as they discover their new environment. Children of school going age are also vulnerable because of the amount of playing and activity they do both at home and in school. Whilst many dental injuries happen at school during organised sports, many more injuries happen out of hours and therefore outwith the protection of school insurance.
Effects of injuries to primary teeth on adult teeth may not be obvious until several years after the injury and include:
· Defects of enamel on the adult tooth underneath the injured baby tooth
· Failed eruption of the adult tooth
· Disfigured root structure of the developing adult tooth beneath the injured tooth
· Arrested development of the developing adult tooth
· A poorly formed adult tooth which cannot be brought into line with the other teeth
The treatments for these complications can be as minor as using a white filling material to camouflage the defects on the enamel, to surgical exposure of an unerupted tooth and orthodontic realignment. Sometimes an adult tooth may not be viable and the only option is an implant when the patient is finished growing.
Injuries to an adult tooth can lead to some serious complications:
· Death of the nerve in a tooth that is not fully developed is complex to treat and may require specialised techniques over multiple visits.
· Sometimes the root of an injured tooth fuses to bone and stops the bone from growing. The result is that it looks like the tooth is sinking. If this happens in growing patients the root of the tooth can disappear in a short space of time, leaving not just a space where the tooth is missing but an unsightly gap in the bone as well.
One of the difficulties with dental injuries in growing children is that the effects can present a long time after the injury occurs. These complications often require complex, multidisciplinary and specialised long term dental care and this can involve significant expense for parents, especially when frequent visits mean days off work as well.
School insurance policies often have an additional option which includes cover for injuries that happen out of school hours for a relatively small additional fee. When the injury happens, it is important that a thorough dental trauma report is completed by a dentist with appropriate expertise and training in the management of injuries in children. It is important that the report covers the likelihood of specific complications which could occur in future so that as the child grows and develops, the costs of future dental treatment relating to the injury will be reimbursed. An example would be the cost of root canal treatment and crowns or the need for implants if the injured tooth is not likely to last in the long term. Sometimes this might require complex interdisciplinary care such as the expertise of an Orthodontist to realign teeth or the input of an Oral Surgeon if complex bone grafting procedures are required.
My advice to parents is to ensure children are always fitted with sports guards for all contact sports. The next step is to check the details on your school insurance policy and see if you can opt for cover for injuries out of school.