We have officially passed our one month anniversary! It still seems surreal to me because this practice is like my “baby.” I remember having to adhere to the one month confinement period after giving birth to my first child. Granted, I followed the restrictions loosely but at the end of the first month, I felt so relieved. Likewise, there was a sense of relief and I’m filled with hope now that we are well into our second month with my start-up practice.
Given that we are right in the middle of summer, I thought I’d dedicate this blog post to children dental trauma. I can recall those days in residency when we would get a surge of calls from the ED (Emergency Department) for dental trauma during the months of June through August. As much as I dreaded going in for every single call, they were some of the most valuable learning experiences for me. One of my attending, Dr. Bob Frank, used to say that even when we know there is nothing to do, still go in to see the patient because that’s how we’d learn. I carry that philosophy with me to this day and I strongly believe that it is my responsibility to care for my own patients, not the Emergency Room physician who will then have to page a dental resident, especially when I am local and available.
As a mother of two active and rambunctious boys, short of bubble wrapping them before they leave the house, I know that trauma is inevitable! Case in point, we were at Airwalk, a local trampoline park, with some friends last year when my son had his accident. My husband and I were not jumping so we were keeping an eye on the kids while we were talking to our friends. Everything was fine and it couldn’t have been more than a couple of minutes when I heard a scream and our friend was carrying our youngest son, who was 2 years old at the time, in his arms towards us. As he was transferred to my husband, all I could see was a pool of blood in his mouth, dribbling down my husband’s arm and then I spotted something white on my husband’s index finger; he was holding it out to show me. The rational part of me was going through the checklist: check for head injury, check for any broken bones, check for any limited range of motion, check for cranial nerve injury, etc. However, the frantic mother part of me combined with the pediatric dentist side of me took over as I grabbed my husband’s hand and snapped: “Is that soft or hard tissue?!” I was praying that it was just soft tissues but half of me was already going through the next steps of what I would do if it was a hard tooth fragment that had fractured from his front tooth. Thankfully it was just soft tissues and I heaved a sigh of relief as I scooped my baby into my arms to comfort him and rushed to the nearest restroom to clean him up. I was now calm and back in control as I reassured him that he’s going to be fine and inspected his injury methodically.
The staff was great and checked on us several times to see if he was ok. One of his front teeth was slightly loose but thankfully, not displaced or broken. The gum tissues above that front tooth was peeled off and I could see the junction where the crown of this tooth met the root. Part of the gum tissues came off (what was on my husband’s fingertip) and the rest laid like a flap over the root.
There was no cut on his lip, no other teeth were injured, he could see fine, there was no broken bone, and he did not lose consciousness. Phew! We kept him on a soft diet and told him not to use his front teeth to bite into anything for at least 2 weeks, kept the area clean with regular brushing, and iced his swollen upper lip. He was a champ! His front tooth has not changed color as some teeth may after an injury and it firmed up over the following months. It’s been a year and he can finally sit for x-rays to allow me to check and the x-ray looked great! I continually check by lifting his upper lip out of the way to see if there is any swelling or pimple-like bubble above the tooth, because that would be day that I march my baby into the office, put on some laughing gas, turn on PJ Mask on the ceiling TV, and take that tooth out for the Tooth Fairy. It may be before he is old enough to lose that tooth naturally (6 or 7 years old) but he will preserve the health of the underlying permanent tooth that is still developing and he will have a great story to tell his friends at school!
I can now fully empathize with other parents who may go through the ordeal of a dental trauma with their child, but not all parents are dentists and may not know what to expect or know what to do next. If you are local please reach out to me! I am on call after hours and on the weekends for my patients. If I am in town I will consult with you and see your child, especially if a permanent tooth is involved. If I am not in town then I will still answer and see if I can’t help via the phone.
My fingers are crossed for no injury this summer 🙂