Managing Baby Tooth Loss: What to Do After a Fall

The primary incisor fell out due to a fall?

My daughter is currently 2 years and 3 months old.
Two days ago, she fell and knocked out her upper left front tooth along with the root.
We went to the emergency room that day for an X-ray, and the break was very clean.
The doctor mentioned that there is a small laceration in the gums and advised that it should heal on its own.
I would like to ask if, with 4 years until her permanent teeth come in, she needs a space maintainer or a prosthetic tooth.
If we don't do anything, will her gums recede, and will her permanent teeth come in crooked? Will getting a space maintainer or prosthetic tooth be painful for a child? It has been 2 days since the incident; how long should I wait before taking her to the dentist for an evaluation?

AMY, 30~39 year old female. Ask Date: 2016/05/31

Dr. Qiu Qiongyao reply Dentistry

Please take them to the dentist for an evaluation and treatment in one month.
If financially feasible, the necessary treatments should be carried out.

Reply Date: 2016/05/31

More Info

When a baby tooth is lost due to trauma, such as a fall, it can be concerning for both parents and the child. In your case, your daughter has lost her left upper front tooth, including the root, and has a small laceration in the gum. Here’s how to manage the situation and what to consider regarding future dental health.

Immediate Care and Healing
Since you have already taken her to the emergency room and had an X-ray, it’s important to follow the doctor's advice regarding the healing of the gum. The small laceration should heal on its own, but you should monitor it for any signs of infection, such as increased redness, swelling, or discharge. Keeping the area clean is essential, so encourage her to avoid touching the area with her fingers or tongue.

Space Maintenance
Regarding your concerns about space maintenance, it is crucial to understand that baby teeth serve as placeholders for permanent teeth. If a baby tooth is lost prematurely, there is a risk that the adjacent teeth may shift into the space, potentially leading to misalignment of the permanent teeth when they erupt.
In your daughter’s case, since she has about four years until her permanent tooth is expected to come in, a space maintainer might be beneficial. A space maintainer is a dental appliance that helps keep the space open for the permanent tooth. It is typically made of metal or plastic and is custom-fitted to your child's mouth.

Should You Get a Space Maintainer?
1. Consultation with a Pediatric Dentist: It is advisable to schedule an appointment with a pediatric dentist for a thorough evaluation. They can assess the situation and determine if a space maintainer is necessary. Generally, it is recommended to see the dentist within a few weeks after the incident, especially since it has already been two days.

2. Potential for Gum Recession: If a space maintainer is not used, there is a possibility that the adjacent teeth could drift into the space, which may lead to crowding or misalignment of the permanent teeth. This could result in the need for orthodontic treatment later on.

3. Pain and Discomfort: Regarding your concern about pain, while the placement of a space maintainer may cause some initial discomfort, it is generally well-tolerated by children. The dentist will ensure that it fits properly and will provide guidance on how to care for it.

Conclusion
In summary, it is essential to have your daughter evaluated by a pediatric dentist to discuss the need for a space maintainer. This will help ensure that her dental development proceeds smoothly and that her permanent teeth have the space they need to erupt correctly. The dentist can also provide you with specific care instructions for the healing gum area and monitor her overall dental health.
In the meantime, encourage her to maintain good oral hygiene practices, such as gentle brushing of her teeth while avoiding the injured area, and ensure she avoids hard or sticky foods that could irritate her gums. Regular dental check-ups will also be important as she grows.

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