AN OUNCE OF PREVENTION: AVOIDING DENTAL DISASTERS

AN OUNCE OF PREVENTION:

AVOIDING DENTAL DISASTERS

by RICHARD HOLSTEIN, D.M.D., FADH

PRINCETON PEDODONTICS

            As your child grows, more and more challenges rise to meet his or her face, often with life-long consequences.

            Newborns are top-heavy; their heads cannot be adequately supported by their musculo-skeletal structure. As they age, and begin to explore, they are still uncoordinated and tend to lead with their heads and faces. It is very common to have a new “cruiser” do a swan dive onto her/her face. If teeth are present, thy usually have a sign on them that says “hit me”. Damage to the primary front teeth can cause damage to the developing permanent ones. If you have questions, please consult your Pediatric Dentist[i]

            As a general safety rule, we would strongly recommend “child-proofing” your house:

1.      Make all accessible corners rounded and padded.

2.      Carpet all steps and pad flooring where possible.

3.      Use gate systems at all stairs.

4.      Have soft kitchen flooring placed, or pad with soft mats where possible. Tile is lethal for teeth.

5.      Remove all heavy objects that can be pulled over, from reach – especially sharp and glass ones.

6.      Secure cabinet doors, lock up medications and cleaning supplies, plug unused electrical sockets and secure all plugs.

7.      Put away and/or secure all power tools (particularly those in the kitchen).

8.      NEVER leave a paper shredder plugged in when you are not present and using it. Children’s fingers are TINY and curious![ii]

Crawl around on the floor, just as our children would, and see things from THEIR perspective. What looks inviting? Is it dangerous? This is really where an ounce of prevention pays off!

As children grow older, they become more mobile. Young children fall, quite often as a rule. They trip; they slide; they bump; they fly; they climb; they usually bounce (but not always). It’s not like watching Buzz Lightyear “falling with style”. Anything from distraction to a misplaced marble or twig, to new sneakers or slippers – to nothing – can cause this. If they have older siblings, they want to emulate them, without their experience or coordination.

ATHLETICS – from the most basic to complex – is the greatest source of oro-facial trauma. Kids throw rocks, and sticks, and toys, and, generally, anything they can get their hands on. What goes up, must come down. Swords, sticks, baseballs, bats, golf clubs, etc. are all threats; some you can control, others, not. If your child is playing an organized spot, he/she should be appropriately protected with padding, eye and face guards, and anything else you can force them to wear. EVERY COACH should require every person on the team to wear protection – or be denied participation. That is, by far, the best way to prevent sports injuries. For non-team activities, like bicycle riding, children should be banned from participation, WITHOUT EXCEPTION, if they don’t wear appropriate protection. It should be unnecessary for government to legislate what common sense would dictate!

A note here about skate boards – dangerous. They should only be used with adequate and appropriate supervision and protection. Boards with elevated “steering” handles are particularly dangerous – when children fall on these (and they will), that handle becomes a potentially fatal projectile.

The middle school child is yet more ambitious. Now we have hockey, cheer leading, two-wheeled bicycles, skate boards, ATVs, etc. Social pressures and “macho” issues surface to complicate matters. We also have PERMANENT FRONT TEETH![iii] Damage to a permanent tooth is forever. The instant it occurs, that’s it. No repair is ever as good as the original tooth, nor as permanent. Accidents happen, but most, from our experience, could have been easily avoided with a little forethought.

The Fall is here. Leaves are falling, the sun sets earlier and the ground is often damp. Kids want to go bicycle riding when they come home from school. They are tired, visibility is poor and the ground is very slippery. This is often a prescription for disaster. You know your children – don’t let them do what they can’t at any particular time. The consequences may be permanent and devastating.[iv]

If a PERMANENT tooth is avulsed (knocked out)[v], it must be re-implanted as soon as possible. Time is extremely critical. This procedure is delicate and quite specific, and requires special knowledge. This should only be done by a Pediatric Dentist or Oral Surgeon. If this happens, PUT THE TOOTH BACK INTO THE CORRECT SOCKET, ALL THE WAY[vi]  (this is not the time to be a weany), have the child hold it there, and call your Pediatric Dentist or Oral Surgeon. Nothing will preserve the integrity of the tooth as well as being where it belongs; milk is a poor substitute for oral fluids.

BROKEN TEETH may, or may not, be emergent problems. As a rule though, always call your Pediatric Dentist right away. He/she will determine whether emergency care is necessary. Any responsible practitioner has coverage 24/7 – which should be by someone with like credentials for just such emergencies.

In “A Christmas Story” Peter Billingsly is told “You’ll shoot your eye out” – but he gets his Red Rider BB Gun anyway. If you have seen the movie, you know what happens. He was lucky.

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