Deciduous  teeth, especially the front, are often subjected to trauma. This happens when children begin to walk, run or when they practice different sports. When your child is subjected to accidental head injuries, it should be also investigated if it shows any damages to the teeth. There are situations when the tooth is visibly affected, presenting mobility, coronal  or root fracture, at which point it is imperative for parents  to come at the dentist office.

But what happens when the child falls, but he shows no clinical symptoms that can alarm you? Most often  the parents does not give much importance to this event, which may have repercussions on the child dental health. In this article I will detail what pathological sequelae may occur in the permanent teeth after the traumatisation of temporary  or "milk" teeth.

 

What happens to deciduous teeth?

As an initial response of the tooth to the shock, the pulp shows a dilation of capillaries. This is called pulpal hyperemia and it manifests in time by changing the color of the tooth. Specifically, the tooth takes on a pinkish tint.

If trauma is stronger and capillaries are broken, then the blood pigments are deposited in the dentin tubules and the tooth is stained pink or red.

Red can also represent an internal inflammatory resorption when, after an injury, odontoclasts come to create a space inside the tooth by increasing dental pulp tissue and the thin layer of enamel transpares the colour of the pulp. This may lead eventually to a broken tooth.

Black or gray coloring of the tooth from an injury can mean most often that the pulp or "nerve" inside the tooth is no longer vital. Then, besides tooth colouring you  have to look out for other symptoms such as pain, swelling or abscess formation. In this case, since the beginning it is necessary to have a dental evaluation.
Calcic metamorphosis is another pulp reaction to trauma. This works abnormally, depositing excess secondary dentin until the pulp chamber comes to be fully calcified. In this case, the tooth becomes yellow and  must be evaluated by the dentist in order to prevent possible complications.

Following studies have found that a number of dental patients have also dental ankylosis. In this process the root cementum  joins with the alveolar bone by the disappearance of periodontal ligaments which may have consequences in terms of permanent tooth eruption.

 

What happens to the permanent teeth?

The consequences of primary teeth trauma on the permanent ones are influenced by the age at which the event occurs and the type of trauma. As the child has a younger age (1-3 years), the  damage over permanent tooth is higher. Studies have shown that the most common damage  to the permanent tooth is enamel hypoplasia. This represents a lack of mineralization at the enamel level, accompanied by a yellow-brown change of the area and low resistance to the dental caries attack.

The ectopic eruption of the permanent tooth is another consequence of temporary teeth trauma. In this case dental and orthodontic consult is absolutely necessary.
If the primary tooth was temporarily displaced during the trauma and influenced by its position the  dental bud, being intrusive, then it can produce angulation between the crown and root of the  permanent tooth.

Each injury is different and also the sequelae it may have on permanent or temporary teeth, but every time it has to be evaluated in a specialised consult.

 

Author:  Dr. Buganu Elena
Sources: www.libraryonline.wiley.com, www.sciencedirect.com
Photo sources: www.kathleenbernstein.com