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Medical Edge Newspaper Column from Mayo Clinic
OPTIONS FOR A CHILD’S IMPACTED TOOTH
DEAR MAYO CLINIC: My 2-year-old son fell and hit his mouth on the coffee table, causing his left lateral (incisor) tooth to be pushed into the gum. Will he need oral surgery to correct the problem? Will his permanent tooth be affected? — Rochester, Minn.
ANSWER: Whether or not your son needs oral surgery largely depends on how far the tooth has been pushed (impacted) into the gum.
If the degree of impaction is minor — up to three millimeters — there’s no need to pursue treatment at this time because the tooth will likely either move itself back into position within the next few months or be pushed out by the permanent tooth before your son turns 8. It’s important, however, that his condition be observed.
If the incisor is completely impacted — that is, you cannot see the tooth, and it has been detached from the bone — it will not erupt on its own and must therefore be surgically removed.
If the impaction is greater than three millimeters but less than complete, it’s a judgment call for the oral surgeon on whether to observe or extract.
A serious concern about tooth impaction is the possibility that the tooth’s nerves and blood supply have been cut, rendering it nonviable and thus subject to infection (abscess). In addition to causing pain and other complications, chronic infection in that area would interrupt development of the permanent tooth.
This concern applies not just to complete or intermediate impactions. Even minor trauma could cause the tooth to eventually become nonviable. You’d be able to spot this early, though, as the tooth would start darkening into a grayish color. Sometimes in such cases, an alternative is to do a root canal on the tooth, which enables it to survive for several more years until naturally replaced by a permanent tooth.
The bottom line is that the chance of injury to your son’s permanent incisor, given his setback at age 2, is very low. A minor impaction of his baby tooth should eventually correct itself, though it must be observed for telltale signs of trouble, and a more-than-minor impaction is readily treatable through dental intervention.
— Eugene E. Keller, D.D.S., M.S.D., Pediatric Oral and Maxillofacial Surgery,
Mayo Clinic, Rochester, Minn.
Additional Resources:
Information on Oral and Maxillofacial Surgery
Appointment Information
READERS: If you’re looking to maintain a healthy weight, don’t skip breakfast. Studies have shown that it’s better to eat a low-fat breakfast that emphasizes whole grains and fiber than to skip the morning meal.
Eating a healthy breakfast has been associated with desirable cholesterol levels and helping to reduce intake of fat and cholesterol throughout the day. It’s also been shown to help you live longer. Here are some heart-healthy breakfast ideas:
— Cereal: Hot or cold, choose one with a fiber content of five grams or more a serving, and a fat content of zero to three grams a serving. Opt for skim milk.
— Fruit: Slice a banana on your cereal or grab an apple for the road. If you enjoy fruit juice, buy 100 percent fruit juice without added sugar. Limit yourself to one serving of these calorie-rich beverages a day.
— French toast: Dip whole-grain bread in a batter made of egg whites or egg substitute, a pinch of cinnamon and a few drops of vanilla. Fry on a nonstick skillet or use a nonstick spray.
— Nontraditional: Make a vegetable sandwich using whole-grain bread. Microwave a potato and top with shredded, low-fat cheese.
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Medical Edge from Mayo Clinic is an educational resource and doesn’t
replace regular medical care. To e-mail a question, go to www.mayoclinic.org,
or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave.,
Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.
© 2005 TRIBUNE MEDIA SERVICES, INC.
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