Zubna trauma kod djece
Treatment
Specialist assessment and treatment of dental injuries in children, from minor chips to complex avulsions, protecting both current and developing teeth.
About the treatment
Dental trauma in children refers to any physical injury to the teeth, supporting bone, gums, or soft tissues of the mouth caused by an impact, fall, or accident. These injuries are remarkably common: studies suggest that one in three children will experience some form of dental trauma before reaching adulthood. The peak ages are toddlers learning to walk (1-3 years) and school-age children engaged in sports and active play (7-12 years). Trauma can present in many forms, ranging from a minor enamel chip to a complete avulsion where the tooth is knocked entirely out of its socket. In between are fractures that extend into the dentine or pulp, luxation injuries where the tooth is pushed sideways, intruded into the bone, or partially pulled out, and root fractures that are invisible without an X-ray. Soft-tissue injuries to the lips, tongue, and gums frequently accompany these dental injuries and may require their own treatment. What makes pediatric dental trauma particularly complex is that children's mouths are still developing. A traumatised baby tooth sits directly above a permanent tooth bud, and the wrong management can cause lasting damage to the adult tooth before it even appears. Similarly, a newly erupted permanent tooth in a young child often has an open root apex, meaning the root is not yet fully formed. These immature teeth respond differently to injury and have a unique capacity for healing if treated correctly, but they also carry a higher risk of complications if treatment is delayed. At BestDent, our pediatric dentists and oral surgeons work together to provide comprehensive trauma care. We follow internationally recognised protocols from the International Association of Dental Traumatology (IADT) to ensure every child receives evidence-based treatment. Beyond the immediate repair, we focus on long-term follow-up because the true outcome of a dental injury may not become apparent for months or even years. Our goal is to save every tooth that can be saved, protect every developing tooth, and help your child return to a confident smile as quickly as possible.
We can make your smile look great
Specialist assessment and treatment of dental injuries in children, from minor chips to complex avulsions, protecting both current and developing teeth.
Keep your teeth healthy
The dentist begins with a focused history: when and how the injury occurred, whether the child lost consciousness, and whether any teeth or fragments are missing. A thorough clinical examination evaluates each affected tooth for mobility, displacement, fracture lines, and nerve exposure. The gums, lips, tongue, and jaw are also checked for lacerations, swelling, or bone tenderness.
The benefits of our dental treatments
- Treatment guided by IADT international protocols, the global gold standard for dental trauma management
- Combined pediatric dentistry and oral surgery expertise for complex injuries under one roof
- High reimplantation success rates when avulsed permanent teeth are treated within the golden hour
- Specialised management of immature permanent teeth to preserve their unique healing potential
- Careful protection of underlying permanent tooth buds when treating injuries to baby teeth
- Low-dose digital imaging and CBCT scanning for accurate diagnosis of hidden root and bone injuries
- Flexible splinting techniques that support healing without restricting normal jaw development
- Structured long-term follow-up programme to detect complications like root resorption early
- Psychological support and gentle communication to minimise dental anxiety after a traumatic event
- Custom-fitted sports mouthguards and preventive strategies to reduce the risk of re-injury
Za koga je namijenjeno?
- Children who have had a tooth completely knocked out during a fall, collision, or accident
- Children with a fractured tooth, from a small enamel chip to a deep break exposing the nerve
- Children whose tooth has been pushed sideways (lateral luxation) or up into the gum (intrusion)
- Toddlers who have injured baby teeth and need assessment to protect developing permanent teeth
- Young athletes with dental or mouth injuries sustained during sports or training
- Children with a loose or wobbly tooth following a blow to the face
- Children with lip, tongue, or gum lacerations accompanying a dental injury
- Children showing delayed signs of trauma such as tooth discolouration, pain, or a gum boil weeks after an injury
- Parents seeking a second opinion on the management of a previous dental injury
- Families who want a custom sports mouthguard to prevent future trauma
Proces Tretmana
Immediate Assessment and History
The dentist begins with a focused history: when and how the injury occurred, whether the child lost consciousness, and whether any teeth or fragments are missing. A thorough clinical examination evaluates each affected tooth for mobility, displacement, fracture lines, and nerve exposure. The gums, lips, tongue, and jaw are also checked for lacerations, swelling, or bone tenderness.
Diagnostic Imaging
Digital periapical X-rays are taken from multiple angles to reveal root fractures, bone damage, and the proximity of baby tooth injuries to underlying permanent tooth buds. In complex cases, a small-field CBCT scan provides three-dimensional detail. These images serve as a critical baseline for comparison during follow-up visits over the coming months and years.
Classification and Treatment Planning
Each injury is classified according to the internationally accepted system: enamel fracture, enamel-dentine fracture, crown-root fracture, root fracture, concussion, subluxation, lateral luxation, intrusion, extrusion, or avulsion. The treatment plan is explained clearly to the parent, including the expected outcome, timeline, and any risks. For baby teeth, the priority is always protecting the permanent successor.
Emergency Treatment
Treatment varies by injury type. Chips and simple fractures are repaired with composite bonding or protected with a temporary crown. Displaced teeth are gently repositioned under local anaesthesia. Avulsed permanent teeth are reimplanted and stabilised. Root-fractured teeth are aligned and splinted. Soft-tissue wounds are cleaned, debrided if necessary, and sutured. Throughout, child-appropriate pain management and communication techniques keep your child as comfortable as possible.
Splinting and Stabilisation
Repositioned, reimplanted, or root-fractured teeth are held in place with a flexible wire-and-composite splint bonded to the adjacent teeth. Flexible splints are preferred over rigid ones because they allow the slight physiological movement that promotes healing of the periodontal ligament. Splints typically remain in place for two to four weeks, depending on the injury type.
Pulp Vitality Monitoring
After trauma, the nerve inside a tooth may recover, become inflamed, or die. We perform pulp sensibility tests at each follow-up visit to track the nerve's status. In immature permanent teeth, the goal is to keep the pulp alive whenever possible so that the root can continue to develop and strengthen. If the pulp does die, regenerative endodontic procedures or apexification may be used to preserve the tooth.
Structured Long-Term Follow-Up
Dental trauma outcomes unfold over time. We schedule follow-up visits at one week, two to four weeks, six to eight weeks, six months, and one year, with annual reviews thereafter for complex injuries. At each visit, we reassess tooth colour, mobility, gum health, and take comparison X-rays. This programme is essential for catching late complications such as inflammatory root resorption, replacement resorption, or pulp canal obliteration.
Definitive Restoration and Prevention
Once healing is confirmed and the follow-up period is complete, any temporary repairs are replaced with durable, aesthetic restorations. For teeth that could not be saved, we discuss space management options and the timing of future prosthetic or implant solutions once the child's jaw growth is complete. We also provide custom sports mouthguards and practical advice to reduce the chance of re-injury.
Često Postavljana Pitanja
What is the most important thing to do if my child knocks out a permanent tooth?
Find the tooth, hold it by the crown (the white part), and avoid touching the root. Rinse it gently with water if dirty but do not scrub. If possible, push it back into the socket immediately. If not, store it in cold milk, saline, or the child's own saliva and get to a dentist within 30 minutes. The faster the tooth is reimplanted, the better the long-term prognosis.
Should a knocked-out baby tooth be put back in?
No. Reimplanting a baby tooth risks damaging the permanent tooth developing underneath it. However, you should still see a dentist promptly to assess for bone or gum injuries and to discuss whether a space maintainer is needed to prevent neighbouring teeth from drifting into the gap.
My child's tooth turned grey or dark after an injury. What does that mean?
Discolouration after trauma usually indicates bleeding inside the tooth or nerve damage. A grey or dark tooth does not always mean the nerve is dead; sometimes the colour partially recovers over several months. However, a persistent colour change warrants monitoring with X-rays and vitality tests to determine whether root canal treatment is needed.
Can a dental injury to baby teeth affect the permanent teeth underneath?
Yes, and this is one of the most important reasons to seek professional assessment after any injury to a baby tooth. The force of impact can disturb the developing permanent tooth bud, potentially causing enamel defects, abnormal shape, delayed eruption, or, in severe cases, arrested development. Regular follow-up X-rays allow us to monitor the permanent tooth's progress.
How long does a dental splint stay on?
The duration depends on the injury type. Luxation injuries typically require splinting for two weeks, avulsed teeth for two to four weeks, and root fractures for up to four weeks or longer. The splint is flexible to allow normal healing movement and is removed in the clinic once the tooth is stable. Your child can eat soft foods normally while the splint is in place.
What is root resorption and should I be worried?
Root resorption is a process where the body gradually breaks down the root of a traumatised tooth. It is one of the most serious long-term complications of dental trauma. There are different types, some treatable and some not, which is why structured follow-up with regular X-rays is so important. Early detection gives us the best chance of intervening before the tooth is lost.
My child's injured tooth seems fine now. Do we still need follow-up appointments?
Absolutely. Many complications of dental trauma, including nerve death, root resorption, and infection, develop silently over weeks or months without any visible symptoms. Follow-up visits with clinical examination and X-rays are the only way to detect these problems early. Skipping follow-ups is one of the most common reasons children lose teeth after trauma.
At what age should my child wear a mouthguard for sports?
A mouthguard is recommended from the moment your child participates in any sport involving contact, falls, or fast-moving objects, which can be as early as age six or seven. Custom-fitted mouthguards from a dentist provide far better protection and comfort than shop-bought alternatives and can be updated as your child's mouth grows.
Can a traumatised tooth still be saved years later if problems develop?
In many cases, yes. Modern endodontic techniques, including regenerative procedures for immature teeth, can extend the life of a traumatised tooth significantly even when complications arise later. The key is regular monitoring so that problems are detected at a stage when treatment options are still available.
What types of dental injuries are most common in children?
The most common injuries are enamel and enamel-dentine fractures (chips and breaks), followed by luxation injuries where the tooth is displaced. Complete avulsion accounts for a smaller but clinically significant proportion. Toddlers most often injure their upper front teeth during falls, while school-age children are more likely to sustain injuries during sports or playground activities.
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