At one time or another, most kids will experience a minor facial injury and most of these will occur during sports time or play. Experts from The Children’s Medical Centre talk to us about trauma types and prevention.
A number of sports activities put children at risk for facial injury, such as martial arts, gymnastics and cycling – pretty much any general contact sport carries a significant risk as well. Proper supervision and appropriate protective gear should always be employed during these activities, but when accidents do happen, children’s facial injuries require special attention.
Facial trauma can range from minor injuries to disfigurement that lasts a lifetime. Children’s facial trauma differs from adult injury because the face is not fully formed and future growth will be a factor in how the child heals and recovers.
Some common types of facial trauma in children
Soft tissue injuries: Injuries such as cuts may occur on the soft tissue of the face. If deeper or longer, they may require suturing or some other form of closure (like special tissue glues). In combination with suturing the wound, the doctor should take care to inspect and treat any injures to the facial nerves, glands or ducts.
Nasal fractures: Children’s noses differ significantly from those of adults. The soft, compliant cartilage of a child’s nose bends easily during blunt trauma. In addition, the nose does not project as much from the face as compared to adults. These two things combine to lead to a decreased incidence of nasal fractures as compared with adults. However, impacting forces during trauma in children are dissipated over the entire face resulting in much more swelling as compared with adults, which often creates dramatic presentation several hours after the trauma. Nasal injuries are often re-evaluated three to four days after the swelling has subsided, when a more accurate assessment of the nasal injury can be made.
Ear haematoma: Ear haematoma is often the result of childhood play and may result in cauliflower ear deformity if not treated early and properly. Haematoma should be properly evacuated and roll bolsters placed to the ear to preserve exact shape of the auricle.
Bone injuries: When facial bone fractures occur, the treatment is similar to that of a bone fracture in other parts of the body. Some injuries may not need treatment, and others may require stabilisation and fixation using wires, plates and screws.
Dental trauma in children
In very young child, injuries to baby teeth usually result from learning to walk. There may also be damage the unerupted permanent teeth. In older adolescents sports injuries are the main source of tooth and mouth injuries. Up to 40 percent of dental injuries in older adolescents occur while playing sports.
Common dental injuries and their treatment
The treatment depends on the type of injury and whether the injured tooth is a baby or a permanent tooth.
Dislocated or loose baby tooth: A baby tooth that is loose may be left in place or removed, depending on the severity of the injury. A baby tooth that was knocked out completely, should never be placed back into the gums because of the risk of damage to the permanent tooth.
Dislocated permanent tooth: A permanent tooth that is knocked out is a dental emergency that requires prompt treatment. The tooth should be placed back into the tooth socket as soon as possible, ideally within 15 minutes but you have up to one hour. The tooth should be stored in a container of cold milk. If cold milk is not immediately available then place the tooth in a container of the child’s saliva. Do not store the tooth in water, because this will reduce the chances of successful healing of the re-implanted tooth. The child should see a dentist as quickly as possible.
Broken tooth: Children with broken teeth should see a dentist promptly. The dentist will determine if the tooth’s nerves could be damaged. Treatment may include smoothing the rough edges of the tooth, repairing it with a tooth-coloured resin material, leaving the tooth in place, or removing it. Tooth fragments should be saved, if possible, and stored in tap water as they can sometimes be reattached.
Prevention and adequate preparation are the key elements in minimising injuries that occur in sports for our little ones. Although most such injuries are minor in nature, they should be evaluated promptly and treated early to reduce any complications.
With thanks to Dr Sasa Janjanin, Pediatric ENT specialist, Dr Q. A. Qasem, Pediatric Ophthalmologist and Specialised Paediatric Eye surgeon and Dr Agnes Roze, Pediatric Dentist. www.tcmcdubai.com
Tips to prevent tooth and mouth injuries
One of the ways that parents can reduce the chances of mouth and dental injuries during recreational and sports activities is to have the child wear proper protection equipment.
Mouth guards: When playing sports, the best way to protect your teeth and mouth is by wearing a mouth guard. They protect not just the teeth but the lips, cheeks and tongue. The better the fit, the more protection they offer.
Face cages: This equipment protects against trauma to the face, especially when playing certain sports positions, like baseball catcher or hockey goalie.
Helmets: It’s always wise to wear a helmet made for the activity that you are participating in. Although most helmets won’t protect the teeth and mouth, they will protect another important area – your head, to help protect against a brain concussion.
