16 month old Baby with a not so badly fractured tooth

Hi Dr. Philips,
I’ve ready your book and have followed your blogs.  Thanks very much for the work you are doing in educating people about how to care for their teeth and health.  
My son, husband and I are all on the program.  We have been giving our son a small amount of xylitol after each meal/snack and have been brushing his teeth with it at night.  It’s been working like a charm and his teeth look wonderful.  My husbands teeth and mine are looking so much better now too.  Sensitivity is all gone.  Floss comes out clean.  Teeth are starting to look white.  I’m convinced your program also saved me in the nick of time from another filing.  All this within less than a year.
However, despite my best efforts, we had a little incident over the weekend whereby my son (16 months old with lots of energy and not so much co-ordination) fell and did a face-plant right into the tile foor in our kitchen.  At first I didn’t notice that he damaged his teeth but later that night when I went to brush his teeth I notice that one had been slightly chipped up the side of the tooth near the bottom (where the front two teeth meet).  To be honest, I thought he had a small bit of white food stuck in between his teeth at first but I realized later, it was the way the tooth chipped.
I took him to the dentist today and x-rays were taken.  Turns out the tooth was fractured, but the dentist said it was not into the pulp or root of the tooth (phew!).  The dentist said I had two choices, he said that baby teeth were very vascular, and could heal themselves unlike adult teeth (guess he hasn’t read your book).   He says the fracture isn’t bad, we could leave it and monitor it over time to see how it heals.  He said the risk would be that the tooth may change color (gray) and he may need to do a pulpectomy in the worst case.  The second option, was to as he put “cosmetically” repair the tooth and fill it.   The benefit would be that there would be less potential for complications down the road if we went with option #2 (i.e., pulpectomy may be avoided all together); however, the second option involves more risk in my mind as it requires sedation at a hospital which I would like to avoid (esp. after reading your book and blogs).  The dentist’s recommendation was to leave the tooth as it was for now, and monitor it.   He suggested that I only feed my son soft foods for the next two weeks to give the tooth a chance to heal.  The dentist recommended that I go back to him again in 2 weeks, then 3 months then 6 months to have the tooth monitored.    
I know you can’t get between a patient and a Dr. in terms of the advice you can provide.  But I do respect your opinion and would appreciate any thoughts you might have to offer on the situation.  Any other helpful remedies or concerns would also be appreciated.  
My feeling is that the tooth is sound, and that we wait to see how things go rather than risk the sedation.   My son is acting normally, eating normally and not showing any sign of tooth pain.  I think that we are doing all we can right now with the use xylitol (to kill bacteria/prevent dental caries and heal the tooth).  Since the incident, I’ve also picked up a bottle of bubble gum Act and have been brushing his teeth with this as an added measure (specifically making sure that fractured tooth gets the first coat).  🙂
I was also told by the dentist that this type of injury (and worse than what my son had) is very common in children of this age.  This might be a stupid question but any thing you can recommend from your years of practice to help prevent this in the future (appart from the obvious like try to baby proof as much as possible).  My son is very fast, and not very careful and I’m very worried this (or worse) will happen again in the future.   All it took for the incident in the kitchen to occur was a fast (and not so careful baby), a misplaced parental foot and a tile floor. 🙂  I joked with my husband yesterday that we might need to by him a baby mouth guard.
Hi C,
I am sorry that this incident happened for your son, but I am thrilled that you have a dentist who gave you truthful options.
I think that the idea to wait is probably the best way to go – and this is what I would recommend, if something like this happened to one of my grandchildren.
Baby teeth rarely die – so even if the tooth turns gray – it may recover and become normal again.
A little tooth can look “bruised” and go from gray to yellowish – like a bruise and then recover completely – so don’t be discouraged if the tooth turns darker.
I like the sound of your dentist – and I totally agree that avoiding a sedation is the main goal.
The other idea – not to fix – avoids putting a white filling on the tooth ( and white fillings contain BPA).
I am sure that everything will resolve – and this is just the training, we parents have to endure, as our kids get hurt in the process called life!
When my son was at high-school we used to park our car facing the emergency room – because every game seemed to end up there!
The good news is that he grew up to be a good looking, fun and well adjusted person ( with a couple of chipped teeth).
Thanks for putting your confidence in my opinion.
It sounds as if you are making great choices and doing everything right.
Let me know if you need more guidance – pictures are always useful if you can get one and send it.
Best wishes for a very Happy Thanksgiving to your family,
Dr. Ellie Phillips DDS
Solutions for Oral Health

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