The Summer of Trauma

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Summer is over and the house feels so, what’s the word–ah, quiet. The girls are back to school and poor Otto is once again an only child between 8 and 4. Ah, I’m almost sorry to see summer go. Except I’m not. Because this summer has been pretty traumatic for all of us. One set of grandparents is seriously unwell. Bavaria suffered a heat wave during a visit that made a cultural disregard for air conditioning seem utterly backward. And it turns out all 3 of my children exude some sort of human candy smell that attracts biting bugs of all types. But for Zoe, well, it’s been particularly rough.

When you last heard from us she was just back from the hospital, long arm cast protecting a nasty fracture. But what is more traumatic than breaking (and I mean really breaking) your arm? Well, it is being stuck in an itchy cast and then watching your sister lose two teeth within a single week. Oh the screams of despair. “It’s not faaaiiirrrrr!!!!” “No,” I said. “The tooth fairy does not accept small white pieces of paper under your pillow as a substitute. No, Zoe, the only way the tooth fairy is going to visit you is when you actually lose a tooth, be that naturally or forced.”

And that is how, 4 weeks after having her arm reset, Zoe wound up in the emergency dentist’s chair, having X-rays of her mouth. Okay, to be perfectly honest, I’m not sure she was trying to knock her tooth out. In fact, when I jokingly implied as much, she was deeply offended. She was hopping and bopping around as usual when she tripped over a cement barrier in the parking lot and bashed her mouth. There was a moment where she lay totally still and I wasn’t sure what had happened. Then the tears began, the hand over her mouth. When I looked, one front tooth was pushed partially in, the gum blanched white. Then came the blood.

My parents were there and my dad immediately suggested we seek expert care at the emergency department. I tried not to act offended as I pointed out the obvious. Ahem. Then we called my sister’s dentist (because of course we were visiting the US relatives before heading to see the German ones) and I gave a careful description of the injury before we were assigned an emergency appointment within the hour.

So, there are several types of dental injuries in children. The tooth can be knocked out, pushed in, or moved around in the socket. It can also be chipped or broken. Otto has a chipped tooth, but since it’s only a bit of enamel that went, and the deeper bits of the tooth weren’t exposed, there was no need to do anything. Just to fight off a deep desire to dress him in denim overalls and stick a piece of straw in his mouth since he looks like a total hillbilly. But I digress.

Zoe suffered what we call an intrusion, where the tooth is pushed in. Teeth are held in place by lots of little ligaments that create a supportive hammock of sorts. So it’s quite possible that a tooth can be pushed in and then return to its original place. Which is what happened to her, although admittedly it does seem a little crooked. Regardless, with a baby tooth injury, you don’t need to do much emergently. Baby teeth are never put back in the socket if knocked out (unlike adult teeth) and unless it is so loose that it is a choking hazard, there is nothing for someone like me to do about it. Except advise dental follow up to make sure the tooth itself and the developing adult teeth above (or below) weren’t injured.

Which is exactly what we found ourselves doing an hour later. I will admit, it was somewhat embarrassing walking around with a kid who had a big cast on her arm and a face covered in blood. I mean, really. But the dentist was extremely kind about the whole event as I told him what happened and then performed an X-ray. The good news was the tooth was not broken. And then we were advised 24 hours of round the clock ibuprofen to help prevent pulpitis and sent home to follow up at the end of summer, assuming no new symptoms developed.

The only really good part of the day was how much I learned about pulpitis. I know, it’s not something most people really think about. But an inflammation of the inner “guts” of a tooth is something no one wants. Our new dentist friend explained that the tooth is a closed space, kind of like the head, and therefore doesn’t do well with lots of internal swelling. So 24-48 hours of an anti-inflammatory could help. He also let me know that the tooth could become discolored, sort of like a bruise. Good news is that 90% of baby teeth that do so will recover (unlike adult teeth). I was also told to let her “self-regulate” her diet (meaning she won’t eat an apple if it hurts) and to watch for pain that was unexpected (like while doing nothing as opposed to eating aforementioned apple).

So good-bye Summer 2015. We had some rough moments. But we also had some really good times. Like a tutorial on pulpitis. (Sarcasm dripping here). Anyway, it’s back to labeling backpacks, checking shot records and early morning alarm clocks.

Hello Autumn. (I’m not about to use the word, “fall.”)