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Paediatric Dentistry BDS3 > Dental Trauma 1 > Flashcards

Dental Trauma 1 Flashcards

1
Q

what are the most common primary tooth to get traumatised

A

maxillary primary incisors

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2
Q

what is the peak incidence of childhood trauma

A

2-4 years of age

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3
Q

how can trauma occur

A

falls
bumping into objects
non-accidental

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4
Q

what are the types of dental hard tissue and pulp injuries

A

enamel fracture
enamel and dentine fracture
enamel, dentine and pulp fracture
crown-root fracture
root fracture

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5
Q

what are the types of supporting tissue injuries

A

concussion
subluxation
lateral luxation
intrusion
extrusion
avulsion
alveolar fracture

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6
Q

what is concussion

A

tooth tender to touch but not been displaced

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7
Q

what is subluxation

A

tooth tender to touch, has increased mobility but not displaced

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8
Q

what is lateral luxation

A

tooth displaced usually palatally or in labial direction

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9
Q

what is intrusion

A

tooth displaced through labial bone plate

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10
Q

what is extrusion

A

partial displacement of tooth out of socket

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11
Q

what is avulsion

A

tooth completely out of socket

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12
Q

what is the most common injury in the primary dentition

A

luxation

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13
Q

what does the appointment look like for trauma patient

A

reassurance
history
examination
diagnosis
emergency treatment
important information
further treatment and review

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14
Q

what do you ask for with trauma history

A

when
where
how
any other symptoms or injuries
lost teeth/fragments

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15
Q

what aspects of medical history influences treatment

A

congenital heart disease
history of rheumatic fever or immunosuppression
bleeding disorders
allergies
tetanus immunisation status

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16
Q

what do we look for extraorally

A

lacerations
haematoma
haemorrhage/CSF
subconjunctival haemorrhage
bony step deformities
mouth opening

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17
Q

what do we look at intraorally

A

soft tissues
alveolar bone
occlusion
teeth

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18
Q

what would a detailed intraoral exam consist of

A

soft tissue damage
tooth mobility
transillumination - show fracture lines
tactile test with probe
percussion
occlusion

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19
Q

what would a dull note on percussion indicate

A

root fracture

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20
Q

what is included in the trauma stamp

A

mobility
colour
TTP sinus
percussion note
radiograph

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21
Q

what radiographs are used for trauma

A

periapical
anterior occlusal
lateral pre-maxilla
panoramic
soft tissue

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22
Q

what is the most appropriate treatment option in emergency situation

A

observation unless aspiration risk, ingestion or occlusal interference

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23
Q

what should the homecare instructions be after trauma

A

analgesia
soft diet for 10-14 days
brush teeth with soft toothbrush after every meal
topical chlorhexidine mouthwash applied twice daily for one week
warn re signs of infection

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24
Q

how do you manage enamel fracture

A

smooth sharp edges

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25
Q

how do you manage enamel/dentine fracture

A

cover exposed dentine with GI/composite

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26
Q

how do you manage enamel-dentine-pulp fracture

A

partial pulpotomy or extract

27
Q

how do you manage crown-root fracture

A

remove loose fragment and determine if crown restorable
if restorable - cover exposed dentine with GI or if pulp exposed then pulpotomy or endo treatment
if unrestorable then extract loose fragments

28
Q

how do you manage a root fracture

A

coronal fragment fine = no treatment
coronal displaced but not too mobile = leave to spontaneously reposition even if some occlusal interference
coronal fragment displaced and excessively mobile = extract only coronal fragment/reposition loose coronal fragment and splint

29
Q

how do you manage concussion

A

no treatment - just observe

30
Q

how do you manage subluxation

A

no treatment
just observe

31
Q

how do you manage lateral luxation

A

if minimal/no occlusal interference - allow to reposition spontaneously
severe displacement - extraction, reposition and splint

32
Q

how do you manage intrusion

A

allow to reposition

33
Q

what radiographs are used for intrusion

A

periapical
lateral premaxilla

34
Q

when a tooth is intruded and the apical tip can be seen but tooth appears shorter compared to contralateral tooth, what has happened

A

it has been displaced towards/through labial bone plate

35
Q

when a tooth is intruded and apex cannot be visualised and tooth appears longer that contralateral tooth what has happened

A

apex displaced toward permanent tooth germ

36
Q

how do you manage extrusion

A

not interfering with occlusion - spontaneous repositioning
excessive mobility/extruded >3mm - extract

37
Q

how do you manage an avulsed primary tooth

A

take radiograph but do not replant

38
Q

how do you manage alveolar fracture

A

reposition segment
stabilise with flexible splint to adjacent uninjured teeth for 4 weeks
teeth may need to be extracted after alveolar stability has been achieved

39
Q

what do you do after managing trauma

A

follow up appointment

40
Q

what do you need to warn patients of

A

possible sequelae to traumatised primary tooth and permanent successor

41
Q

what are the direct complications of trauma to the primary tooth

A

discolouration
discolouration and infection
delayed exfoliation

42
Q

what does a mild grey discolouration indicate

A

it is immediate but may maintain vitality

43
Q

what does opaque/yellow discolouration mean

A

pulp obliteration

44
Q

how do you manage asymptomatic discolouration

A

no treatment and review as no signs of pulpal necrosis or infection

45
Q

what would symptomatic discolouration and infection present as

A

sinus, gingival swelling and abscess
increased mobility
periapical pathology on radiograph

46
Q

how do you treat symptomatic discolouration and infection

A

extract or endo treatment

47
Q

what type of trauma causes the most disturbance to permanent teeth

A

intrusion

48
Q

what injuries can occur in the permanent tooth as a result of primary trauma

A

enamel defects
abnormal crown/root morphology
delated eruption
ectopic tooth position
arrested development
complete failure of tooth to form
odontome formation

49
Q

what is enamel hypomineralisation

A

qualitative defect of enamel with normal thickness but poor mineral

50
Q

what does enamel hypomineralisation look like

A

white/yellow defect

51
Q

what are the treatment options for enamel hypomineralisation

A

no treatment
composite masking
tooth whitening

52
Q

what is enamel hypoplasia

A

reduced thickness but normal mineralisation

53
Q

what does enamel hypoplasia look like

A

yellow/brown defects

54
Q

what is the treatment for enamel hypoplasia

A

no treatment
composite masking

55
Q

what is dilaceration

A

abrupt deviation of long axis of crown or root portion of tooth

56
Q

how do you manage crown dilaceration

A

surgical exposure and ortho realignment
improve aesthetics restoratively

57
Q

how do you manage root dilaceration

A

combined surgical and orthodontic approach

58
Q

why can delated eruption occur as a response to premature loss of primary tooth

A

due to thickened mucosa

59
Q

when would you radiograph a delayed erupted tooth

A

if > 6 month delay compared to contralateral tooth

60
Q

how do you manage delayed eruption

A

surgical exposure and orthodontic realignment

61
Q

what are the treatment options for ectopic tooth position

A

surgical exposure and ortho realignment
extraction

62
Q

what are the treatment options for arrested development

A

endo treatment
extraction

63
Q

what do you need to do if tooth fails to form

A

tooth germ might need removed

64
Q

what treatment is there for an odontome

A

surgical removal

Paediatric Dentistry BDS3 (8 decks)

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