Dental Trauma

Question 1

complicated fracture

Answer 1

enamel, dentine and pulpal involvement

Question 2

crown - root fracture

Answer 2

enamel dentine and root
classed as complicated or uncomplicated depending on pulpal involvement

Question 3

concussion

Answer 3

‘bruised’
tooth tender to touch but not displaced

Question 4

subluxation

Answer 4

tender to touch AND increased mobility but not displaced

Question 5

lateral luxation

Answer 5

tooth displaced
usually labial or lingual

Question 6

intrusion

Answer 6

tooth displaced towards alveolar bone
can damage permanent tooth bud

Question 7

extrusion

Answer 7

partial displacement of tooth out of socket

Question 8

avulsion

Answer 8

tooth completely out of socket

Question 9

alveolar fracture

Answer 9

fracture involving alveolar bone

Question 10

what vaccination status would you enquire about if a child came do you with a re-implanted avulsed tooth that had been in contact with soil

Answer 10

tetanus

Question 11

what 3 medical conditions would you enquire about if a child presented to you with trauma that posed an infection risk

Answer 11

congenital heart disease, history of rheumatic fever (inflammation/ swelling of heart, joints and brain) and history of immunosuppression

Question 12

what technique may be utilised to check for fracture lines and pulpal degeneration

Answer 12

transillumination

Question 13

what does a dull note upon percussion suggest

Answer 13

root fracture

Question 14

what 6 things are included within a trauma stamp for a examination of primary tooth trauma

Answer 14

mobility: +/-
colour: normal/grey/yellow/pink
TTP: +/-
Sinus: +/-
radiograph: +/-
Percussion note: normal/ dull

Question 15

what homecare advice should be given post deciduous trauma

Answer 15

take analgesia as required - ibuprofen , paracetamol
soft diet for 10-14 days, cut normal foods small and chew with molars
brush teeth with a soft bristled toothbrush after every meal
use chlorhexidine mouthwash twice a day for one week

Question 16

Treatment on deciduous teeth: enamel fracture

Answer 16

smooth sharp edges - soft flex discs

Question 17

Treatment on deciduous teeth: enamel/dentine fracture

Answer 17

cover exposed dentine with GI/composite
can restore lost structure immediately or at a later date

Question 18

Treatment on deciduous teeth: enamel/dentine/pulp fracture

Answer 18

pulpotomy or extraction

Question 19

Treatment on deciduous teeth: crown/root fracture (restorable)

Answer 19

cover exposed dentine with GI and restore
if pulpal involvement pulpotomy

Question 20

Treatment on deciduous teeth: crown/root fracture (unrestorable)

Answer 20

extract loose fragments

Question 21

Treatment on deciduous teeth: root fracture (3 scenarios)

Answer 21

• coronal fragment not displaced - no tx
• coronal fragment displaced but not mobile - no tx, leave to spontaneously reposition
• coronal fragment displaced, mobile and interfering with occlusion - extract only loose coronal fragment OR reposition fragment and splint

Question 22

Treatment on deciduous teeth: concussion

Answer 22

no tx

Question 23

Treatment on deciduous teeth: subluxation

Answer 23

no tx

Question 24

Treatment on deciduous teeth: lateral luxation

Answer 24

minimal/no occlusal interference : leave to spontaneously reposition itself
interference: extract or reposition and splint for 4 weeks

Question 25

Treatment on deciduous teeth: intrusion

Answer 25

severe injury
leave to spontaneously reposition - can take up to 1 year

Question 26

Treatment on deciduous teeth: extrusion

Answer 26

no interference with occlusion: leave to spontaneously reposition
occlusal interference/ extrusion >3mm - extract

Question 27

Treatment on deciduous teeth: avulsion

Answer 27

radiograph to confirm
DO NOT replant primary teeth

Question 28

Treatment on deciduous teeth: alveolar fracture

Answer 28

reposition segment and splint for 4 weeks
may still extract after alveolar stability achieved