Dental Trauma

Question 1

How does dental trauma matter long term?

Answer 1

It is the most common cause of loss of permanent incisors in childhood
Can cause pulpal necrosis resulting in long term restorative problems

Question 2

What are the three peak times for dental trauma to occur?

Answer 2

2 - 4 years
8 - 10 years
14 - 16 years

Question 3

What may be used to prevent dental trauma?

Answer 3

Mouthguards

Question 4

How do you manage dental trauma?

Answer 4

1. Proper diagnosis
2. Treatment plan
3. Follow up appointments

Question 5

Sequence of what you do if someone presents with dental trauma?

Answer 5

1. Check for head injury
2. Assess injury
3. Does story fit?
4. Where is the tooth?
5. Do emergency treatment to stabilise
6. Clean up
7. Review and treat or refer
8. Document everything

Question 6

What are the 2 types of dental injuries?

Answer 6

1. Injury to the tooth
2. Injury to the socket

Question 7

What is an example of injury to the tooth and what causes this?

Answer 7

Crown or root fracture - caused by something hard

Question 8

What is an example of injury to the socket and what is this caused by?

Answer 8

Tooth intact but displaced or loosened within socket - caused by something soft

Question 9

What is the main concern with dental injuries?

Answer 9

Bacteria invade the pulp so it is important to cover all exposed dentine quickly

Question 10

What is the main concern with dento alveolar injuries?

Answer 10

Any movement within the socket will sever all blood vessels entering the pulp via the apical foramen and pulp becomes necrotic

Question 11

What are 4 types of dental traumas?

Answer 11

1. Luxation
2. Avulsion
3. Crown fracture
4. Root fracture

Question 12

What are the 4 types of luxation?

Answer 12

1. Concussion
2. Subluxation
3. Intrusive luxation
4. Extrusive and lateral luxation

Question 13

What is concussion?

Answer 13

Injury to the tooth without displacement or mobility - involves damage to periodontal ligament

Question 14

What is subluxation?

Answer 14

Tooth is mobile but not displaced - involves damage to periodontal ligament

Question 15

If periodontal ligament is damaged what becomes important?

Answer 15

Oral hygiene because increased risk of bacterial entry

Question 16

Bleeding and mobility only happens when teeth have been what?

Answer 16

Subluxated

Question 17

What is the management for concussion and subluxation?

Answer 17

1. PA radiograph
2. Soft diet for 1 week
3. Follow up
4. Check immunizations

Question 18

What is intrusive luxation?

Answer 18

Most common injury in upper primary incisors, palatal and superior displacement of the crown

Question 19

Management for intrusive luxation?

Answer 19

1. If crown is visible - leave tooth to re erupt
2. Whole tooth intruded - extract

Question 20

What is extrusive and lateral luxation?

Answer 20

Displacement of tooth with partial or total separation of periodontal attachments

Question 21

Management for extrusive and lateral luxation?

Answer 21

Excessive mobility of tooth = extract

Question 22

What is avulsion?

Answer 22

Complete displacement of tooth = tooth out

Question 23

Should primary teeth be replanted and why?

Answer 23

No because may damage developing permanent tooth

Question 24

Should you replant permanent tooth?

Answer 24

Yes

Question 25

How do you replant tooth?

Answer 25

1. ASAP
2. Do not rinse (can remove ligament)
3. Bite gently on cloth

Question 26

How to manage crown fractures that don’t involve the pulp?

Answer 26

1. Smooth enamel and dentine
2. Restore with GI or composite resin

Question 27

How to manage fractures that may involve the pulp?

Answer 27

1. Remove loose fragments
2. Remaining tooth can be extracted later
3. Small pieces of root can be left