Dental Trauma Flashcards
How does dental trauma matter long term?
It is the most common cause of loss of permanent incisors in childhood
Can cause pulpal necrosis resulting in long term restorative problems
What are the three peak times for dental trauma to occur?
2 - 4 years
8 - 10 years
14 - 16 years
What may be used to prevent dental trauma?
Mouthguards
How do you manage dental trauma?
- Proper diagnosis
- Treatment plan
- Follow up appointments
Sequence of what you do if someone presents with dental trauma?
- Check for head injury
- Assess injury
- Does story fit?
- Where is the tooth?
- Do emergency treatment to stabilise
- Clean up
- Review and treat or refer
- Document everything
What are the 2 types of dental injuries?
- Injury to the tooth
- Injury to the socket
What is an example of injury to the tooth and what causes this?
Crown or root fracture - caused by something hard
What is an example of injury to the socket and what is this caused by?
Tooth intact but displaced or loosened within socket - caused by something soft
What is the main concern with dental injuries?
Bacteria invade the pulp so it is important to cover all exposed dentine quickly
What is the main concern with dento alveolar injuries?
Any movement within the socket will sever all blood vessels entering the pulp via the apical foramen and pulp becomes necrotic
What are 4 types of dental traumas?
- Luxation
- Avulsion
- Crown fracture
- Root fracture
What are the 4 types of luxation?
- Concussion
- Subluxation
- Intrusive luxation
- Extrusive and lateral luxation
What is concussion?
Injury to the tooth without displacement or mobility - involves damage to periodontal ligament
What is subluxation?
Tooth is mobile but not displaced - involves damage to periodontal ligament
If periodontal ligament is damaged what becomes important?
Oral hygiene because increased risk of bacterial entry
Bleeding and mobility only happens when teeth have been what?
Subluxated
What is the management for concussion and subluxation?
- PA radiograph
- Soft diet for 1 week
- Follow up
- Check immunizations
What is intrusive luxation?
Most common injury in upper primary incisors, palatal and superior displacement of the crown
Management for intrusive luxation?
- If crown is visible - leave tooth to re erupt
- Whole tooth intruded - extract
What is extrusive and lateral luxation?
Displacement of tooth with partial or total separation of periodontal attachments
Management for extrusive and lateral luxation?
Excessive mobility of tooth = extract
What is avulsion?
Complete displacement of tooth = tooth out
Should primary teeth be replanted and why?
No because may damage developing permanent tooth
Should you replant permanent tooth?
Yes
How do you replant tooth?
- ASAP
- Do not rinse (can remove ligament)
- Bite gently on cloth
How to manage crown fractures that don’t involve the pulp?
- Smooth enamel and dentine
- Restore with GI or composite resin
How to manage fractures that may involve the pulp?
- Remove loose fragments
- Remaining tooth can be extracted later
- Small pieces of root can be left
