Dental Trauma

Question 1

What are the 3 peak times for dental trauma to occur?

Answer 1

2-4 yrs
8-10 yrs
14-16 yrs

Question 2

What is the correct order to examine a patient with dental trauma?

Answer 2

check for head injury
assess the dental/facial injury
does the story fit?
where are the bits?
do emergency dental treatment to stabilise injuries
clean up patient
review and treat or refer to specialist
document everything

Question 3

two types of injury may occur from a blow to the teeth, what are they?i

Answer 3

injuries to the tooth
-crown fracture
-root fracture
Due to impact against something hard
injuries to the socket
-tooth intact but displaced or loosened within its socket
Result of an impact with something soft

Question 4

what is the main concern of dental injuries and how to you prevent this?

Answer 4

bacteria can invade the pulp
cover all exposed dentine quickly and monitor vitality

Question 5

what is the main problem with dento-alveolar injuries?

Answer 5

any significant movement within the socket will almost certainly sever all the blood vessels entering the pulp via the apical foramen so the pulp becomes necrotic

Question 6

4 types of dental trauma

Answer 6

luxation
avulsion
crown fractures
root fractures

Question 7

what is the most common injury to the primary teeth involving displacement of the teeth in the alveolar bone?

Answer 7

luxations

Question 8

what are the types of luxations?

Answer 8

concussion
subluxation
intrusive luxation
extrusive and lateral luxation

Question 9

what is concussion?

Answer 9

an injury to the tooth without displacement or mobility of the tooth

Question 10

what is subluxation?

Answer 10

when the tooth is mobile but is not displaced

Question 11

If tooth mobile and there has been recent injury do you check for TTP?

Answer 11

no, vitality check 1 week post trauma

Question 12

what is the management of concussion and subluxation?

Answer 12

PA radiograph
soft diet for 1 week
advice to parents, possible sequelae
follow up
check immunisation ie tetanus

Question 13

what is intrusive luxation?

Answer 13

dislocation of a tooth in an axial direction into the alveolar bone.

Question 14

management of an intrusive luxation

Answer 14

crown visible with minor alveolar damage - leave tooth to re-erupt
whole tooth intruded - extract

Question 15

what is extrusive luxation?

Answer 15

An extrusive luxation occurs when the periodontal ligament separates. Your tooth has moved out of its socket, but the socket is still intact. The tooth is very loose and looks longer than usual (elongated)

Question 16

what is lateral luxation?

Answer 16

a traumatic displacement of a tooth in any direction other than axially

Question 17

what is avulsion?

Answer 17

a complete displacement of a tooth from its socket in the alveolar bone

Question 18

if avulsion in a primary tooth occurs, should the tooth be replanted?

Answer 18

no

Question 19

if a carer/parent has replanted tooth prior to appointment what should you do?

Answer 19

if stable, leave in situ

Question 20

if avulsion in a permanent tooth occurs, should the tooth be replanted?

Answer 20

yes, immediately

Question 21

What is the best treatment options for crown fractures not involving pulp of primary incisors?

Answer 21

smooth enamel and dentine with disc
if possible restore with GI or composite resin

Question 22

what is the management of fractured primary incisors?

Answer 22

-loose tooth fragments should be removed
-remaining tooth can be extracted at a later date
-small pieces of root remaining in socket after fracture may be safely left in situ
-root fracture - signs of pulpal necrosis, excessive mobility or sinus formation remove coronal portion, root will resorb

Question 23

what must be stressed when damaage to the PDL occurs

Answer 23

OH - increased risk of bacterial entry

Question 24

what are the possible damages to primary and permanent teeth due to trauma?

Answer 24

• necrosis of the pulp of the primary tooth with grey discolouration and possible abscess formation
• internal resorption of the primary tooth
• ankylosis of primary teeth
• hypoplasia or MIH of successory teeth
• dilaceration of the crown or root
• resorption of the permanent tooth germ

Question 25

what is the main aim of managing trauma to primary incisors?

Answer 25

to prevent further damage to the developing permanent incisors
maintain or possibly regain, vitality of the pulp