Dental Trauma Guide

Question 1

T/F: The emergency department is not designed for dental care

Answer 1

True- no definitive care will occur here

Question 2

What is the FIRST step of an examination of a patient with a traumatic injury?

Answer 2

Take a short medical and dental history

Question 3

Questions relating to the dental injury:

Answer 3

1. Where did the injury occur?
2. How did the injury occur?
3. When did the injury occur?
4. Was there a period of unconsciousness?
5. Is there any disturbance in the bite?
6. Is there any reaction in the teeth to cold and/or heat exposure?

Question 4

For children, aged 0-6 years, oral injuries account for ______ of all physical injuries and the mouth are the _____ most common area of the body to be injured

Answer 4

18% ; second

Question 5

List the most common reasons for traumatic dental injuries:

Answer 5

1. unintentional falls
2. collisions
3. leisure activities

Question 6

Concussion of the tooth means:

Answer 6

Basically the tooth was just bumped

Question 7

Displacement of tooth into the alveolar. This injury is accompanied by communition or fracture of the alveolar bone

Answer 7

intruded tooth

Question 8

Tooth intrusion is associated with potential risk of:

Answer 8

damage to the permanent tooth

Question 9

What is the possible treatment for an intruded tooth?

Answer 9

If the apex is displaced toward or through the labial bone plate, tooth should be left for spontaneous repositioning

Question 10

For the general typical case, what is the treatment choice for an intruded primary tooth?

Answer 10

Leave it alone

Question 11

The tooth is completely displaced out of its socket:

Answer 11

avulsed tooth

Question 12

For an avulsed primary tooth, should it be replanted?

Answer 12

NO- Do NOT replant primary teeth

Question 13

T/F: It is not recommended to replant avulsed primary teeth:

Answer 13

True

Question 14

A fracture confined to dental & enamel:

Answer 14

Enamel-dentin fracture

Question 15

On primary teeth what is more common evulsion or fractures? What about permanent teeth?

Answer 15

Primary - evulsion are more common
Permanent - fractures are more common

Question 16

Treatment for enamel dentin fracture:

Answer 16

If possible seal the involved dentin completely with glass ionomer to prevent micro leakage. In case of large lost tooth structure, the tooth can be restored with composite

Question 17

A fracture involving the enamel and dentin with loss of tooth structure and exposure of the pulp:

Answer 17

enamel-dentin - pulp fracture

Question 18

What type of x-ray is indicated for enamel-dentin-pulp fracture?

Answer 18

cookie bite

Question 19

T/F: Sensibility tests on primary teeth are reliable tests

Answer 19

False- we go by percussion and visibility & x-ray

Question 20

Treatment of enamel-dentin - pulp fracture:

Answer 20

If possible, preserve pulp by pulp capping or partial pulpotomy. The treatment depends on the Childs maturity and ability to cope. Extraction is an alternative option

Question 21

Permanent tooth- Displacement of the tooth into the alveolar bone. This injury is accompanied by commimution or fracture of the alveolar bone socket:

Answer 21

Intrusion

Question 22

Ris intruded permanent tooth:

Answer 22

Tooth intrusion is associated with potential risk of tooth loss due to progressive root resorption (ankylosis or infection related resorption)

Question 23

Treatment of intruded permanent tooth with immature root development:

Answer 23

let it come down on its own; at four weeks if it hasn’t re-erupted we have to bring it down

Question 24

Treatment of intruded permanent tooth with mature root development:

Answer 24

If the tooth is intruded less than 3mm you can kind of allow the tooth to spontaneously re-errupted; at four weeks if it hasn’t re-erupted surgical reposition or orthodontic repositioning

Question 25

If a permanent toot his intruded 3-7mm and has a mature root, treatment entails:

Answer 25

orthodontic or surgical reposition

Question 26

If a permanent tooth is intruded beyond 7mm and has mature root, treatment entails:

Answer 26

surgical repositioning

Question 27

With permanent teeth, the key to determining treatment on intruded teeth is:

Answer 27

Determining whether the root apex is opened or closed

Question 28

About how long after the tooth erupts does the root apex close (mature):

Answer 28

2-3 years

Question 29

If you had a 12 year old with an intruded #8, would you expect the root apex to be open or closed?

Same situation but for a six year old?

Answer 29

closed; open

Question 30

Permanent tooth fracture involving enamel and dentin with the loss of tooth structure and exposure of the pulp:

Answer 30

Enamel-dentin - pulp fracture

Question 31

apexogensis:

Answer 31

We want to genesis the apex- continue to keep tooth vital so it can grow the rest of the root

Question 32

In young patients with an EPD fracture, what is the treatment:

Answer 32

It is very important to preserve pulp vitality by pulp capping or partial pulpotomy in order to secure further root development. This treatment is also the choice of treatment in patients with close apices. CaOH compounds and non-staining calcium silicate cements are suitable materials to be placed on the pulp wound

Question 33

If the tooth has a fistula it is:

Answer 33

dead- no vitality

Question 34

If the tooth has an abscess the tooth is:

Answer 34

non-vital

Question 35

Apexificaiton:

Answer 35

we have a wide open apex that’s infected, sensibility is negative because the tooth is dead, they clean out the pulp and do instrumentation and use MTA and etc. to try to make a new apex

Question 36

Permanet tooth- complete displacement of the tooth out of its socket:

Answer 36

avulsion

Question 37

What is the most ideal treatment for an avulsed permanent tooth:

Answer 37

To replant the tooth - however this is not always an option

Question 38

Why should you take a lot of X-rays when a patient comes in with a tooth that’s been “knocked out” (avulsed)?

Answer 38

To make sure the tooth hasn’t been completely intruded

Question 39

For an avulsed permanent tooth, what is the favorable extraoral dry time? (time tooth has been out of the mouth):

Answer 39

less than 60 min

Question 40

What do we mean by “extra oral dry time” when discussing an avulsed tooth?

Answer 40

How long the tooth has been out of the mouth

Question 41

T/F: Delayed replantation of a permanent tooth has a poor prognosis

Answer 41

True

Question 42

If you have to transport an avulsed tooth it needs to be in:

Answer 42

a physiological medium (not dry!!)