Dental Trauma Guide Flashcards
T/F: The emergency department is not designed for dental care
True- no definitive care will occur here
What is the FIRST step of an examination of a patient with a traumatic injury?
Take a short medical and dental history
Questions relating to the dental injury:
- Where did the injury occur?
- How did the injury occur?
- When did the injury occur?
- Was there a period of unconsciousness?
- Is there any disturbance in the bite?
- Is there any reaction in the teeth to cold and/or heat exposure?
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
18% ; second
List the most common reasons for traumatic dental injuries:
- unintentional falls
- collisions
- leisure activities
Concussion of the tooth means:
Basically the tooth was just bumped
Displacement of tooth into the alveolar. This injury is accompanied by communition or fracture of the alveolar bone
intruded tooth
Tooth intrusion is associated with potential risk of:
damage to the permanent tooth
What is the possible treatment for an intruded tooth?
If the apex is displaced toward or through the labial bone plate, tooth should be left for spontaneous repositioning
For the general typical case, what is the treatment choice for an intruded primary tooth?
Leave it alone
The tooth is completely displaced out of its socket:
avulsed tooth
For an avulsed primary tooth, should it be replanted?
NO- Do NOT replant primary teeth
T/F: It is not recommended to replant avulsed primary teeth:
True
A fracture confined to dental & enamel:
Enamel-dentin fracture
On primary teeth what is more common evulsion or fractures? What about permanent teeth?
Primary - evulsion are more common
Permanent - fractures are more common
Treatment for enamel dentin fracture:
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
A fracture involving the enamel and dentin with loss of tooth structure and exposure of the pulp:
enamel-dentin - pulp fracture
What type of x-ray is indicated for enamel-dentin-pulp fracture?
cookie bite
T/F: Sensibility tests on primary teeth are reliable tests
False- we go by percussion and visibility & x-ray
Treatment of enamel-dentin - pulp fracture:
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
Permanent tooth- Displacement of the tooth into the alveolar bone. This injury is accompanied by commimution or fracture of the alveolar bone socket:
Intrusion
Ris intruded permanent tooth:
Tooth intrusion is associated with potential risk of tooth loss due to progressive root resorption (ankylosis or infection related resorption)
Treatment of intruded permanent tooth with immature root development:
let it come down on its own; at four weeks if it hasn’t re-erupted we have to bring it down
Treatment of intruded permanent tooth with mature root development:
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
If a permanent toot his intruded 3-7mm and has a mature root, treatment entails:
orthodontic or surgical reposition
If a permanent tooth is intruded beyond 7mm and has mature root, treatment entails:
surgical repositioning
With permanent teeth, the key to determining treatment on intruded teeth is:
Determining whether the root apex is opened or closed
About how long after the tooth erupts does the root apex close (mature):
2-3 years
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?
closed; open
Permanent tooth fracture involving enamel and dentin with the loss of tooth structure and exposure of the pulp:
Enamel-dentin - pulp fracture
apexogensis:
We want to genesis the apex- continue to keep tooth vital so it can grow the rest of the root
In young patients with an EPD fracture, what is the treatment:
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
If the tooth has a fistula it is:
dead- no vitality
If the tooth has an abscess the tooth is:
non-vital
Apexificaiton:
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
Permanet tooth- complete displacement of the tooth out of its socket:
avulsion
What is the most ideal treatment for an avulsed permanent tooth:
To replant the tooth - however this is not always an option
Why should you take a lot of X-rays when a patient comes in with a tooth that’s been “knocked out” (avulsed)?
To make sure the tooth hasn’t been completely intruded
For an avulsed permanent tooth, what is the favorable extraoral dry time? (time tooth has been out of the mouth):
less than 60 min
What do we mean by “extra oral dry time” when discussing an avulsed tooth?
How long the tooth has been out of the mouth
T/F: Delayed replantation of a permanent tooth has a poor prognosis
True
If you have to transport an avulsed tooth it needs to be in:
a physiological medium (not dry!!)
