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

Questions relating to dental injury:

Answer 2

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 3

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

Answer 3

Take a short medical and dental history

Question 4

When taking a medical history for a trauma case, what should be included?

Answer 4

the patients general health, allergies, and other info that may influence treatment

Question 5

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

Answer 5

18%; second

Question 6

List the most common reasons for traumatic dental injuries:

Answer 6

1. unintentional falls
2. collisions
3. leisure activities

Question 7

What is the most common complication of traumatic dental injuries in minor children?

Answer 7

pulp necrosis

Question 8

Concussion of the tooth means:

Answer 8

basically it was just bumped

Question 9

displacement of tooth into the alveolar bone. This injury is accompanied by commitution or fracture of the alveolar bone

Answer 9

Intruded tooth

Question 10

Tooth intrusion is associated with a potential risk of:

Answer 10

damage to the permanent tooth

Question 11

What is the possible treatment for an intruded tooth:

Answer 11

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

Question 12

What is the treatment of choice for a primary intruded tooth (in general)

Answer 12

LEAVE IT ALONE

Question 13

The tooth is completely displaced out of its socket: (primary)

Answer 13

avulsion

Question 14

For an avulsed baby tooth, should it be replanted?

Answer 14

Absolutely NOT

Question 15

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

Answer 15

TRUE

Question 16

A fracture confined to the dentin & enamel:(primary)

Answer 16

Enamel-dentin fracture

Question 17

Treatment for enamel-dentin fracture: (primary)

Answer 17

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 18

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

Answer 18

Enamel-dentin- pulp fracture

Question 19

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

Answer 19

cookie bite

Question 20

T/F: Sensibility tests on primary are reliable tests

Answer 20

false- we go by percussion and visibility and x-ray

Question 21

Treatment of enamel-dentin-pulp fracture (primary)

Answer 21

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

Question 22

Permanent tooth- displacement of the tooth into the alveolar one. This injury is accompanied by comminution of fracture of the alveolar socket:

Answer 22

Intrusion

Question 23

Risks associated with intrusion of permanent tooth:

Answer 23

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

Question 24

Immature root development + intrusion of permanent tooth

Answer 24

let it do its thing, and then re-evalute after 4 weeks to see if its re-erupted yet, if not intimated orthodontic repositionig

Question 25

Mature root + Intrusion of permanent tooth + less than 3 mm of intrusion Treatment:

Answer 25

allow for spontaneous re-eruption, evaluate after 4 weeks, reposition surgically and splint for 2 weeks or reposition the tooth orthodontically

Question 26

Mature root + intrusion of permanent tooth + 3-7mm of intrusion Treatment:

Answer 26

reposition surgically or orthodontically

Question 27

Mature root + intrusion of permanent tooth + beyond 7mm Treatment:

Answer 27

reposition surgically

Question 28

How many years does the root apex close after tooth eruption?

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 for a six year old?

Answer 29

closed; open

Question 30

Permanent tooth a fracture involving the enamel & dentin with exposure of pulp:

Answer 30

Enamel-dentin-pulp fracture

Question 31

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

Answer 31

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 closed apices. CaOH com[pounds and non-staining calcium silicate cements are suitable materials to be placed on the pulp wound.

Question 32

Treatment for enamel-dentin-pulp fracture: (generic)

Answer 32

pulp capping or partial pulpotomy

Question 33

T/F: If there is an abscess the tooth may still be vital:

Answer 33

False- NON-VITAL

Question 34

Apexification:

Answer 34

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 35

The permanent tooth is completely displaced out of socket :

Answer 35

avulsion

Question 36

T/F: It is ideal to replant an avulsed permanent tooth

Answer 36

True

Question 37

What the reason behind taking x-rays for an avulsed permanent tooth:

Answer 37

to make sure the tooth is not intruded

Question 38

What is a favorable time line for an avulsed permanent tooth?

Answer 38

extraoral time of less than 60 min

Question 39

For an avulsed permanent tooth, delayed replantation has a:

Answer 39

poor prognosis