Dental Trauma Guide Flashcards
T/F: The emergency department is NOT designed for dental care
True- no definitive care will occur here
Questions relating to 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
What is the FIRST step of an examination of a patient with a traumatic injury?
Take a short medical and dental history
When taking a medical history for a trauma case, what should be included?
the patients general health, allergies, and other info that may influence treatment
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
18%; second
List the most common reasons for traumatic dental injuries:
- unintentional falls
- collisions
- leisure activities
What is the most common complication of traumatic dental injuries in minor children?
pulp necrosis
Concussion of the tooth means:
basically it was just bumped
displacement of tooth into the alveolar bone. This injury is accompanied by commitution or fracture of the alveolar bone
Intruded tooth
Tooth intrusion is associated with a 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, the tooth should be left for spontaneous repositioning. I
What is the treatment of choice for a primary intruded tooth (in general)
LEAVE IT ALONE
The tooth is completely displaced out of its socket: (primary)
avulsion
For an avulsed baby tooth, should it be replanted?
Absolutely NOT
T/F: It is not recommended to replant avulsed primary teeth:
TRUE
A fracture confined to the dentin & enamel:(primary)
Enamel-dentin fracture
Treatment for enamel-dentin fracture: (primary)
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: (primary)
Enamel-dentin- pulp fracture
What type of x-ray is indicated for enamel-dentin-pulp fracture? (primary)
cookie bite
T/F: Sensibility tests on primary are reliable tests
false- we go by percussion and visibility and x-ray
Treatment of enamel-dentin-pulp fracture (primary)
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
Permanent tooth- displacement of the tooth into the alveolar one. This injury is accompanied by comminution of fracture of the alveolar socket:
Intrusion
Risks associated with intrusion of permanent tooth:
tooth intrusion is associated with a potential risk of tooth loss due to progressive root resorption (ankylosis or infection related resorption)
Immature root development + intrusion of permanent tooth
let it do its thing, and then re-evalute after 4 weeks to see if its re-erupted yet, if not intimated orthodontic repositionig
Mature root + Intrusion of permanent tooth + less than 3 mm of intrusion
Treatment:
allow for spontaneous re-eruption, evaluate after 4 weeks, reposition surgically and splint for 2 weeks or reposition the tooth orthodontically
Mature root + intrusion of permanent tooth + 3-7mm of intrusion
Treatment:
reposition surgically or orthodontically
Mature root + intrusion of permanent tooth + beyond 7mm
Treatment:
reposition surgically
How many years does the root apex close after tooth eruption?
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 for a six year old?
closed; open
Permanent tooth a fracture involving the enamel & dentin with exposure of pulp:
Enamel-dentin-pulp fracture
In young patients with an EDP 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 closed apices. CaOH com[pounds and non-staining calcium silicate cements are suitable materials to be placed on the pulp wound.
Treatment for enamel-dentin-pulp fracture: (generic)
pulp capping or partial pulpotomy
T/F: If there is an abscess the tooth may still be vital:
False- NON-VITAL
Apexification:
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
The permanent tooth is completely displaced out of socket :
avulsion
T/F: It is ideal to replant an avulsed permanent tooth
True
What the reason behind taking x-rays for an avulsed permanent tooth:
to make sure the tooth is not intruded
What is a favorable time line for an avulsed permanent tooth?
extraoral time of less than 60 min
For an avulsed permanent tooth, delayed replantation has a:
poor prognosis
