Dental Trauma Primary Dentitition Flashcards
How common is dental trauma?
Head and facial injuries make up 40% of somatic injuries
Toddlers fall over on average 17 times an hour
30% of children have had sustained injuries to primary teeth.
46% of children have a history of traumatic injuries to primary and/or permanent teeth
How should you deal with dental trauma in the primary dentition when you first encounter it?
Warm water/saline and some gauze first. Lots of blood usually.
Make a short medical/dental history including previous dental traumas, information which may explain radiographic findings.
Ask questions relating to the injury.
What questions should be asked to patients with dental trauma?
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 heat?
What should be noted if there is unconsciousness?
Whether or not the head injury was bad enough to require hospitalization
What evidence will indicate potential alveolar jaw fracture or condylar fracture?
Loss of occlusion or space between teeth
What type of radiographs should be taken following dental trauma?
Maxillary occlusal radiograph and a series of PA radiographs. This is because of radiographs being 2D the occlusal gives a more understandable picture.
What are the types of trauma injuries to teeth?
Fractures and luxations. Lots of injuries can be both.
What are the types of fractures?
Infraction
Enamel fracture
Enamel-dentin fracture
Enamel-dentin-pulp fracture
Crown-root fracture without pulp involvement
Crown-root fracture with pulp involvement
Root fracture
Alveolar fracture
What are the types of luxations?
Concussion
Subluxation
Extrusion
Lateral luxation
Intrusion
Avulsion
What is more common fractures or luxations?
Luxations much more common than fractures.
What are the treatment options for dental trauma?
Conservative management: Soft diet, analgesia, ongoing review and monitoring
OR
Extraction: Depending on:
Extent of injury
Occlusal interference
Pulpal exposure
Degloving injuries
What should be done for concussions or subluxations?
Generally no need for treatment with <10% risk of complications. Conservative management is the best management.
When do most complications occur following dental trauma?
Most complications occur within the first 12 months.
More likely in children >4 years
What should be done for intrusions?
80% of intruded teeth re-erupt spontaneously. 1/3rd will develop complications such as infection or ankylosis.
Conservative treatment and watching is often the way to go.
When is risk of pulp necrosis lowest following intrusion?
<2 years of age. Degree of intrusion or concomitant frature does not affect rate.
