IADT trauma guidelines

Question 1

parent/ patient guidance if trauma to primary dentition

Answer 1

• be careful when eating not to further traumatise area
• clean area with cotton swab soaked in 0.2% chlorhexidine mouthwash twice a day for 1 week
• monitor tooth for unfavourable outcomes

Question 2

unfavourable outcomes if trauma to primary dentition

Answer 2

symptomatic
crown discolouration
infection
pulp necrosis
no further root development

negative impact on succesors eruption/ devlopment (if PDL injury)

Question 3

first aid advice at site of avulsion (4)

Answer 3

1. keep patient calm and assess if adult or primary tooth
2. locate tooth and only hold by crown (white part)
3. if tooth dirty, rinse in milk, saline or patients saliva
4. replant tooth as soon as possible and bite on gauze or napkin to hold in place.
   - seek dentist asap

Question 4

what situations would see
- viable
- compromised
- likely non viable
PDL cells after an avulsion

Answer 4

viable - tooth replanted within 15 mins
compromised - tooth replanted within 60 mins and stored in a suitable medium
non - viable - tooth replanted after 60 mins

Question 5

GDP treatment if patient attends with avulsion

Answer 5

1. calm patient and locate tooth
2. irrigate area/ socket with saline
3. administer LA if required (ideally no vasoconstrictor)
4. replant if not already done so
5. malpositioned/ wrongly positioned teeth can be repositioned up to 48 hours post injury
6. stabilise with flexible splint (0.4mm wire)
7. prescribe systemic antibiotics and assess tetanus status
8. initiate RCT within 2 weeks

Question 6

adverse outcomes of trauma to permanent tooth

Answer 6

swelling/ sinus tract
discolouration
root resorption
ankylosis / infra occlusion
excessive mobility
loss of tooth

Question 7

nursing bottle caries

Answer 7

caries in seen in young children when given feeder cups with substances other than water overnight

(lower incisors often protected by tongue)

Question 8

advice to parent of child with nursing bottle caries

Answer 8

if feeder cup overnight - only water
milk and water only between mealtimes
no sweetened milk/ soy milk - unless medically advised
safe snack recommendations - cheese, breadsticks, crackers
ensure parent assisting toothbrushing until 7 years old

Question 9

knee to knee

Answer 9

body on parents lap head on dentists
baby can keep watching parent
parent hold hands out way

Question 10

pulpotomy in primary tooth

Answer 10

1. give LA and place dam if able
2. access cavity and de roof chamber
3. slow speed or excavator to remove chamber contents
4. thoroughly irrigate with saline
5. if bleeding, cotton wool soaked in ferric sulphate
6. once haemmhorage stopped, MTA in chamber
7. restore with ZOE and place PMC

Question 11

pulpotomy in permanent tooth

Answer 11

1. LA and dam
2. access cavity
3. de roof pulp chamber with z bur
4. disinfect chamber with hypochlorite
5. remove coronal pulp tissue incrementally with slow speed or excavator
6. apply pressure with pellet soaked in hypochlorite
7. place MTA in chamber
8. restore with direct restoration

Question 12

how many canals do primary molars have

Answer 12

upper - 3
lower - 2