Paediatric Trauma I

Question 1

What are some of the main ways that primary tooth trauma occurs?

Answer 1

• falls
• bumping into objects
• non-accidental (abuse/neglect)

Question 2

what are the type of crown fractures that exist?

Answer 2

Enamel only

enamel-dentine fracture (no pulp exposure)

Complex (enamel-dentine + pulp exposre)

Question 3

what is a crown-root fracture?

Answer 3

fracture that involves enamel, dentine and root (may or may not involve pulp)

Question 4

what are concussion and subluxation injuries?

Answer 4

concussion: tooth tender to touch but has NOT been displaced

subluxation: tooth tender to touch, has INCREASED mobility but has NOT been displaced (PDL disrupted)

Question 5

what is a luxation injury and what are the types of luxation injuries?

Answer 5

Luxation of tooth = displacement of tooth from original

lateral luxation - tooth displacement on horizontal plane

intrusion - displacement into the bone

extrusion - PARTIAL displacement out of the bone

Question 6

what is a tooth avulsion?

Answer 6

complete displacement out of the socket

Question 7

whats the most prevalent injury in primary dentition?

Answer 7

luxation injurys - 60-70%

Question 8

what is important information to parent/carer of a child with injured tooth to optimise healing?

Answer 8

• analgesia
• soft diet for 10-14 days (use molars for chewing)
• soft toothbrush
• mouthrinse
• possible infection, keep an eye out

Question 9

what would you do an an enamel fracture review?

Answer 9

its an uncomplicated crown fracture, just smooth any sharp edges

Question 10

what would you do to an enamel-dentine fracture patient?

Answer 10

If uncomplicated (no pulp exposure). Ensure all dentine covered with GI/Comp then restore tooth properly when appropriate for patient

if complicated (pulp exposure), partial pulpectomy or extract since primary tooth

Question 11

what would you do an crown-root fracture?

Answer 11

remove loose fragment and determine if crown is restorable, if restorable make sure pulp exposure is taken care of

if unrestorable: extract loose fragments

Question 12

how do you manage concussion, subluxation injuries?

Answer 12

no treatment, observation. PDL may heal for subluxation

Question 13

how do you manage lateral luxation injuries?

Answer 13

if there’s minimal occlusal interference, allow to reposition spontaneously

if severe:
1) extract
2) reposition with splint

Question 14

why DONT you reimplant a primary tooth during avulsion?

Answer 14

can damage permanent dentition coming through

Question 15

what are some complications of dental trauma to primary teeth?

Answer 15

discoloration, infection, delayed exfoliation (tooth falling out, permanent replacing it)

Question 16

what are some discolorations that can occur and what do they mean?

Answer 16

mild grey - immediate discoloration (may be alive)
opaque/yellow: pulp obliteration

Question 17

what are some enamel defects in primary teeth and what are the symptoms?

Answer 17

enamel hypomineralisation: same thickness as normal BUT poorly mineralised (low), white/yellow defect. No treatment

Enamel hypoplasia: LOWER thickness but normal mineralisation. Yellow/brown defects