Paediatric Trauma - Intro

Question 1

What % children have obtained injury to permanent incisors?

Answer 1

12% 12 years olds
10% 15 year olds

Male:female 2:1

Question 2

What is the peak age for incidence of injury?

Answer 2

8-10years

Question 3

What % of children have trauma to primary dentition?

Answer 3

Boys - 31-40%

Girls 16-30%

Question 4

What is the aetiology for trauma to primary dentition?

Answer 4

Falls
Contact sport
Activities - bike/ swimming
Serious: assault, N-A-I

Question 5

Examples of predisposing factors?

Answer 5

Increased overjet (2x risk if OJ >6mm)
Poor lip coverage
Previous trauma
Epilepsy - poorly controlled
ADHD

Question 6

What preventative measures could be used to reduce incidence?

Answer 6

Mouthguard for sports
Seatbelts
Early orthodontic intervention
Playground design

Question 7

What is enamel infarction?

Answer 7

Incomplete fracture - no toothloss
Dental trauma to brittle enamel - remain adherent underlying dentine
Can be seen w/ transillumination

Question 8

What in enamel fracture?

Answer 8

Uncomplicated crown fracture
Most common type injury permanent tooth
Loss of tooth tissue - enamel only
No sign/ symptoms - may be some sensitivity

Question 9

What is an enamel-dentine fracture?

Answer 9

Uncomplicated crown fracture
Loss of enamel and dentine
No plural involvement
See sensitivity

Question 10

What is a complicated crown fracture?

Answer 10

Fracture involving pulp
See pain
May see bleeding

Question 11

What are the different types of root fractures?

Answer 11

1. Apical 1/3
2. Middle 1/3
3. Coronal 1/3
4. Horizontal
5. Oblique
6. Complicated
7. Uncomplicated

Question 12

What radiographs should be taken if root fracture?

Answer 12

2 views: PA/ USO - if taken in same direction as root fracture may miss

Question 13

What are dents-alveolar injuries?

Answer 13

1. Concussion
2. Subluxation
3. Luxation

Question 14

What is concussion?

Answer 14

Injury to tooth supporting structures w/o abnormal losing or displacement of the tooth

Question 15

What is subluxation?

Answer 15

Injury to tooth supporting tissues w/ abnormal loosening but w/o displacement

Question 16

What are the 4 types of luxation?

Answer 16

1. Intrusion - moved into socket
2. Extrusion - moved out socket
3. Lateral - moved on axis
4. Avulsion -lost socket

Question 17

What are different types of alveolar injuries?

Answer 17

Crushing/ compression alveolar wall
Fracture alveolar socket wall/ process
Fracture mand/ max

Question 18

What hx is important to take for children?

Answer 18

Who attended with
HPC 
If lost tooth - is accounted for
Head-injury/ other injuries 
Safeguarding concerns

Question 19

How may EO exam vary in children?

Answer 19

May want to include a diagram of injuries - can be helpful for medico-legal issues

Trauma:
SF: swelling, bruising, lacerations
Bony: open/ close

Question 20

How does IO vary in trauma case?

Answer 20

ST: lacerations, haematoma, torn frenum
Teeth: fracture, plural exposure, discolouration, mobility, TTP, occlusion

Question 21

Why are radiographs useful trauma case?

Answer 21

Assist diagnosis
Basis for comparison later films
Size pulp, development apex, presence root fractures, any PA pathology, relation permanent successor

Question 22

If tooth concussed/ lunation injury will nerve damage recover?

Answer 22

Yes - may recover in 3 months