Paeds - Trauma to Baby Teeth Flashcards
what is the most common injury to deciduous teeth?
luxation injuries (PDL injury)
what would you examine in an intra-oral assessment? (5)
Check for damage to soft tissues - penetrating wounds and foreign bodies
Assess the alveolar bone
Assess Tooth mobility
Fractures/lines
Check the occlusion - traumatic occlusion must be treated urgently
what advice do we give for home management to all patients?
Soft diet 10-14 days - cut all food into small bites and chew with molars
Brush teeth with a soft bristled brush after every meal
Apply topical chlorhexidine 2x a day for 1 week (parent applies)
how do we manage enamel only fractures to deciduous teeth?
Smooth off the sharp edges
how do we manage enamel dentine fractures to deciduous teeth?
Cover the exposed dentine by placing a composite bandage/compomer
how do we manage enamel dentine pulp fractures to deciduous teeth?
Usually just extracted
Can consider endodontic therapy
if you are endodontically treating a deciduous tooth what material do we use to fill the canal and why?
use CaOH paste - allows tooth to be resorbed
how do we manage crown and root fractures to deciduous teeth?
Remove the obvious extracoronal fragment
Don’t try to remove any fragments that aren’t obvious - leave these to resorb physiologically
how do we manage an alveolar bone fracture to deciduous teeth?
splint the segment for 3/4 weeks then possible extraction of the teeth on the splinted segment
how do we manage an alveolar bone fracture to deciduous teeth?
splint the segment for 3/4 weeks then possible extraction of the teeth on the splinted segment
how do we manage concussion to deciduous teeth?
observe
how do we manage lateral luxation to deciduous teeth? (3)
Preferably - allow to Spontaneously reposition
Consider repositioning
If theres occlusal interference - extract!
how do we manage intrusion to deciduous teeth?
Monitor for re-eruption:
If no re-eruption after 6 months consider extraction to prevent problems with the permanent successor.
how can we tell which direction the apex of the root has been intruded on a radiograph? (palatal/labial)
If apical tip appears short compared to the contralateral tooth = displaced towards/through the buccal plate.
If apical tip appears indistinct and the tooth looks elongated = displaced towards the tooth germ (unfavourable!!)
how do we manage extrusion to deciduous teeth?
extract
why do we not reposition extruded deciduous teeth?
can cause damage to the permanent successor
how do we manage avulsion to deciduous teeth?
Take a radiograph to confirm it’s not intrusion (if no tooth brought alongside the child)
Do not replant
what are the long term affects on the permanent teeth after trauma to the primary dentition? (10)
Discolouration Discolouration and infection Delayed exfoliation Enamel defects (most common) Abnormal morphology of crown/root of permanent tooth Delayed eruption Ectopic position Arrest in formation Failure to form Odontome formation
how do we treat discolouration and infection of a PRIMARY tooth after trauma? (2)
If tooth discolours immediately = may maintain vitality and will improve over time
If tooth discolours after a few weeks = non-vital and its the necrotic pulp thats causing the discolouration so we can either leave (if no sinus), RCT or extract
how do we prevent delayed exfoliation of a primary tooth after trauma?
extract to prevent ectopic teeth
what is the most common long term affect of traumatised primary teeth?
enamel defects
how do we treat hypomineralisation of permanent teeth after trauma to the primary dentition? (4)
Leave
Restore to mask the colour
Localised removal and then restore
External bleaching
how do we treat hypoplasia of teeth after trauma to the primary dentition? (2)
Restore with composite
> 16 years = porcelain veneer (when gingival levels stabilise)
how can trauma to the primary dentition cause delayed eruption? how long does it delay it by? (2)
Premature loss = delay eruption of the permanent successor by 1 year due to the thickened mucosa.
how do we treat delayed eruption after trauma to the primary dentition? (3)
Palpate
Take a radiograph if its 6 months more delayed than the contralateral tooth
Then surgically expose the tooth and use orthodontics (if abnormal morphology)
how do we treat crown dilaceration after trauma to the primary dentition? (2)
Surgical exposure
Orthodontic realignment
how do we treat root dilaceration after trauma to the primary dentition? (2)
Surgical exposure
Orthodontic realignment
how do we manage an odontome after trauma to the primary dentition?
Surgical removal
what is an odontome?
A ball of compact dentine enamel and cementum
how do we manage arrested root development after trauma to the primary dentition?
extraction
RCT
how do we manage an undeveloped tooth germ after trauma to the primary dentition? (2)
Monitor as it may sequestrate spontaneously
surgical removal
