Paeds - Trauma to Baby Teeth Flashcards

1
Q

what is the most common injury to deciduous teeth?

A

luxation injuries (PDL injury)

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2
Q

what would you examine in an intra-oral assessment? (5)

A

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

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3
Q

what advice do we give for home management to all patients?

A

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)

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4
Q

how do we manage enamel only fractures to deciduous teeth?

A

Smooth off the sharp edges

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5
Q

how do we manage enamel dentine fractures to deciduous teeth?

A

Cover the exposed dentine by placing a composite bandage/compomer

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6
Q

how do we manage enamel dentine pulp fractures to deciduous teeth?

A

Usually just extracted

Can consider endodontic therapy

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7
Q

if you are endodontically treating a deciduous tooth what material do we use to fill the canal and why?

A

use CaOH paste - allows tooth to be resorbed

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8
Q

how do we manage crown and root fractures to deciduous teeth?

A

Remove the obvious extracoronal fragment

Don’t try to remove any fragments that aren’t obvious - leave these to resorb physiologically

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9
Q

how do we manage an alveolar bone fracture to deciduous teeth?

A

splint the segment for 3/4 weeks then possible extraction of the teeth on the splinted segment

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10
Q

how do we manage an alveolar bone fracture to deciduous teeth?

A

splint the segment for 3/4 weeks then possible extraction of the teeth on the splinted segment

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11
Q

how do we manage concussion to deciduous teeth?

A

observe

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12
Q

how do we manage lateral luxation to deciduous teeth? (3)

A

Preferably - allow to Spontaneously reposition

Consider repositioning
If theres occlusal interference - extract!

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13
Q

how do we manage intrusion to deciduous teeth?

A

Monitor for re-eruption:

If no re-eruption after 6 months consider extraction to prevent problems with the permanent successor.

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14
Q

how can we tell which direction the apex of the root has been intruded on a radiograph? (palatal/labial)

A

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!!)

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15
Q

how do we manage extrusion to deciduous teeth?

A

extract

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16
Q

why do we not reposition extruded deciduous teeth?

A

can cause damage to the permanent successor

17
Q

how do we manage avulsion to deciduous teeth?

A

Take a radiograph to confirm it’s not intrusion (if no tooth brought alongside the child)

Do not replant

18
Q

what are the long term affects on the permanent teeth after trauma to the primary dentition? (10)

A
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
19
Q

how do we treat discolouration and infection of a PRIMARY tooth after trauma? (2)

A

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

20
Q

how do we prevent delayed exfoliation of a primary tooth after trauma?

A

extract to prevent ectopic teeth

21
Q

what is the most common long term affect of traumatised primary teeth?

A

enamel defects

22
Q

how do we treat hypomineralisation of permanent teeth after trauma to the primary dentition? (4)

A

Leave
Restore to mask the colour
Localised removal and then restore
External bleaching

23
Q

how do we treat hypoplasia of teeth after trauma to the primary dentition? (2)

A

Restore with composite

> 16 years = porcelain veneer (when gingival levels stabilise)

24
Q

how can trauma to the primary dentition cause delayed eruption? how long does it delay it by? (2)

A

Premature loss = delay eruption of the permanent successor by 1 year due to the thickened mucosa.

25
Q

how do we treat delayed eruption after trauma to the primary dentition? (3)

A

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)

26
Q

how do we treat crown dilaceration after trauma to the primary dentition? (2)

A

Surgical exposure

Orthodontic realignment

27
Q

how do we treat root dilaceration after trauma to the primary dentition? (2)

A

Surgical exposure

Orthodontic realignment

28
Q

how do we manage an odontome after trauma to the primary dentition?

A

Surgical removal

29
Q

what is an odontome?

A

A ball of compact dentine enamel and cementum

30
Q

how do we manage arrested root development after trauma to the primary dentition?

A

extraction

RCT

31
Q

how do we manage an undeveloped tooth germ after trauma to the primary dentition? (2)

A

Monitor as it may sequestrate spontaneously

surgical removal