permanent tooth trauma Flashcards
How many 15 year olds are missing a tooth due to trauma?
1 in 100
Why is it essential our notes are accurate and comprehensive?
Because cases are often associated with police reports and medico-legal reports/compensation claims.
The peak age for primary tooth trauma is between 2 and 4. What is this age range for permanent dentition?
Between 7 and 10 years old.
Why is trauma to permanent dentition a problem between 7-10 years old?
The tooth root is still developing.
What are 2 examples of medical factors which may lead to an increased susceptibility to trauma in permanent dentition?
- Seizures
- Susceptible to falls.
For the prevention of dental trauma, a mouthguard may be recommended if the child plays sports such as rugby.
Name 3 types you could recommend?
- Stock
- Boil and Bite
- Custom Made - provides superior protection.
Mouthguards can be made in all different colours for a patient. What kind of material is used to make a mouthguard?
Ethylene-Vinyl Acetate (EVA)
Ideally what kind of thickness is needed in a mouthguard to protect tissues?
3-4mm thickness
To which tooth should a mouthguard extend back to?
First permanent molars.
How far should the labial flange extend above the gingival margin?
2mm
Why should the labial flange extend 2mm above the gingival margin?
To provide cushioning and dissipation of force upon impact.
In order to enclose the anterior hard palate, how far should the mouthguard extend above the gingival margin?
10mm
When a person presents with trauma, which 5 aspects of RMH should particularly be considered?
- Does the patient have a condition where there is an infection risk?
- Does the patient have a condition which may impact compliance?
- Any bleeding disorders?
- Allergies?
- Tetanus state.
decides if this patient needs medical attention
Before viewing the oral cavity, what is it important to do first so you are able to view all injuries?
Clean the face and oral cavity with water or saline.
When completing the dental trauma chart for PERMANENT dentition, can sensibility testing be included?
Yes as sensibility tests are more reliable in permanent teeth.
When listening to percussion sound, what should be expected?
Dull sound.
When testing percussion sound, if this is extremely dull what might this be indicative of?
Inflammatory resorption processes.
If on tapping the tooth a high pitched sound can be heard, what might this be indicative of?
Loss of PDL so loss of cushioning around the tooth.
What is the purpose of splinting following trauma?
To reduce pathological movement or further trauma during the healing period.
What is an enamel infraction?
A crack in the enamel without loss of tooth structure.
Will symptoms be present in an enamel infraction?
No but the crack may stain.
What is an enamel fracture?
Loss of a small amount of enamel.
In the event of an uncomplicated crown fracture involving enamel and dentine, what should be done with the missing fragment?
Locate and reattach where possible.
If the pulp is exposed in an immature tooth crown fracture, what is indicated?
Partial pulpotomy (removing 3mm of inflamed pulp) or pulp capping.
If a mature tooth suffers a crown fracture exposing the pulp, what is indicated?
Partial pulpotomy using non-setting CaOH or calcium silicate cements.
What is usually observed in an alveolar bone fracture?
Several teeth moving together.
Is it more common for a mature or immature tooth to become non-vital following lateral luxation?
Mature tooth - RCT indicated.
Steps to follow in the event of an avulsed permanent tooth:
- Find the tooth.
- Pick it up BY THE CROWN.
- Rinse with milk, water or the pts saliva if dirty.
- Immediately re-implant into the socket.
- Pt should bite on a handkerchief or t-shirt to hold in place.
- If unable to re-implant, avoid dehydration by storing in pts saliva, milk or saline.
- Note time of injury and see a dentist.
How should a tooth be picked up following avulsion?
By the crown.
3 steps in treating an avulsed tooth:
- Reposition
- Confirm Position
- Splint for 2 weeks
How long should an avulsed tooth be splinted for?
2 weeks
In a mature tooth, what pulpal action should be taken within 7-10 days following an avulsion?
RCT
Post injury advice following trauma:
- Attend and comply with follow up care.
- Avoid participation in contact sports.
- Avoid parafunctional habits (chewing pens etc.)
- Brush teeth after each meal.
- Soft diet for 2 weeks and resume normal diet asap.
- Use chlorhexidine x2 day for a week.
