Primary Tooth Trauma

Question 1

How treat concussion and subluxation in primary teeth?

Answer 1

Monitor clinically, do nothing

Question 2

How treat extrusion in primary teeth?

Answer 2

Let it spontaneously reposition if no occlusal interference

Excessively mobile or extruded >3mm then extract

Question 3

How treat intrusion in primary teeth?

Answer 3

Allows spontaneous repositioning

clinical follow up 1 week

Then monitor clinically and radiographically 3-4 weeks, 6-8 weeks, 6mo, 1yr

Question 4

How treat lateral luxation in primary teeth?

Answer 4

Spontaneous repositioning if no to minimal occlusal interference

Severe = reposition and splint

Or extract

Question 5

How treat avulsion in primary teeth?

Answer 5

Don’t reimplant

Make sure tooth is accounted for and not lost or fully intruded etc

If tooth not found then refer to paediatrician

Review clinically 6-8 weeks

Question 6

How treat infraction in primary tooth?

Answer 6

No treatment necessary

Question 7

How treat enamel fracture in primary tooth?

Answer 7

Smooth sharp edges

No review

Question 8

How treat ED fracture in primary tooth?

Answer 8

Smooth sharp edges

Cover dentine with GIC

In large fracture consider restoring in composite

Clinical review 6-8 weeks

Question 9

How treat EDP fracture in primary tooth?

Answer 9

If possible, preserve vitality with pulp cap or partial pulpotomy

Extraction is alternative depending on cooperation for first option

Question 10

How treat crown-root fracture without pulpal involvement in primary teeth?

Answer 10

Remove loose root fragments and cover exposed dentine with GIC

Extract if fragment is not stable

Clinical follow up 1 week, then 6-8 wks then year

Question 11

How treat Crown-root fracture with pulpal involvement in primary tooth?

Answer 11

Large stable fragment? - perform pulpotomy or RCT depending on tooth

Extract in other instances

Clinical follow up 1 week, 6-8 weeks, 1 year

Question 12

How treat root fracture in primary teeth?

Answer 12

Coronal fragment not displaced = no treatment

Coronal fragment displaced but not excessively mobile = leave for spontaneous repositioning

Excessive displacement - reposition under LA and 4 week splint, or extract only loose coronal fragment

Question 13

How treat alveolar fracture in primary teeth?

Answer 13

Manual repositioning often sufficient

GA indicated

Flexible splint for 4 weeks

Review 1 week, radiograph when splint off, then review 8 weeks etc