primary tooth trauma Flashcards
Where is one of the most common areas to injure during trauma?
The mouth.
What percentage of children 0-6 have sustained TDIs?
22%
What is a Traumatic Dental Injury?
Injury related to the teeth and/or periodontium.
many involve soft tissue injury
(gingiva, periodontal ligament or alveolar bone)
What is the difference between resulting injuries from trauma to primary vs permanent dentition?
Primary Teeth - luxation injurty; result in in movement of the teeth. Affects PDL.
Permanent Teeth - fractures are most common
What percentage of children who have suffered physical abuse will have an oreo-facial injury?
50%
Aetiology: boys vs girls.
Trauma is more common in boys (30-40%) than girls (15-30%).
What is the peak age of dental trauma in primary dentition?
2-4 years old
(due to children finding the ability to walk etc)
Trauma History:
- Who are they with and who is on the PR form.
- Where did the injury occur - consider contamination.
- How did it occur - impact zone.
- When - allows for appropriate management.
- Other injuries?
- Any period of unconsciousness?
- if so, how long for, amnesia, nausea, brain damage? - Any disturbance of bite?
When would a non-accidental injury be considered?
- If the history foes not fit with the presentation.
- If the child presents with repeated episodes of trauma.
- Delayed presentation.
- Failure to follow up.
What are 5 things to consider with regards to medical history when treating a child with trauma?
- If the child has a condition where there is a risk of infection.
- If the child has a condition affecting compliance.
- Bleeding disorders - are we able to achieve haemostasis
- Allergies
- Tetanus status.
Are antibiotics given routinely for trauma?
No
When is the tooth re implanted in trauma cases?
Almost always unless there is a reason not to.
What would be the first step in examining a child with trauma?
Cleaning the face and oral cavity with water or saline.
What are the benefits of cleaning the face and oral cavity before examination?
It will make the patient feel more comfortable and facilitate extraoral and oral examination.
After cleaning the child, what would the next 5 steps of the EO examination be?
- Photographs to document the injuries.
- Look for any extraoral wounds (bruises or lacerations).
- Palpation of the facial skeleton (look for fractures).
- Palpation of the TMJ.
- Observing mandibular opening and closing.
When examining intra orally, what are 3 things to look out for?
- Soft tissue injury.
- If there is a missing tooth or fragment in the lip.
- Make note of the appearance of the:
- gingiva
- fraenum
- palate
- lips
- tongue
- cheeks
When examining hard tissues, what are 8 things to look out for?
- Fractures
- Pulpal exposures
- Colour changes
- Displacement
- Disturbance in occlusion
- Mobility of teeth
- Mobility of segments
- Palpation of alveolar processes.
Which proforma is filled out in the event of dental trauma?
The dental trauma chart.
What is the most common tooth colour present due to traumatic injury?
Grey
(think elliot giles)
When a grey discolouration is seen, what is the reason for this?
Bleeding into the dentinal tubules (similar to a bruise).
Either due to the trauma or because the tooth has lost vitality.
Why are sensibility tests not recommended in primary teeth?
As they are unreliable.
When might a yellow discolouration be seen in a tooth post-trauma?
PULP CANAL OBLITERATION -
Due to further dentine being laid down in the canal.
When might a red discolouration be seen in a tooth having experienced trauma?
Due to resorption within the tooth or because it is due to exfoliate.
What should be looked out for when examining for sinus pathology?
Spots/swelling within the gum above the root of the teeth.
Which trauma guidelines are currently being used?
IADT 2020
International Association of Dental Traumatology
