Primary Trauma: Examination and Classification Flashcards
What primary tooth is most affected with trauma?
Maxillary primary incisors
What is the peak age of primary tooth trauma?
2-4
What is the prevalence of primary tooth trauma at 5 years old?
16-40%
What are the most common causes of primary tooth trauma?
Falls - most common
Bumping into objects
Non-accidental
What are the different injuries to dental hard tissues and pulp?
Enamel fracture (uncomplicated crown fracture)
Enamel and dentine fracture (uncomplicated crown fracture)
Enamel, dentine and pulp fracture (complicated crown fracture)
Crown-root fracture
Root fracture
What are the different injures to supporting tissues?
Concussion
Subluxation
Lateral luxation
Intrusion
Extrusion
Avulsion
Alveolar fracture
What is concussion?
PDL injury
Tooth tender to touch but has not been displaced
Normal mobility and no bleeding into gingival sulcus
What is subluxation?
Tooth tender to touch, has increased in mobility but has not been displaced
Bleeding from gingival crevice can be noticed
What is lateral luxation?
Tooth displaced usually in a palatal/lingual or labial direction
What is intrusion?
Tooth usually displaced through the labial bone plate, or it can impinge on the permanent tooth bud
What is extrusion?
Partial displacement of tooth out its socket
What is avulsion?
The tooth is completely out of the socket
What should you do if you notice a tooth is avulsed?
Locate missing tooth as it could be embedded in soft tissue, ingested or inhaled
If not found, send child for medical assessment
Describe alveolar fracture
Fracture that involves the alveolar bone (labial and palatal/lingual) and may extend to the adjacent bone
What is the most common injury in the primary dentition and what is the prevalence?
Luxation - 62 - 69%
What are the 7 points following traumatic injury to the primary dentition?
- Reassurance
- History
- Examination
- Diagnosis
- Emergency tx
- Important information
- Further tx and review
What is important to know about an injury in trauma history?
When, where, how, any other symptoms or injuries, any lost teeth or fragments
What elements of medical history may influence tx so infection risk is minimised?
Congenital heart disease
History of rheumatic fever or immunosuppression
Bleeding disorders
Allergies
Tetanus immunisation status
What questions should be asked in dental history for a trauma history?
Any previous trauma
What tx have they experienced before
Legal guardian
Childs attitude
What should be explored extraorally in a trauma examination?
Lacerations
Haematoma
Haemorrhage/CSF
Subconjunctival haemorrhage
Bony step deformities
Mouth opening
What should be explored intra orally in a trauma examination?
Soft tissues - penetrating wounds, foreign bodies
Tooth mobility - may indicate displacement, root or bone fractures
Transillumination - may show fracture lines in teeth, pulpal degeneration and caries
Alveolar bone
Occlusion - traumatic occlusion demands urgent tx
Teeth
Percussion - dull note may indicated root fracture
Tactile test with probe - may help detect horizontal and vertical fractures, pulpal involvement
What is a trauma stamp?
Records factors which are important to monitor in a traumatised tooth
What is recorded in a trauma stamp?
Mobility
Colour
TTP
Presence of a sinus
Percussion note
Radiograph
What radiographs can be used in a trauma examination?
Periapical
Anterior occlusal
Lateral pre-maxilla
Panoramic
Soft tissues
