Trauma

Question 1

How can trauma be prevented?

Answer 1

Reduction of overjet

Provision do mouthguard

Question 2

Describe immediate assessment/ treatment re. Trauma

Answer 2

Check for head injury or other injuries requiring medical attention
Assess dental/ facial injury
Does story fit?
Any teeth avulsed? Storage? 
Tetanus?

Question 3

What types of dental injuries can occur as result of trauma?

Answer 3

Crown or root fracture
Luxation
Avulsion

Question 4

What is of concern re. Crown/ root fracture

Answer 4

Bacteria can invade the pulp

Question 5

What are they different types of luxation?

Answer 5

Concussion
Subluxation
Intrusive luxation
Extrusive and lateral luxation

Question 6

What is concussion?

Answer 6

Injury without displacement or mobility

Question 7

What is subluxation?

Answer 7

Tooth mobile but not displaced

Question 8

What is the management of concussion and subluxation

Answer 8

Soft diet for 1. Week
Periapical radiograph
Check immunisation
Review

Question 9

Describe intrusive luxation and management

Answer 9

Most common trauma
Palatal and superior displacement of the crown

If crown visible , leave to re erupt
If whole tooth intruded - XLA

Question 10

Describe extrusive and lateral luxation and management

Answer 10

Tooth displaced laterally and outwardly

Tx dependant on mobility and extent of displacement

Question 11

Describe avulsion and management

Answer 11

Complete displacement of tooth out of socket

Do not replant primary teeth - if parent re plants- check viable and leave in situ

Permanent tooth:
Replant immediately if possible
If stored- in milk
Bite gently on clean hanky
Warn parents of chance of becoming non vital and ankylosis

Question 12

Describe management off fractures of primary incisors

Answer 12

If no pupal involvement - smooth enamel and dentine with disc
Restore with gi or composite resin

If pulpal involvement -
Pulpotomy if vital
Pulpectomy if not vital

Question 13

What are possible outcomes from trauma

Answer 13

Pulpal necrosis- grey colouration of tooth
Abscess
Internal resorption of primary teeth
Ankylosis of primary teeth
Dilaceration of crown/root- problems with eruption
Resorption of permanent tooth germs-
Hypoplasia
Damage to permanent tooth germs- abnormal colour or shape of permament.

Question 14

What group of patients is trauma most commonly seen in?

Answer 14

Boys
Peak ages-
2-4
8-10
14-16