Trauma I Flashcards
What is the most common injury in the primary dentition
luxation
What is the most common injury in the permanent dentition
crown fracture - enamel/dentine fracture
What is the peak period for trauma
7-10 years
What teeth are most likely to experience trauma in the permanent teeth
upper incisors
more likely to be centrals than laterals
What children is trauma to front teeth more common with
large overjet
in younger age group it won’t be corrected yet
How great an overjet increases incidence of trauma
○ An overjet of greater than 9mm doubles the incidence of trauma
○ For these patients it is important they were mouthguards when playing contact sports
What are common causes of trauma
Falls
Bike, skateboard, RTA
Sport
Fights
What questions do you ask when taking a detailed history
○ How did it happen
○ Where are the lost teeth/fragments
○ When did it happen exactly
○ Any other symptoms
What are examples of aspects in medical history that may influence treatment options
○ Rheumatic fever
○ Congenital heart defects
○ Immunosuppression
These condition are not contraindications to treatment but appropriate additional treatment may need to be given such as antibiotic cover
What do we look at in an extra oral examination
○ Laceration (soft tissues) ○ Haematomas ○ Haemorrhage/CSF § Any CSF in medial stream of nose bleed, appears to be ea straw coloured liquid ○ Subconjunctival haemorrhage ○ Bony step deformities ○ Mouth opening § Does the mouth open properly
What do we look at in an intra oral examination
○ Soft tissue § Look for laceration or tears ○ Alveolar bone § Anything mobile? ○ Occlusion § Are they biting normally? § Look out for malocclusion ○ Teeth • It is important to rule out facial/jaw fractures
Where are foreign bodies most likely to be
○ Most likely to be on the floor
Could be in the soft tissues
How do we check for lacerations
Use a soft tissue radiograph
What may tooth mobility indicate
○ Displacement of tooth ○ Root fracture § Would make it more loose ○ Bone fracture § Unlikely to be just one mobile tooth, several tooth in the segment would be mobile
What does the tactile test help for
○ Fracture lines whether they maybe horizontal or vertical (transillumination can help)
Pulpal involvement
What special tests do u want to do
sensibility tests
percussion
occlusion
radiographs
What are sensibility tests
to test the nerve of the tooth. A sensibility test is based on the principle that you would not get a patent nerve without a patent supply. But the converse is not true, you can have a patent blood supply and a dead nerve.
What are the types of sensibility tests
Thermal: ethyl chloride (ECL) or warm gutta percha
Electrical: electric pulp tester (EPT)
Used on labial third of px tooth which stimulates an electrical impulse onto the tooth and the patient will tell you if they can feel it or not
What can percussion help look for
A duller note may indicate a root fracture
What can occlusion help look for
§ Traumatic occlusion demands urgent treatment
§ A traumatic occlusion is when a patient can’t get their teeth back together normally and usually the tooth that has been traumatised is propping the patient’s occlusion open or it’s the first thing they touch when they bite
What radiographs can be taken
§ Intra-oral
§ Occlusal
§ OPT
Soft tissue
What can trauma stickers be useful for
can be used in clinic to help monitor the trauma long term