Trauma in the Primary Dentition

Question 1

How prevalent is trauma to the primary dentition

Answer 1

11-30%

Question 2

In which age group is trauma to the primary dentition most common

Answer 2

1-5-2.5 years

Question 3

What are the steps we take to come to a diagnosis of the traumatising primary dentition

Answer 3

1. History
2. Head injury
3. Medical and dental history
4. Exam
5. Special tests

Question 4

What questions about the incident do we ask in the history

Answer 4

1. How?
2. When?
3. Where?

Also ask the child about the incident and see if the stories are consistent

Question 5

Do we carry out sensibility testing in primary dentition cases

Answer 5

very rarely as very unreliable

Question 6

List the different types of injuries primary dentition can suffer form

Answer 6

1. Luxation

2. Fractures

Question 7

Describe a luxation injury

Answer 7

1. Displacement

2. Damage to the periodontal ligament

Question 8

Are luxation or fracture injuries more common in primary teeth

Answer 8

Luxation

Question 9

What are the aims of primary dentition trauma treatment

Answer 9

1. Prevent further damage to permanent successor
2. Treat pain
3. Restore funciton
4. Restore aesthetics

Question 10

What is treatment dependant on

Answer 10

1. Behaviour of child
2. Parental choice
3. Medical history
4. Type of injury

Question 11

What are the treatment options for a subluxation or concussion injury

Answer 11

1. Soft diet
2. Analgesics
3. Monitor

Question 12

What are the treatment options for a lateral luxation injury

Answer 12

1. Leave it

2. Extract it

Question 13

When would we leave a lateral luxation injury to primary teeth

Answer 13

1. If stable
2. There’s no interference with occlusion
3. The tooth can undergo spontaneous repositioning

Question 14

When would we extract a lateral luxation injury to primary teeth

Answer 14

1. If unstable
2. If tooth is significantly extruded
3. If there is interference with occlusion

Question 15

How would we treat an extrusion injury

Answer 15

Extract

Question 16

Why do we opt to extract teeth suffering from extrusion injury

Answer 16

As usually interfered with occlusion and becomes non vital

Question 17

What are the treatment options for intrusion injuries to primary teeth

Answer 17

Leave or extract

Question 18

what do we use to aid our decision to leave or extract an intrusion injury

Answer 18

Lateral radiographs to determine relationship of primary tooth to permanent successor

Question 19

When do we opt to extract an intrusion injury

Answer 19

1. If there is a clear interface with the permanent successor
2. If the primary tooth is infected
3. If there has been failure to re erupt within 3-6 months

Question 20

How do we treat a primary tooth that has been avulsed

Answer 20

DO NOT RE IMPLANT

Question 21

What can fractures of primary teeth be split into

Answer 21

1. No pulp exposure

2. Pulp exposure

Question 22

How do we treat a primary tooth fracture with no pulpal exposure

Answer 22

Leave and smooth over

Can do a composite restoration or strip crown

Question 23

How do we treat a primary tooth fracture with pulpal exposure

Answer 23

Extraction

Pulpotomy/pulpectomy

Question 24

How common are root fractures in primary teeth

Answer 24

3%

Question 25

How do we further classify root fractures

Answer 25

Stable or unstable

Question 26

How do we treat stable primary root fractures

Answer 26

Leave and monitor

Question 27

How do we treat unstable primary root fractures

Answer 27

Extract coronal segment and leave apical segment

Question 28

Before extracting an injured primary teeth what do we need to do

Answer 28

Anaesthetise

Question 29

What are the different anaesthetic routes we can take before extracting primary teeth

Answer 29

1. LA 2. Sedation 3. GA

Question 30

What colours can an injured primary tooth be clinically

Answer 30

Grey or yellow

Question 31

What can a grey primary tooth suggest

Answer 31

Haemmorhage

Question 32

What can a yellow primary tooth suggest

Answer 32

Pulp canal obliteration

Question 33

What clinical features may suggest loss vitality of a primary tooth

Answer 33

1. Chronic abscess 2. Periodical pathology 3. Pain 4. Mobility 5. Discolouration

Question 34

Which injuries have a higher likelihood of causing damage to permanent successor

Answer 34

More likely following intrusion and avulsion

Question 35

How common is damage to permanent successor in 2years olds and younger

Answer 35

63%

Question 36

How common is damage to permanent successor in 5years olds and OLDER

Answer 36

25%

Question 37

What damage can occur to permanent successors

Answer 37

1. White or brown discolouration with or without hypoplasia 2. Dilaceration of Crown 3. Dilaceration of Root 4. Odontome Like Formation 5. Root Duplication 6. Partial or Total Failure Root Development 7. Failure Tooth Development

Question 38

What is dilaceration

Answer 38

Displacement of formed hard tissue in relation to developing root Abrupt change in direction of root