Trauma to the permanent dentition

Question 1

History of trauma?

Answer 1

when
How
Where
Other injuries - loss of consciousness
Medical history
Previous trauma

Question 2

Examination of dental trauma?

Answer 2

extra oral

Facial lacerations

Facial skeleton - maxilla, tmj
Start at tmj and work inwards

Intra oral
- soft tissues, lips, gingivae

• teeth
• supporting bone

Question 3

Once recorded the type of injury, what investigations should be carried out?

Answer 3

tooth- what tooth, tooth either side

TTP -

Mobility - 0,1,2,3

Colour - any colour change and what site

EPT - record value

ECL - ethyl chloride
- yes or no, cold or not

Radiographs

Sinus - sinus present yes or no

P-note - is the sound normal when tapped the tooth

Question 4

Avulsion?

Answer 4

the tooth is completely displaced out of its socket

Question 5

Tx for avulsion?

Answer 5

keep pt calm

Find the tooth

Wash under running water 10 seconds. If confident to reimplant

Place in appropriate storage medium

Question 6

Extra-oral dry time?

Answer 6

the time the tooth is out if the mouth before reimplantation

Question 7

Good places to store a tooth?

Answer 7

full fate milk

Parents mouth

Pt mouth

• Same osmotic gradient as saliva

Question 8

How to replace tooth after avulsion?

Answer 8

clean goth with saline

Reimplant

Splint - flexible 2/52

Pax antibiotics

Initiate RCT 7-10 days after reimplanataion

Caoh up to 1/12

Review every 3 months and annually thereafter