Management of Trauma to Anterior Teeth in Children

A comprehensive set of question–answer flashcards covering epidemiology, classification, assessment, investigations, immediate and definitive treatments for dental trauma in children, including management of both permanent and primary teeth and preventive strategies.

What percentage of children under 7 years sustain injury to their primary incisors?

Between 8 % and 30 % according to epidemiological studies.

In Nigerian studies, what is the reported prevalence range of traumatized anterior teeth in 6- to 16-year-olds?

6.5 % – 19 %.

Name the four major classifications used for dental injuries.

Ellis’s, Garcia-Godoy’s (1981), Andreasen’s (1999), and the WHO classification.

Which dental-injury classification is described as simple, quick, reliable, reproducible, and with no overlapping injuries?

Garcia-Godoy’s classification (1981).

Into which three phases is the general management of dental trauma divided?

Assessment and immediate treatment, intermediate treatment, and final treatment.

Why might a chest radiograph be ordered after a crown fracture?

To rule out inhalation of a missing tooth fragment.

How does a long interval between a complicated crown fracture and treatment affect prognosis?

A longer interval worsens the prognosis.

Which radiographs are commonly taken in dental-trauma investigations?

Periapical radiographs and soft-tissue radiographs (for penetrating lip lesions).

List two pulp sensibility tests used in traumatized teeth.

Thermal tests (e.g., cold refrigerants) and electric pulp testing.

Which two devices assess pulp vitality by measuring blood flow?

Laser Doppler flowmetry and pulse oximetry.

Why is photographic documentation recommended for dental trauma?

It provides exact records for treatment planning, legal claims, and research.

For how long should pulp-vitality reviews be continued after a crown fracture?

For at least two years (first at 1 month, then at 3- to 6-month intervals).

What is the immediate treatment for an uncomplicated enamel fracture?

Smooth rough edges; splint only if the tooth is loose.

Why must exposed dentine be covered with calcium hydroxide after a fracture?

To protect the pulp from bacterial ingress and thermal irritation.

Give four restorative options for a fracture through dentine.

Composite resin (bandage or full restoration), glass-ionomer cement, stainless-steel crown, or reattachment of the fragment.

State two benefits of reattaching a fractured crown fragment.

Optimal aesthetics and economical, uniform incisal wear.

When is direct pulp capping justified after traumatic pulp exposure?

When the patient presents within a few hours and the exposure is pinpoint with minimal contamination.

What is the treatment of choice for a vital pulp exposure in an immature tooth?

Vital pulpotomy (apexogenesis) using calcium hydroxide.

Which clinical factors help decide between a full and a partial (Cvek) pulpotomy?

Colour of the pulp and extent of bleeding, indicating the degree of coronal-pulp inflammation.

Define apexification and name the material traditionally used.

Induction of a calcific barrier at an open apex in a non-vital immature tooth, traditionally with non-setting calcium hydroxide.

Which material allows immediate formation of an apical barrier as an alternative to long-term apexification?

Mineral Trioxide Aggregate (MTA).

What is the main purpose of splinting a tooth with a root fracture?

To encourage repair at the fracture site.

How long is a tooth typically splinted after a root fracture?

About 2 months.

What is the usual management for an apical-third root fracture?

Often no active treatment; monitor vitality because sufficient coronal root remains for support.

Give two management options when a cervical-third root fracture lies close to the gingival crevice.

Extract the coronal fragment and retain the root for a post crown, or orthodontically extrude the root before restoration.

How is a concussion injury to supporting tissues managed?

Soft diet and warm saline rinses; no splinting required.

What is the treatment for subluxation if the tooth is mobile?

Splint for 1–2 weeks and monitor vitality.

Why is splinting usually not required for intrusive luxation?

The tooth is mechanically held by surrounding alveolar bone.

For mature intruded teeth, what treatment is inevitable and when should it start?

Endodontic treatment, begun as soon as possible because pulp death is inevitable.

List three factors that improve prognosis after tooth avulsion.

Replantation within 30 minutes, intact periodontal ligament kept moist, and stabilization for 1–2 weeks.

What is considered the best transport medium for an avulsed tooth?

Hank’s Balanced Salt Solution (Save-A-Tooth / EMT Toothsaver).

If extra-oral dry time exceeds two hours, what solution should the root be soaked in before replantation?

Topical fluoride solution for about 20 minutes (after a 5-minute citric-acid pre-soak).

After replantation, how long is the tooth typically splinted?

1–2 weeks.

What is the first step in managing soft-tissue lacerations of the mouth?

Debride the wound, then suture if necessary.

How often should calcium-hydroxide dressing be replaced when monitoring for inflammatory root resorption?

Every 3 months, based on radiographic review.

What are the two most common traumatic injuries to primary teeth?

Subluxation and luxation (displacement).

How is an intruded primary tooth usually managed initially?

No immediate treatment; it often re-erupts within weeks—monitor monthly and reassure parents.

Why are avulsed primary teeth generally not replanted?

Because of limited child cooperation, splinting difficulties, and risk of damaging the permanent successor.

What is often the only early sign of a non-vital primary incisor, and how is it managed?

Crown discoloration; monitor regularly and treat (extraction or pulpectomy) only if infection develops.

Which children are strongly advised to wear mouthguards during contact sports?

Those with increased overjet, incompetent lips, or previously replanted teeth (especially Class II Div I malocclusion).