PDENT800: Introduction to Dental Trauma in the Primary Dentition

Craniofacial, head, face, and neck injuries occurs in more than ___ % of child abuse cases?

50%

Traumatic dental injuries compromise _% of all injuries in children and young adults

5%

__% of school-aged children experience dental trauma

25%

For children ages 0-6, oral injuries account for __% of all physical injurie

18%

What is the second most common area of the body to be injured?

mouth

What is the most common injury in children ages 2-6?

periodontal tissue

What is the most common traumatic dental injury in the primary dentition?

luxation injuries

What it the most common site for inflicted oral injuries?

lips

T/F:

Dentists are mandated reporters of abuse or neglect

TRUE

Calcification of the incisal and middle 1/3 of the permanent incisor enamel is occurring up to ___ years of age

2

What injuries are most commonly associated with anomalies in the permanent dentition?

intrusion

avulsion

T/F: Males are more likely to sustain dental injuries than females

TRUE

What is the peak age for orofacial injuries?

7-11 years old

Concussion

injury to tooth-supporting structures without loosening or displacement, but with a marked reaction to percussion

T/F: Teeth are tender to percussion with concussion

TREU

Treatment of Concussion?

Observation

Subluxation

injury to tooth-supporting structures with abnormal loosening, but without displacement clinically or radiographically

Treatment of Subluxation

Radiograph

Re-evaluate

Luxation injury types

extrusive

intrusive

lateral

Extrusive Luxation

partial displacement of the tooth out the socket

If the tooth is excessively mobile > 3 mm, what is the treatment?

EXT

Lateral Luxation

tooth is displaced in a palatal or labial direction

T/F: The tooth is usually immobile in lateral luxation

TRUE

Intrusive Luxation

tooth has almost or completely disappeared into the socket and can be palpated labially

How long does it take for a tooth to reposition?

6 months

Avulsion

tooth is completely out of the socket

T/F: Reimplant the tooth

FALSE

Why is it bad to reimplant an avulsed tooth?

ankylosis

necrosis

Enamel-Fracture

fracture confined to the enamel

T/F: There is pain on percussion in enamel-fracture

FALSE

Enamel-Dentin Fracture

fracture involving loss of enamel and dentin

T/F: pulpal testing is very helpful in pediatrics

FALSE

Cover exposed dentin with?

Glass Ionomer

Enamel-Dentin-Pulp Fracture

fracture involving the enamel, dentin, and pulp exposure

Cvek Pulpotomy

Root Fracture

coronal fragment may be mobile and may be displaced

occlusal interference may be present

What is the poorest prognosis for root fracture?

coronal

_% of primary tooth injuries are rooth fractures

2-4%

___% of teeth with root fracture exhibited pulpal necrosis

9.4%

___% of teeth with root fracture exhibited pulp obliteration

9.2%

Root fractures are usually the ___ to -__

middle to apical 1/3

T/F: Treatment must occur if there is coronal fragment displacement

FALSE

Alveolar Fracture

alveolar bone

several teeth

occlusal interference

Treatment of Alveolar Fracture

splint

When do you splint in primary dentition trauma?

- lateral luxation where displacement was severe and tooth remained unstable in new position after gentle repositioning

-root fracture where coronal fragment was displaced / excessively mobile, and coronal fragment was repositioned, but fragment remained unstable

- alveolar fracture

When do you reimplant an avulsed tooth in the primary dentition?

NEVER

Which injuries do not require an initial radiograph?

concussion

enamel fracture

enamel+ dentin fracture

Which injuries do not require any clinical follow-up?

enamel fracture

Which injuries require radiographic follow-up ?

pulp-treated teeth

alveolar fracture

T/F: tetanus booster may be required if the injury was environmental caused?

TRUE

T/F: child should be on a soft diet after treatment?

TRUE

3/5-10/14 days

When would you send the patient to the hospital?

lugwigs angina - difficulty breathing, submandibular swelling