The greatest incidence of trauma to the primary teeth occurs at 2 to 3 years of age, when motor coordination is developing. The most common injuries to permanent teeth occur secondary to falls, followed by traffic accidents, violence, and sports. All sporting activities have an associated risk of orofacial injuries due to falls, collisions, and contact with hard surfaces.

How to Assess, Diagnose, Manage and Prevent the Dental Trauma

 

Assessment and Diagnostics   

• The face, lips, and oral musculature should be thoroughly examined for soft tissue lesions

•  Traumatized regions should be checked for fractures, abnormal tooth position, and tooth mobility

•  Full physical examination of the head, neck, and face

•  Assessment of possible injuries to adjacent areas and structures (eg, facial fractures or head and neck trauma)

•  Panoramic radiography of the teeth

 

 

Management

The treatment of the dental traumas are depends on the type of the injury involved

 

• Such as:

• Fracture

• Avulsion

• Luxation (tooth displacement)

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• Tetanus booster and antibiotics should be administered whenever a dental injury is at risk for infection. Arrangements should be made for prompt follow-up with a dentist or an oral and maxillofacial surgeon.

 

Management for dental avulsions include the following:

·         An adult tooth that is avulsed should be reimplanted in its socket as soon as possible.

·         If the tooth cannot be reimplanted, it should be placed in a protective solution; it should never be allowed to dry.

·         If the tooth has been dry for a significant period, it should be soaked in the appropriate solution (which depends on the length of the dry period).

·         Some studies suggest that when a tooth has been out of the mouth for longer than 60 minutes, immediate reimplantation is not required, and a root canal of the tooth should be performed with the tooth outside the mouth before it is reimplanted.

·         After reimplantation, any other injuries are repaired.

·         In children with dental avulsions, primary teeth are never reimplanted, because reimplantation of a deciduous tooth can cause harm to the developing permanent tooth.

 

 

 

Treatment of luxations includes the following:

 

·   Concussion and subluxation – A soft diet, administration of nonsteroidal anti-inflammatory drugs (NSAIDs), and referral to a dentist; subluxation is a more significant injury and is more often associated with pulpal necrosis

·    Extrusion – Restoration of the tooth to its original position; splinting

·    Lateral luxation – Repositioning of the tooth, often made more difficult by a fractured alveolar bone; splinting, done by a general practitioner only if the alveolar bone fracture is minimal and done by a dentist or an oral and maxillofacial surgeon if the fracture is more extensive

·    Intrusion – Usually, the general practitioner can provide no emergency treatment; referral to a dentist within 24 hours is indicated