Trauma Management

Trauma Management img 2
Trauma to the teeth can be a devastating and costly affair. Poor management of dental trauma can result in several poor outcomes including loss of teeth and supporting bone, resulting in aesthetic and functional comprimises. Traumatic dental injuries (TDIs) occur frequently in children and young adults, comprising 5% of all injuries. Twenty‐five percent of all school children experience dental trauma and 33% of adults have experienced trauma to the permanent dentition, with the majority of the injuries occurring before age 19. (International Association of Dental Traumatology).

What do I do in case of dental trauma?

If the trauma happens to a baby tooth or teeth?

I’ve knocked my front tooth and it is chipped, what happens now?

Diagnosis determines the treatment. These are the possible outcomes:

1

Enamel only chip. Usually fixed by rebonding the missing bit of tooth, or with a ‘cap’, or simply by smoothing the rough edge out. Review at 6 weeks is recommended.

2

Enamel and dentine fracture. The tooth may be very sensitive and may require an insulating layer over the sensitive part of the tooth before a full repair can be made. Review at 6 weeks is recommended.

3

Nerve exposure. In an immature adult tooth, the nerve may be capped or cleaned by a ‘pulpotomy’ before a cap can be placed. In mature adult teeth a root canal therapy and more involved restorative treatment may be required. Review at 6 weeks is recommended following treatment.

4

Crown-root fracture. This may need immediate stabilising by gluing the fragments back together. Definitive treatment depends on the severity but may require root canal, crown lengthening or orthodontic movement, or extraction and implant treatment.

5

Horizontal root fracture. This would require stabilising using a flexible splint for 4 weeks, followed by review. If the tooth dies, the fragment closest to the crown of the tooth may need root therapy. Even with the best treatment, sometimes extraction is unavoidable

6

Fracture of the jawbone holding the teeth. This requires splinting ad repositioning of the broken segment and regular review. Many outcomes are possible following this type of trauma including loss of teeth vitality, root therapy and tooth loss.

What to do if I have knocked my tooth out?