Traumatic dental injuries
It may result in loosening, displacement and or loss of teeth, fracture of teeth and or bone, lacerations and bleeding. The commonest causes are falls (in sports and play) at home or school and motor accidents. Most affected are upper incisors.
Signs and symptoms
Tooth concussion- Is an injury to supporting tissues of tooth, without displacement
Tooth concussion- Is the partial displacement, but is commonly used to describe loosening of a tooth without displacement
Intrusion- Is the displacement of tooth into its socket often accompanied by fracture of alveolar bone
Luxation- Is the displacement of tooth laterally, labially or palatally
Avulsion-Is the complete loss of tooth from the socket
Soft tissue Injuries
Abrasion: where friction between an object and the surface of the soft tissue causes a wound. This wound is usually superficial, denudes the epithelium, and occasionally involves deeper layers.
Contusion/Bruising: indicates that some amount of tissue disruption has occurred within the tissues, which resulted in subcutaneous or sub mucosal hemorrhage without a break in the soft tissue surface.
Laceration: is a tear in the epithelial and sub epithelial tissues. It is perhaps the most frequent type of soft tissue injury, is caused most commonly by a sharp object
• X-rays (periapical x-ray) especially for suspected root fracture and
• OPG xray: for suspected alveolar bone fracture and jaw fracture
- Check for facial fractures and trauma to other sites, rule out evidence of head injury (amnesia, loss of consciousness, neurological signs)
Intra-oral examination: Look for soft-tissue lacerations, dentoalveolar fractures and damage to teeth
Check for tooth fragments which may be displaced in soft tissues
Examine traumatized teeth for mobility and check mobility
Suture for any soft tissue wounds
Extraction is treatment of choice for significantly traumatized primary/deciduous teeth with mobility and or displacement.
- Pain control by analgesics
• Paracetamol (PO) 1g 8 hourly for 3 days
• Diclofenac (PO) 50 mg 8 hourly for 3 days
• Ibuprofen (PO) 400 mg 8 hourly for 3 days
Prophylactic antibiotics are indicated in cases of suspected contamination or extensive damage
• Amoxicillin (PO) 500 mg 8 hourly for 5 days6
Note: Give tetanus toxoid (0.5% IU) if patient has not received vaccination in the previous 10 years.
4 Novemba 2020 10:06:44