Paeds Trauma 1

Question 1

Causes of trauma

Answer 1

Fails, collisions, child abuse

Question 2

5 injuries to hard tissues and pulp

Answer 2

Enamel, enamel-dentine, complicated (enamel dentine pulp), crown-root fracture (comp/non comp), root fracture

Question 3

Injuries to supporting tissues

Answer 3

Concussion
Subluxation
Luxation injuries: lateral luxation, intrusion, extrusion
Avulsion
Alveolar Fracture

Question 4

Concussion

Answer 4

Tooth tender to touch but not displaced

Question 5

Subluxation

Answer 5

Tooth tender to touch, increased mobility, NOT displaced
Bleeding into gingival sulcus

Question 6

Lateral luxation

Answer 6

Tooth displaced palatally, lingually or labially

Question 7

Intrusion

Answer 7

Tooth displaced through labial bone plate
Can impinge on permanent tooth bud

Question 8

Extrusion

Answer 8

Partial displacement of tooth out it’s socket

Question 9

Most common injury to supporting tissues

Answer 9

Luxation injuries (lateral luxation, intrusion, extrusion)

Question 10

Avulsion

Answer 10

Tooth completely out socket
if tooth not found- medical assessment esp if child showing respiratory symptoms

Question 11

Alveolar fracture

Answer 11

Involves alveolar bone (labial and palatal/lingual), may extend to adjacent bone
Mobility of segment of bone along with several teeth are common
Occlusal interference usually present

Question 12

Patient management

Answer 12

Reassurance
Trauma history/History
Exam
Diagnosis
Treat
Inform pt
Further treatment and review

Question 13

Trauma history

Answer 13

When? Where? How? Other symptoms? Lost teeth/ Fragments?

Question 14

What could limitation (or deviation) of mandibular movement indicate

Answer 14

Broken/dislocated jaw

Question 15

Use of transillumination

Answer 15

Can show fracture ;ones on teeth (crazing), pulpal degeneration and caries

Question 16

Duller percussion note

Answer 16

May indicate fracture

Question 17

Trauma stamp

Answer 17

Mobility
Colour
TTP
Sinus
Percussion note
Radiograph

Question 18

What should diagnosis include

Answer 18

Both injury to hard tissue and pulp/ supporting tissues

Question 19

Emergency treatment

Answer 19

Observation most appropriate
UNLESS risk of aspiration, ingestion or occlusal interference
N.B Childs cooperation

Question 20

Important information to give

Answer 20

Analgesia- paracetamol/ibuprofen
Soft diet 10-14 days (cut small/chew with molars)
Soft toothbrush after every meal
Topical chlorhexidine 0.12%
Apply topically twice daily for one week (cotton bud)
Warn re signs of infection