Trauma Flashcards
(36 cards)
What is a concussion of a tooth?
The tooth is tender to touch but it has not yet been displaced
It has normal mobility and no sulcular bleeding
Treatment for concussion of tooth
No baseline radiograph indicated
No treatment is needed.
Observation
Advice - Care when eating, clean affected area with soft toothbrush and cholrohexidn mouthwash twice a day for one week to encourages gingival healing and prevent plaque accumulation
What are the clinical findings of a subluxation
The tooth is tender to touch and it has increased mobility however the tooth has not been displaced
Bleeding from the gingival crevice may be noted
What kind of radiograph would be taken for a subluxation injury and what would expect to be seen
A periapical of affected tooth should be taken to establish a baseline - Normal to slight widening of the PDL space expected
Is any treatment required for a subluxation injury
No treatment required
Care on eating
Soft brushing and chlorohexidine mouth wash applied topically for 1 week twice daily
Child comes in following injury and there tooth appears to be enlongated and is excessively mobile, there is an occlusion interference
Which type of injury is this
Extrusive luxation
The tooth has PARTIAL displacement out of its socket
What treatment should be carried out for an extrusive luxation injury
Periapicals should be taken to establish a baseline ( slight increase to substantially widened PDL space apically)
Treatment depends on the degree of displacement, mobility and the ability of the child to cooperate in an emergency situations
Not interfering with occlusion - let it spontaneously respotion
Excessively mobile or extruded more than 3mm. -extract under LA
Soft brushing and chlorohexide topicalally to the area 2x daily for a week
What is lateral luxation
The tooth is displaced usually in a palatal/lingual/labial direction. The tooth will be immobile, occlusal interference may be present
When would extraction be indicated in a lateral luxation
When the tooth is at risk of aspiration or ingestion
What kind of treatment can be offered for a severe lateral luxation, other than extraction
Gently reposition the tooth,if its unstable in its new position, splint for 4 weeks using a flexible splint attached to the adjacent uninjured teeth
Child comes in following a traumatic injury, clinical findings are the tooth has almost or completely disappeared into the socket and can be palpated labailly.
What has happened here and what is the diagnosis
This is intrusive luxation
The tooth has most likely been displaced through the labial. Bone plate , it can impinge on developing permanent tooth bud
How can we radiographically tell if a intrusive luxation injury has been displaced toward a permanent tooth germ
The apical tip cannot be visualised and the image of the toooth will appear ELONGATED
If in an intrusive luxation the tooth has been is placed through the lateral bone plate how would this present on a radiograph
The apical tip can be seen and the image of the tooth will appear shorter than the contralateral tooth
Which kind of treatment should be carried out for an intrusive luxation
The tooth should be allowed to spontaneously reposition itself, irrespective of the direction of the displacement
Spontaneous reposition usually occurs within 6months but can take up to a year
Excercose care with eating, topically apply chloroehexidine mouthwas 2x daily for a week
Clinical findings - the tooth is completely out of the socket what kind of injury is this
An avulsion
What must you check for when a patient comes in presenting with an avulsion injury
The location of the missing tooth should be explored during the trauma history and examination - especially if the injury was not witnessed by an adult or there was loss of consciousness
There is a risk it may be embedded in the soft tissues of lip,cheek r tongue,pushed into the nose or aspirated
What should you do if an avulsed tooth cannot be found
If the avulsed tooth cannot be found then the child should be referred for a medical evaluation to an emergency room for further examination - especially if there are respiratory symptoms
Treatment for an enamel dentine fracture when the pulp is not exposed
Cover all of the exposed dentine with GI or composite, lost tooth structure can be restored with composite immediately or at a later date.
Excersice care when eating to not cause further trauma to injured tooth, encouraging return to normal function ASAP.
Encourage gingival healing and prevent plaque accumulation by parents cleaning affected area with a soft brush or cotton swab with alcohol free chlorhexidne mouthwash applied topically 2x daily for 1 week.
What is the patient/parent care advice for all trauma injuries
Excersice care when eating to not cause further trauma to injured tooth, encouraging return to normal function ASAP.
Encourage gingival healing and prevent plaque accumulation by parents cleaning affected area with a soft brush or cotton swab with alcohol free (0.1-0.2%) chlorhexidine gluconate mouthwash applied topically 2x daily for 1 week.
What is the difference between a complicated and non complicated fracture
Complicated involves pulpal exposure, non complicated does not
How do we manage a complicated crown fracture
Preserve the pulp via a PARTIAL PULPOPTOMY
- la required
- non setting calcium hydroxide paste should be applied over the pulp and then GI over than and then restored with composite resin.
If the child presents with a complicate crown fracture with a large pulp exposure what kind of treatment is indicated
Cervical pulpotomy
For note about treatment plan
The treatment depends on the child’s maturity and ability to tolerate the procedure
Therefore discussing treatment options with the parent is essential.
Each option is invasive and has the potential to cause long term dental anxiety.
Treatment is best preformed b a child-oritenteated team with the exerperience and expertise in the management of paediatrics trauma injuries
Often no treatment may be the most appropriate option in the emergency scenario but only when there is potential for rapid referral (within several days) to the child oriented teeth.
What are the 6 things to make a note of on the trauma stamp
Mobility
Colour
TTP
Presence of sinus
Percussion note
Radiograph
