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Flashcards in Trauma Deck (76)
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1

What is always the first thing you do when a pt comes in with physical trauma?

History and examination

2

True or false.. all injuries should be treated immediately

False.

3

What are seven things you should inquire when obtaining the history of the injury?

Date and time of injury

Where and how injury occurred

Date of last tetanus inoculation

Other medical history, allergies, medicine being taken

The pt should be assessed for nausea, vomiting, etch.

Complete dental hx can help the dentist learn of previous injuries to teeth

The pts complains and experiences after injury, pain to thermal changes, pain to closing mouth, etc. can be helpful

4

A force strong enough to fracture, intrude, or avulse a tooth is also strong enough to...

Result in cervical spine or intracranial injury.

The pt should be assessed for nasuea, vomiting, drowsiness, or possible cerebral sinus fluid leaking from ears or nose (skull fracture)

Complete dental history can help dentist learn of previous injuries to teeth

5

True or false... repeated injuries to the teeth are uncommon in children

False. They are not uncommon

6

As part of the extraoral exam, you should check and describe observed injuries. Name 8 things you may find.

Facial fractures

Lacerations

Contusions

Swelling

Abrasions

Hemorrhage/drainage

Foreign bodies - asphalt on face and teeth

TMJ deviation/asymmetry

7

The clinical intraoral exam should be conducted after...

The teeth in the area of injury have been cleaned of debris

8

A traumatized tooth may be in a state of shock and as a result may...

Fail to respond to the accepted methods of testing pulp vitality

9

What should you include in your radiographic examination of a traumatic injury?

Traumatized tooth, surrounding teeth, and sometimes of opposing arch


Look for root fracture and pulp expsoure, size of pulp chamber, open or closed apex.

If fractured tooth fragmement is missing, check soft tissues

If mandible was hit, TMJ deviation, or bruising in FOM, take panorex to check for jaw or TMJ fracture

10

Another value of radiographs is that it provides a record of the tooth immediately after injury. Frequent, periodic radiographs reveal...

Evidence of continued pulp vitality or adverse changes that take place within the pulp or the supporting structures

11

True or false... if the fracture goes below the crest of the bone its hopeless

True

12

If a tooth is intruded, what is the treatment?

Extraction. Don't want to risk hitting the permanent tooth because it can damage it.

13

What is the most common type of crown fracture?

Class 2

14

Describe the 5 classes of crown fractures.

Class 1 - simple fracture of the crown involving little or no dentin

Class 2 - extensive fracture of the crown involving considerable dentin but not the dental pulp

Class 3 - extensive fracture of the crown with an exposure of the dental pulp

Class 4 - loss of the entire crown

15

What is a class5, 6, 7, 8, 9 fracture?

5 - total loss of tooth (avulsion)

6 - fracture of the root with or without loss of crown structure

7 - displacement of tooth with neither crown or root fracture

8 - fracture of crown en masse and its displacement

9 - traumatic injuries of primary teeth

16

What are you going to do and in what order for traumatic injuries?

Soft tissue management

Pulp therapy

Repositioning

Stabilization

Restoration

Extraction

Medication/prescription

Referral

Record all treatment and rationale

17

What is typically the first thing you do to treat emergency injuries?

Treat soft tissue first

18

Since injuries are considered dirty wounds, always check what?

Check that tetanus inoculation is current. Check with child's physician if uncertain

19

True or false... you should always suture a torn labial frenum.

False.. sometimes do sometimes dont

20

What is a complication that can happen when the lower lip is lacerated and then closed with sutures?

Mucoceles may form

Sometimes its better to leave it alone so a mucocele isn't created. You dont want to suture any glands closed

21

What is the treatment of a class 1 fracture (no dentin)?

May only need smoothing off or bonded resin, however, without exception a thorough examination should be completed, sometimes hidden problems

22

True or false... it is always advisable to restore a class 2 fractured tooth with a crown on the first visit

False. Best not to manipulate tooth anymore then necessary.

23

What is typically the best immediate treatment for a class 2 fractured tooth?

A temporary cover of dentin can be accomplished easily without too much additional trauma to tooth. This is often the treatment of choice.

24

True or false... the temporary resin can be left on when final restoration is finished

True

25

What is the most common fracture in permanent teeth?

Class 2 fracture

26

In a significant class 2 fracture, what do you cover exposed dentin with?

Ca(OH)

27

When you have to extract a primary tooth due to injury, what do else do you do?

Use a pedo partial to replace lost teeth.

Reassure parents that you are trying to save the permanent tooth

28

What are the reactions of the tooth to trauma?

Pulp hyperemia

Internal hemorrhage

Tooth color alteration

Calcific metamorphosis of dental pulp

29

What is pulpal hyperemia?

Difficult to determine the initial pulpal response and in predicting the long-range reaction of the pulp, congestion of blood in the pulp chamber can often be seen in exam, color often appears reddish.

30

What is an internal hemorrhage?

Hyperemia and increased pressure causes the rupture of capillaries and the escape of RBCs with subsequent breakdown and pigment formation in the tubules. Color change is evident in 1-3 after injury. Color change may lighten. Rarely goes back to white.