Proper emergency treatment for traumatic dental injuries

Dental emergencies are often caused by accidents that result in blunt force trauma to the face or mouth. Knocked-out teeth, cracked, chipped or broken teeth, lacerations to the lips, inside of cheeks and gum, toothaches, headaches as well as excessive bleeding in the mouth are common examples of dental emergencies.

Dental emergencies cause great pain and discomfort, can lead to other, more complicated dental problems and inhibit one’s ability to utilize the functionality of one’s mouth and live a happy, normal life.

Traumatic injuries to the dentition and its surrounding structures resulting from sporting activities or from an accident require immediate care and may involve a long recovery. The entire dental team which includes the dentist, specialist, hygienist, assistants and staff plays a significant role in managing an emergency dental trauma. The goal is to provide immediate care and comfort for the patient, to restore the damaged dentition, and to improve the long-term prognosis.

Dental trauma can be classified as:

  • Crown fractures
  • Root fractures
  • Luxation injuries:
    • Concussion
    • Subluxation
    • Extrusive luxation
    • Lateral luxation
    • Intrusive luxation
  • Avulsions
  • Alveolar fractures

There are three categories of treatment for dental trauma: primary, secondary, and tertiary care. Primary care is urgent care immediately following an injury. The dental team is in emergency care code, quickly assessing the situation, gathering information, obtaining diagnostic radiographs, and formulating a diagnosis. Treatment involves repairing or reattaching fractured teeth, splinting luxated teeth, or the re-implantation of avulsed teeth. Chipped or fractured teeth, with or without pulp exposure, can be treated within 48 hours with pulp’s long-term outcome not affected.

Secondary care which follows primary care consists of evaluation and monitoring of the pulp and surrounding structures. Treatment may include endodontic therapy, soft tissue therapy, surgery, restoration, or the De-coronation of a tooth for a young patient.

Tertiary care is a definitive treatment which may occur years after the injury. It may include: fixed partial dentures, dental implants, orthodontics, or autotransplantation. Treatment for any of the above injuries should follow the general guidelines for the treatment of permanent teeth from International Association of Dental Traumatology.

Dental trauma during sporting activities or form an accident can be very traumatic. These injuries, if not addressed properly and in a timely manner can result in future damages that may not be reversible. The function and health of the dentition are critical, but esthetic consideration is also of high priority when an injury occurs in the esthetic zone of the patient. Proper home care after an injury is also important, such as Chlorhexidine rinses and pain medication if indicated, a soft food diet and continued brushing and flossing. In today’s society being active is commonplace and dental injuries can be a result. The dental team must be prepared to handle any resultant injuries.

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