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Dental Trauma Management

A forceful trauma to the teeth may result in the following:

  1. Chipped/Fracture crown
  2. Luxation (tooth is partially displace)
  3. Avulsion (tooth is completely displace)
  4. Root Fracture
Chipped/Fracture

After a trauma, the tooth may be chipped. This chipped may be confined to the enamel (outer layer of tooth), enamel-dentine (involving the second layer of tooth) or extend to the pulp (Fig 1). When the chipped is confine to the enamel/enamel dentine (Fig 2), the treatment may range from smoothening up the chipped surface to doing a filling or putting a crown on the tooth. However, when the fracture has extended to the pulp of the tooth, root canal treatment is indicated.

Luxation

A tooth may be displaced partially from the socket after the trauma (Fig 1). It is carefully repositioned and splinted with a flexible wire. A root canal treatment is usually required if the tooth becomes non vital.

Avulsion

An avulsed tooth is a tooth that is completely displaced out of its socket (Fig 1). The avulsed tooth should be replanted into the socket within an hour. If the tooth cannot be replanted immediately, it should be stored in a suitable medium e.g. cold milk, and the child should be brought to the dentist as soon as possible. A tooth that is replanted within an hour has a better prognosis. The avulsed tooth will be splinted for stabilization (Fig 2). Root canal treatment must be instituted within 2 weeks for an avulsed tooth.

Root Fracture

Trauma may result in root fracture. The tooth usually will be presented with a slight mobility. It will be tender to biting. Radiographs will be needed to identify the root fracture. The tooth with a root fracture needs to be stabilized with a splint. Root canal treatment may be required if the tooth becomes non vital.