Management of Dental Trauma in Children.

 

Injuries to children’s teeth can be very distressing for children as well as their parents. Dental trauma may occur as a result of sport mishap, an altercation, a fall inside of the home, or other causes. Management of dental injuries in mostly depends on the age of the patient and the extent of tooth and alveolar involvement. Because children have larger amounts of pulp in their interior teeth than adults do, most tooth fractures in children involve a fracture of the pulp. Fortunately, children also have a greater capacity to regenerate pulp. As patients age, their teeth include progressively more dentin and less pulp, which makes fractures through the pulp chamber increasingly unlikely.

The peak period for trauma to the primary teeth is 18- 40 months of age. This is because there is increased mobility for the uncoordinated toddler. Injuries to primary teeth usually result from falls and collisions as the child learns to walk and run. The upper (maxillary) central incisors are the most commonly injured teeth. Maxillary teeth protruding more than 4 mm are two to three times more likely to suffer dental trauma than normally aligned teeth. Dentoalveolar trauma may be classified into categories based on treatment protocols. These categories include:

ü  Dental avulsion

ü  Dental luxation and extrusion

ü  Enamel and crown fracture

ü  Dental intrusion

ü  Dental concussion and subluxation, root fracture

ü  Alveolar bone fracture.

A thorough examination is necessary to assess the full extent of all dental injuries. Important information to be gathered for each patient includes: vital signs, review of all systems, head and neck exam and accident information.

A permanent tooth that has been knocked out is a dental emergency. The dentist should also be called whenever a dental trauma results in pain, dislocation of the tooth, or tooth sensitivity to hot or cold. Dental trauma is readily on examination. X rays may be taken to determine the extent of the damage to fractured tooth.

Treatment of a broken tooth varies depending on the severity of the fracture. For immediate first aid, the injured tooth and surrounding area should be rinsed gently with warm water to remove dirt, and then covered with a cold compress to reduce swelling and ease pain.

A broken jaw must be set back into its proper position and stabilized with wires while it heals. This is usually done by an oral surgeon. Healing may take six weeks or longer depending on the severity of the fracture.

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