Avulsion Injuries: Assessment and Management.

Avulsion injuries, though relatively uncommon, are one of the most serious of dentoalveolar injuries. Replantation at the scene of the incident is almost always the treatment of choice whenever possible. This paper outlines a step-by-step approach for the management of avulsion injuries, including a splinting protocol. This aims to support general dental practitioners in feeling more confident with managing these injuries.

Evaluation of Knowledge on Emergency Management of Avulsed Teeth Among Turkish Medical and Dental Students

Abstract Objective: To evaluate the knowledge of medical and dental students regarding the emergency management of avulsed teeth. Material and Methods: This cross-sectional survey study was performed on 1841 students. Medical (n=746) and dental (n=845) students from different universities were included in this study. A questionnaire about the emergency management of avulsed teeth was conducted on the students. Also, 250 medical students from 3rd grade were included in the study and trained. The questionnaire was applied twice, before and after the training on the subject. Results: The mean correct answer scores were similar among the medical students in different grades (p>0.05). There were no statistically significant differences between the trained medical students and clinical dental students' correct answer scores, but there was a significant difference between the pre-clinical (1st-2nd-3rd years) and clinical (4th-5th years) dental students (p<0.01). Conclusion: Medical and preclinical dental students had lack of knowledge about the emergency management of avulsed teeth, while clinical dental and trained medical students were very knowledgeable. This result indicates the importance of education (AU).

Retrospective Analysis of Dento-alveolar Injuries at a Swiss University Clinic (2011-2015).

The aim of this study was to evaluate all dento-alveolar injuries occurring within a period of 5 years that were examined at the Department of Oral Surgery and Stomatology at the University of Bern. The case histories of 852 patients (522 males and 330 females) were assessed retrospectively. The mean age was 17 years and 9 months. The youngest patient was 10 months old, the oldest was 91 years old. Most accidents were recorded in the months of March and July. Friday was observed as the weekday when accidents were at their peak. 54% of trauma patients were first examined on the day of the accident. The most frequent causes of accident were falls, cycling or sports accidents. Injury types included concussion (72.4%), subluxation (14%) and luxation (7.7%). Crown fractures without pulp exposure were recorded in 522 teeth (10.7%). Rare types of trauma were crown fractures with pulp exposure (3.7%), and avulsion injuries (3.2%). The most frequently affected teeth were central incisors (40%), followed by lateral incisors (35.6%) and canines (19.5%). 71.5% of the patients with dento-alveolar trauma also had soft-tissue injuries (from abrasions to lacerations), mostly lip (51.6%), gingival (19%), and chin injuries (10.9%). The multivariate analysis showed that age had a significant impact on concussions, subluxations, intrusions, crown fractures, root fractures and non-oral injuries. For concussions and subluxations, the probability of an injury was the highest for the mixed dentition group. For intrusions, the probability of an injury decreased with age, but it was vice versa for crown fractures, root fractures and non-oral injuries. It was found that bicycle injuries had the highest injury probability for avulsions, luxations, subluxations, soft tissue - and non-oral injuries.

Awareness and Preferred Mode of Getting Information on First Aid Management of Avulsed Permanent Teeth: Survey of Nigerian Mothers

ABSTRACT Objective: To determine the awareness and sources of information on first aid management of avulsed permanent teeth in a group of South-western Nigerian mothers. Material and Methods: An 18-item interviewer-administered questionnaire was used to survey 385 mothers attending the antenatal and immunization clinics on their perception towards dental avulsion, its management, sources, and preferred mode of receiving information on first aid. The effect of all significant factors was inferred at p<0.05. Results: Mothers who had previous information on the first aid management of dental avulsion had significantly higher knowledge (p=0.000). Majority (80.8%) of the mothers did not know that an avulsed permanent tooth could be replanted, though mothers whose children had not experienced dental trauma had significantly higher knowledge (p=0.003). The knowledge of first aid management of avulsed permanent tooth was low, regardless of age, education and employment status of the respondents. Conclusion: There was low knowledge among mothers regarding the first aid measures in the management of avulsed permanent teeth. Their main preference for receiving information was through social media and television. There is a need to increase oral health educational campaigns targeted towards mothers.

Traumatic dental injuries in the primary dentition - a review.

Traumatic oral injuries in children involve trauma to the dentition and the surrounding oral soft tissue structures. They usually present as an emergency hence their management poses a challenge globally. Treatment of a tooth fracture, displacement or loss is determined by the type and severity of the injury independent of the etiology. It necessitates the experience for behavior management in a child, ascertaining a patient centered diagnosis, formulating a definitive treatment plan, explanation and consent of oral care to the parents or carer with optimal operator skills. This article provides an overview on the types of oral injury in a child patient, their recognition, diagnosis and management based on credible, practical and readily understandable evidence.

Effect of First Aid Management of Dental Avulsion Posters on Primary School Teachers Knowledge

Abstract Objective: To investigate the effect of deploying a "First Aid Management of Dental Avulsion" poster in a primary school setting to improve teachers' knowledge. Material and Methods: The present study was conducted at public primary schools in central Jakarta, with 54 teachers meeting the inclusion criteria. The questionnaire contained 13 questions, divided into two sections. The first section consisted of questions about sex, age, education, length of service, field of education, and whether the teacher had received first aid management education before. The second section consisted of 7 questions about the teacher's knowledge regarding dental avulsion and its management. Baseline knowledge was defined by using a questionnaire and then teachers were shown the educational poster covering the first aid management of dental avulsion. Next, the teachers answered a post-education questionnaire, which included the same questions as the first questionnaire. A paired t-test or Wilcoxon's signed-rank test was used based on the distribution of data to determine the significance of the differences between before and after education. Results: The median score before reading the poster was 5, while the median score after reading it was 10. The difference was statistically significant. Conclusion: "First Aid Management of Dental Avulsion" poster could improve the knowledge of primary school teachers in Jakarta.

Dental Emergencies.

Dental emergencies present frequently to the emergency department and urgent care centers. Trauma to the teeth includes fractures, luxations, and avulsions, which can be reduced in most cases. Avulsed primary teeth should never be replaced. Mouthguards should be worn in most youth sports to prevent many dental injuries. Dental caries can progress to worsening infection and should be diagnosed and promptly referred. More severe infections may require antibiotics, imaging, or incision and drainage. Dental blocks can assist with analgesia and patient comfort during other procedures.

Guidelines for the Management of Traumatic Dental Injuries: 1. Fractures and Luxations of Permanent Teeth.

Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and followup are important for improving a favorable outcome. Guidelines should assist dentists and patients in decision making and for providing the best care effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members. The guidelines represent the best current evidence based on literature search and professional opinion. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented.

Guidelines for the Management of Traumatic Dental Injuries: 2. Avulsion of Permanent Teeth.

Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the task group. The guidelines represent the current best evidence and practice based on literature research and professionals' opinion. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate orurgent care of avulsed permanent teeth.

Guidelines for the Management of Traumatic Dental Injuries: 3. Injuries in the Primary Dentition.

Traumatic injuries to the primary dentition present special problems and the management is often different as compared with the permanent dentition. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialities were included in the task group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care for management of primary teeth injuries. The IADT cannot and does not guarantee favorable outcomes from strict adherence to the guidelines, but believe that their application can maximize the chances of a positive outcome.

Guidelines for the Management of Traumatic Dental Injuries: 1. Fractures and Luxations of Permanent Teeth.

Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and followup are important for improving a favorable outcome. Guidelines should assist dentists and patients in decision making and for providing the best care effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members. The guidelines represent the best current evidence based on literature search and professional opinion. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented.

Guidelines for the Management of Traumatic Dental Injuries: 2. Avulsion of Permanent Teeth.

Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the task group. The guidelines represent the current best evidence and practice based on literature research and professionals' opinion. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate orurgent care of avulsed permanent teeth.

Guidelines for the Management of Traumatic Dental Injuries: 3. Injuries in the Primary Dentition.

Traumatic injuries to the primary dentition present special problems and the management is often different as compared with the permanent dentition. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialities were included in the task group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care for management of primary teeth injuries. The IADT cannot and does not guarantee favorable outcomes from strict adherence to the guidelines, but believe that their application can maximize the chances of a positive outcome.

Adult Dental Trauma: What Should the Dental Practitioner Know?

The management of adult dental trauma can be a daunting challenge for practitioners at any level. Like medical emergencies, initial management can have a large influence on prognosis. It is important that practitioners understand the basic principles of managing the acute presentations of dental trauma. This article aims to illustrate a step-by-step approach in order to improve the management within general dental practice for better outcomes for patients.

Adult Dental Trauma: What Should the Dental Practitioner Know?

The management of adult dental trauma can be a daunting challenge for practitioners at any level. Like medical emergencies, initial management can have a large influence on prognosis. It is important that practitioners understand the basic principles of managing the acute presentations of dental trauma. This article aims to illustrate a step-by-step approach in order to improve the management within general dental practice for better outcomes for patients.

Traumatic injuries to athletes.

The timeliness of treatment after dental trauma is crucial to successful tooth preservation. This article focuses on the emergency treatment of common forms of dental trauma in athletes, both at the site of the injury and at the dental office. When dental injuries happen to young patients, saving the tooth is an absolute priority, because few long-term replacement solutions can be performed in a growing child. Preserving pulpal vitality of immature teeth is essential to allow continued root development.

Traumatic Intrusion of a Maxillary Canine Tooth: 3 Cases.

Of the six recognized types of tooth luxation injuries, intrusion generally carries the most guarded long-term prognosis due to the high risk of complications, including root resorption, ankylosis, marginal bone loss, and pulp canal obliteration or necrosis. The degree of traumatic intrusion and stage of root development affects the outcome and treatment planning. This report describes the clinical history, oral and radiographic examination findings, and rationale for surgical extraction in 2 dogs and 1 cat with traumatic intrusion of a maxillary canine tooth.

Traumatic displacement of a maxillary primary canine tooth into the middle nasal concha presenting as chronic facial pain: a case report.

The case of a 32-year-old woman who sustained a nasal bone fracture and dental trauma at the age of 9 is described in this article. Misdiagnosis of the dental displacement into the middle turbinate at the initial examination led to chronic facial pain. The cause of the pain was incorrectly diagnosed or misinterpreted by several medical specialists, including an otolaryngologist, neurologist, physiatrist, ophthalmologist, internist, radiologist, oral surgeon, dentist, and the patient's family physician. Finally, 23 years after the dental trauma, a multislice computed tomogram revealed that the primary maxillary canine was dislocated into the right middle nasal concha. The tooth, which had become embedded into necrotic, inflammatory tissue, was removed by endoscopic surgery, which resulted in full resolution of the patient's pain.

Dental problems in athletes.

Orofacial injuries and diseases occur in athletes, and they may not always have access to dentists. Therefore team physicians should be aware of the common injuries and initial management. Treatment of dental injuries will depend on whether the teeth are primary or permanent. The most common type of fracture is crown fracture, but there are other dental injuries that can lead to future complications if not treated promptly and monitored closely. Tooth avulsions need to be handled properly, and athletes should see a dentist as soon as possible. Despite the urgency of some injuries, other orofacial injuries or diseases, such as lacerations and caries, should not be overlooked. Proper education and use of mouth guards can assist athletes in reducing their risk of orofacial injuries.