Tooth Injuries in the Emergency Department

ABSTRACT

PURPOSE: Tooth injuries are common complaints presenting at emergency departments, so emergency physicians (EP) should play an important role in the initial care of dental trauma. However, there has been little interest in and research on this subject. Examining the various clinical factors helpful for the emergency physician's care of tooth injuries, we attempted to acquire basic data for establishing treatment guideline. METHODS: A retrospective analysis was done by reviewing the dental charts of 214 patients who presented to the emergency departments of one secondary hospital and one tertiary hospital following tooth injuries during a 1-year period (Oct. 2000-Sept. 2001). The following variables were extracted and examined: age, mechanism of injury, number and location of injured teeth, radiograph performance, diagnosis, type of treatment. RESULTS: With the 1992-WHO classification, 9 types of tooth injuries were found (multiple response): in adults, concussion (23.5% of cases), subluxation (16.7%), pulp-exposed crown fracture (16.7%), avulsion (10.8%), and non-pulpexposed crown fracture(15.7%); in children, subluxation (20.2%), luxation (17.2%), avulsion (17.2%), and concussion (11.1%), Seven types of treatment were performed based on single most difficult treatment recorded per patient: 91 conservative cares (42.5% of cases), 9 pulp cappings (4.2%), 49 splints (22.9%), 7 replantations (3.3%), 17 pulpectomies (7.9%), 30 extractions (14.0%), and 10 others. CONCLUSION: Considering that the most prevalent treatments were splints and conservative cares, we think emergency medicine could play a wide role in the initial management of tooth injuries and suggest a further co-study with a dentist.