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Dental Trauma

Sheila O. Stille, DMD and Hugh Silk, MD, MPH, FAAFP Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Loss or fracture of a tooth and/or supporting bone and tissue due to trauma; can result in shifting of remaining teeth, loss of teeth, loss of alveolar bone, and displaced or nonunio...

DIAGNOSIS

HISTORY

  • Assess airway, breathing, and circulation (ABC).

  • Determine mechanism of injury, time of injury; associated injuries

  • Multiple fracture and luxation types that result in different healing...

TREATMENT

ABC and neurologic exam for associated problems 

GENERAL MEASURES

  • Primary goal of reimplantation/repositioning is to protect periodontal ligament; tooth pulp may die, but tooth can be treated ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Follow up with dentist or oral surgeon within 24 hours of any dental trauma. 
  • Restrict use of pacifiers if dental injuries are involved.

  • Ellis III fractures in chil...

REFERENCES

1
Kenny KP, Day PF, Sharif MO, et al. What are the important outcomes in traumatic dental injuries? An international approach to the development of a core outcome set. Dent Traumatol.  ...

ADDITIONAL READING

  • Clark MB, Douglass AB, Maier R, et al. Smiles for Life: A National Oral Health Curriculum. 3rd ed. Leawood, KS: Society of Teachers of Family Medicine; 2010. www.smilesforlifeoral...

CODES

ICD10

  • S02.5XXA Fracture of tooth (traumatic), init for clos fx

  • S02.5XXB Fracture of tooth (traumatic), init encntr for open fracture

  • K08.119 Complete loss of teeth due to trauma, unspecified class

  • S...

CLINICAL PEARLS

  • Do not reimplant primary teeth.

  • Avulsed permanent teeth represent a medical emergency. Reimplant permanent teeth ASAP.

  • Milk is the best (widely available) transport medium; Hank solution...

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