Dental trauma
Encyclopedia
Dental trauma refers to trauma
to the face
, mouth
, and especially the teeth lips and periodontium
. The study of dental trauma is called dental traumatology.
during sports and other high-risk activities (such as military trainings) are the most effective prevention for dental trauma. However, studies in various high risk populations for dental
injuries are repeatedly reporting of a low compliance
of individuals for the regular using of mouthguard during activities. Moreover, even with regular use, effectiveness in prevention on dental injuries is not complete, and injuries can still occur even when mouthguards are used as users are not always aware of the best makes or size, which inevitably result in a poor fit.
, requiring root canal treatment
or tooth extraction. However, recommended in all dental traumas are good oral hygiene
with 0.12% chlorhexidine gluconate
mouthwash
, a soft and cold diet, and avoidance of smoking
for several days. When the injured teeth are painful
with function due to damage to the periodontal ligament
s (e.g., dental subluxation
), a temporary splinting of the injured teeth may relief the pain
and enhance eating ability.
Avulsed
permanent tooth should be gently rinse under tap water and immediately re-planted
in its original socket within the alveolar bone and later temporarily splinted by a dentist
. Failure to re-planted the avulsed tooth within the first 40 minutes after the injury may resulted in very poor prognosis for the tooth.
Management of injured primary teeth differs from management of permanent teeth; avulsed primary tooth should not be re-planted (to avoid damage to the permanent dental crypt).
Physical trauma
Trauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death...
to the face
Face
The face is a central sense organ complex, for those animals that have one, normally on the ventral surface of the head, and can, depending on the definition in the human case, include the hair, forehead, eyebrow, eyelashes, eyes, nose, ears, cheeks, mouth, lips, philtrum, temple, teeth, skin, and...
, mouth
Mouth
The mouth is the first portion of the alimentary canal that receives food andsaliva. The oral mucosa is the mucous membrane epithelium lining the inside of the mouth....
, and especially the teeth lips and periodontium
Periodontium
Periodontium refers to the specialized tissues that both surround and support the teeth, maintaining them in the maxillary and mandibular bones. The word comes from the Greek terms peri-, meaning "around" and -odons, meaning "tooth." Literally taken, it means that which is "around the tooth"...
. The study of dental trauma is called dental traumatology.
Types
- Tooth fractures
- Enamel infractionEnamel infractionEnamel infractions are microcracks seen within the dental enamel of a tooth. They are commonly the result of dental trauma to the brittle enamel, which remains adherent to the underlying dentine...
- Enamel fracture
- Enamel-dentine fracture
- Complex fracture of tooth
- Root fracture of tooth
- Enamel infraction
- Injuries of the periodontal apparatus
- SubluxationDental subluxationDental subluxation is an traumatic injury in which the tooth has increased mobility but hasnot been displaced from its original site in the jawbone.- Prevalence :This is a quite common condition and one of the commonest dental traumatic disorders...
of the tooth - Luxation of the tooth
- IntrusionIntrusionAn intrusion is liquid rock that forms under Earth's surface. Magma from under the surface is slowly pushed up from deep within the earth into any cracks or spaces it can find, sometimes pushing existing country rock out of the way, a process that can take millions of years. As the rock slowly...
of the tooth - AvulsionDental avulsionDental avulsion is the complete displacement of a tooth from its socket in alveolar bone owing to trauma.-Management:Dental avulsion is a real dental emergency in which prompt management effects the prognosis of the tooth...
of the tooth
- Subluxation
- Soft tissue laceration, most commonly the lipLipLips are a visible body part at the mouth of humans and many animals. Lips are soft, movable, and serve as the opening for food intake and in the articulation of sound and speech...
s and the gingivaGingivaThe gingiva , or gums, consists of the mucosal tissue that lies over the mandible and maxilla inside the mouth.-General description:...
.
Risk factors
- Young children
- Sports, especially contact sports
- PiercingBody piercingBody piercing, a form of body modification, is the practice of puncturing or cutting a part of the human body, creating an opening in which jewelry may be worn. The word piercing can refer to the act or practice of body piercing, or to an opening in the body created by this act or practice...
in tongueTongue piercingA tongue piercing is a body piercing usually done directly through the center of the tongue, and is the most popular piercing site in the western world after the ear and nostril.-History and culture:...
and lipsLip piercingA lip piercing is a type of body piercing that penetrates the lips or the area surrounding the lips, which can be pierced in a variety of ways.Approximate healing times for most lip piercings are between 1 to 2 months, however there is a possibility of serious infections developing if the piercing... - MilitaryMilitaryA military is an organization authorized by its greater society to use lethal force, usually including use of weapons, in defending its country by combating actual or perceived threats. The military may have additional functions of use to its greater society, such as advancing a political agenda e.g...
trainings - Acute changes in barometric pressure, i.e. dental barotraumaDental barotraumaDental barotrauma is a condition in which barometric pressure changes in the external environment cause damage to the dentition. The problem can occur owing to a miniature void within a filled tooth. It is technically difficult to completely prevent void spaces occurring when placing a filling and...
, which can affect scubaScuba divingScuba diving is a form of underwater diving in which a diver uses a scuba set to breathe underwater....
diversUnderwater divingUnderwater diving is the practice of going underwater, either with breathing apparatus or by breath-holding .Recreational diving is a popular activity...
and aviatorAviatorAn aviator is a person who flies an aircraft. The first recorded use of the term was in 1887, as a variation of 'aviation', from the Latin avis , coined in 1863 by G. de la Landelle in Aviation Ou Navigation Aérienne...
s - Class II malocclusionMalocclusionA malocclusion is a misalignment of teeth or incorrect relation between the teeth of the two dental arches. The term was coined by Edward Angle, the "father of modern orthodontics", as a derivative of occlusion, which refers to the manner in which opposing teeth meet.-Presentation:Most people have...
Prevention
A regular use in mouthguardMouthguard
A mouthguard is a protective device for the mouth that covers the teeth and gums to prevent and reduce injury to the teeth, arches, lips and gums...
during sports and other high-risk activities (such as military trainings) are the most effective prevention for dental trauma. However, studies in various high risk populations for dental
Dental
The word dental is used for things pertaining to teeth and could refer to:* Dentistry, a medical profession**Dental Auxiliary*** Dental hygienist, a licensed practitioner*** Dental technician...
injuries are repeatedly reporting of a low compliance
Compliance
Compliance can mean:*In mechanical science, the inverse of stiffness*Compliance , a patient's adherence to a recommended course of treatment...
of individuals for the regular using of mouthguard during activities. Moreover, even with regular use, effectiveness in prevention on dental injuries is not complete, and injuries can still occur even when mouthguards are used as users are not always aware of the best makes or size, which inevitably result in a poor fit.
Management
The sequelae of dental trauma can be serious and can involve pulp necrosisNecrotic pulp
Necrotic pulp is a finding in dentistry to describe dental pulp within a tooth which has become necrotic. It is a finding of interest to dentists as the process of pulp death may be painful causing a toothache....
, requiring root canal treatment
Endodontic therapy
Endodontic therapy is a sequence of treatment for the pulp of a tooth which results in the elimination of infection and protection of the decontaminated tooth from future microbial invasion...
or tooth extraction. However, recommended in all dental traumas are good oral hygiene
Oral hygiene
Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities , gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened...
with 0.12% chlorhexidine gluconate
Chlorhexidine gluconate
Chlorhexidine is a chemical antiseptic. It is effective on both Gram-positive and Gram-negative bacteria, although it is less effective with some Gram-negative bacteria. It has both bactericidal and bacteriostatic mechanisms of action, the mechanism of action being membrane disruption, not ATPase...
mouthwash
Mouthwash
Mouthwash or mouth rinse is a product used to enhance oral hygiene. Some manufacturers of mouthwash claim that antiseptic and anti-plaque mouth rinse kill the bacterial plaque causing cavities, gingivitis, and bad breath. Anti-cavity mouth rinse uses fluoride to protect against tooth decay...
, a soft and cold diet, and avoidance of smoking
Smoking
Smoking is a practice in which a substance, most commonly tobacco or cannabis, is burned and the smoke is tasted or inhaled. This is primarily practised as a route of administration for recreational drug use, as combustion releases the active substances in drugs such as nicotine and makes them...
for several days. When the injured teeth are painful
Toothache
A toothache, also known as odontalgia or, less frequently, as odontalgy, is an aching pain in or around a tooth.-Causes:* Dental etiology, In most cases toothaches are caused by problems in the tooth or jaw, such as** Dental caries...
with function due to damage to the periodontal ligament
Periodontal ligament
The periodontal fiber or periodontal ligament, commonly abbreviated as the PDL, is a group of specialized connective tissue fibers that essentially attach a tooth to the alveolar bone within which it sits...
s (e.g., dental subluxation
Dental subluxation
Dental subluxation is an traumatic injury in which the tooth has increased mobility but hasnot been displaced from its original site in the jawbone.- Prevalence :This is a quite common condition and one of the commonest dental traumatic disorders...
), a temporary splinting of the injured teeth may relief the pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
and enhance eating ability.
Avulsed
Dental avulsion
Dental avulsion is the complete displacement of a tooth from its socket in alveolar bone owing to trauma.-Management:Dental avulsion is a real dental emergency in which prompt management effects the prognosis of the tooth...
permanent tooth should be gently rinse under tap water and immediately re-planted
Treatment of knocked-out (avulsed) teeth
The Treatment of knocked-out teeth consists of replantation, immediately if possible.Immediate replantation insures the best possible prognosis but is not always possible since more serious injuries may be present...
in its original socket within the alveolar bone and later temporarily splinted by a dentist
Dentist
A dentist, also known as a 'dental surgeon', is a doctor that specializes in the diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aides in providing oral health services...
. Failure to re-planted the avulsed tooth within the first 40 minutes after the injury may resulted in very poor prognosis for the tooth.
Management of injured primary teeth differs from management of permanent teeth; avulsed primary tooth should not be re-planted (to avoid damage to the permanent dental crypt).