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Tips for managing primary dental trauma

BDJ Student (2023)Cite this article

Oral injuries account for 18% of all injuries suffered by 0-6 year olds, with traumatic dental injuries (TDI) being the most common type of oral injury.1 The immediate management of dental trauma can be stressful for clinicians and upsetting for parents and patients, therefore it is essential that examination and treatment are efficient.

  1. 1.

    Get the full story: Establishing an accurate history is essential. You must ascertain how, when and where the TDI occurred and if anyone witnessed the incident.

  2. 2.

    Head injuries: It is also important to check that the child did not sustain a head injury at the time of the accident. Common symptoms of head injury can include loss of consciousness, confusion, vomiting or visual disturbances. If you have any suspicion that the child may have had a head injury it is important to directly refer them to paediatric emergency services for review by a medical professional.

  3. 3.

    Medical history: The child's medical history should be recorded and may contribute to future treatment planning or may give an indication of how likely a child would be able to tolerate treatment or predict likelihood of repeated TDIs. You should also establish if the child has had a tetanus vaccination and if there are concerns of contamination you should direct them toward to an urgent care centre.

  4. 4.

    Safeguarding: Take some time to consider if the mechanism of injury matches the history given. If you have any concerns that the child may have suffered a non-accidental injury, escalate your concerns to a senior for a second opinion and document your findings clearly. If there is suspicion of non-accidental injury, then it may trigger safeguarding concerns and it is important for you to be familiar with the protocol followed at your institution.

    Young children can be distressed and in pain following a TDI. It is important to explain the examination process to the parent prior to starting.

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References

  1. Day P F, Flores, M T, O'Connell A C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dent Traumatol 2020; 36: 343-359.

  2. Dental Trauma Guide. Dental Trauma Guide - evidence based treatment guide. 2022. Online information available at:https://dentaltraumaguide.org/ Accessed August 2022.

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Authors and Affiliations

  1. St Thomas´ Hospital, London, United Kingdom

    Rachael O´Rorke & Nabina Bhujel

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  1. Rachael O´Rorke
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  2. Nabina Bhujel
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Correspondence to Rachael O´Rorke.

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O´Rorke, R., Bhujel, N. Tips for managing primary dental trauma. BDJ Student (2023). https://doi.org/10.1038/s41406-023-0938-6

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  • DOI: https://doi.org/10.1038/s41406-023-0938-6

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