Sir, most teenagers are inseparable from their smartphones and dropping one certainly would be a disaster. A 17-year-old female presented for a second opinion complaining of persistent painful symptoms associated with a traumatised upper central incisor.

Clinical examination revealed a repaired incisal edge to 11 with visible fracture lines to the coronal enamel extending toward the root surface. Sensitivity testing was hyper-responsive to both ethyl chloride and electric pulp testing. Digital pressure to the tooth yielded a painful response to lateral forces. Radiographs showed an oblique root fracture in the mid to apical third of the root. A diagnosis was made of complicated crown and root fracture and irreversible pulpitis. The extent of this injury we found to be surprising given the description of the injury by the patient being the result of her rapidly turning her head to engage in conversation and hitting her tooth against the side of the phone being held by her boyfriend.

The tooth was considered to be of poor long-term prognosis but an initial decision was made to attempt root canal therapy to maintain bone and crucially soft tissues over the medium term. Unfortunately, symptoms did not resolve following pulp extirpation and subsequent redressing of the root canal system on multiple occasions. In view of the complexity of the fracture and ongoing symptoms the patient ultimately requested extraction. An immediate denture has been provided with a view to longer term options in the near future.

With the ever increasing use of smartphones in society with the trend for 'selfies' we wonder whether these devices will become a more prevalent factor to be considered in dental trauma.

1. Newcastle