Oral surgery II: Part 1. Acute management of dentoalveolar trauma

Key Points

  • The management of injuries is based on fast and accurate diagnosis.

  • General dental practitioners are likely to encounter traumatic injuries at any time.

  • This article acts as an aide-memoire for use in the acute setting to ensure that the correct initial management is carried out, thus ensuring the best possible long-term prognosis.


The aesthetics of the mouth are important in determining overall facial attractiveness. People with a relatively normal dental appearance are perceived as more attractive, more intelligent and more desirable as friends.1 Although the oral region comprises only 1% of the body area it accounts for 5% of all bodily injuries, and of facial injuries, dental injuries are the most common.2 A US survey among people aged 6-50 years showed that 1 in 4 had evidence of dental trauma.3

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5: (a) Extrusive luxation of tooth 21 on the day of injury; (b) Lateral luxation of teeth 11 and 21 presenting 1 day after injury; (c) Intrusive luxation of tooth 11 presenting 3 weeks after injury.
Figure 6
Figure 7
Figure 9
Figure 10
Figure 11


  1. 1

    Andreasen J O, Andreasen F, Andreasen L . Textbook and colour atlas of traumatic dental injuries to the teeth. 4th ed. pp. 197–206. Oxford: Munksgaard, 2007.

    Google Scholar 

  2. 2

    Petersson E E, Andreasen L, Sorensen S . Traumatic oral vs non-oral injuries. Swed Dent J 1997; 21: 55–68.

    PubMed  Google Scholar 

  3. 3

    Kaste L M, Gift H C, Bhat M, Swango P A . Prevalence of incisor trauma in persons 6 to 50 years of age: United States, 1988-1991. J Dent Res 1996; 75: 696–705.

    Article  Google Scholar 

  4. 4

    Andreasen J O . Aetiology and pathogenesis of traumatic dental injuries. A clinical study of 1298 cases. Scand J Dent Res 1970; 78: 339–342.

    Google Scholar 

  5. 5

    Office of National Statistics. Children's dental health in the United Kingdom, 2003. http://www.ons.gov.uk/ons/guide-method/method-quality/specific/health-methodology/dental-health/dental-health-of-children. ONS, 2008 (accessed 25 November 2014).

  6. 6

    Schendel K U, Schwartz O, Andreasen J O, Hoffmeister B . Reinnervation of autotransplanted teeth. A histological investigation in monkeys. Int J Oral Maxillofac Surg 1990; 19: 247–249.

    Article  Google Scholar 

  7. 7

    Cvek M, Granath L, Cleaton-Jones P, Austin J . Hard tissue barrier formation in pulpotomized monkey teeth capped with cyanoacrylate or calcium hydroxide for 10 and 60 minutes. J Dent Res 1987; 66: 1166–1174.

    Article  Google Scholar 

  8. 8

    Bender I B, Freidland J B . Clinical considerations in the diagnosis and treatment of intra-alveolar root fractures. J Am Dent Assoc 1983; 107: 595–600.

    Article  Google Scholar 

  9. 9

    Flores M T, Andersson L, Andreasen J O et al. Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth. Dent Traumatol 2007; 23: 66–71.

    Article  Google Scholar 

  10. 10

    Flores M T, Andersson L, Andreasen J O et al. Guidelines for the management of traumatic dental injuries. II. Avulsion of permanent teeth. Dent Traumatol 2007; 23: 130–136.

    Article  Google Scholar 

  11. 11

    Andreasen J O . Fractures of the alveolar process of the jaw. A clinical and radiographic follow-up study. Scand J Dent Res 1970; 78: 263–272.

    PubMed  Google Scholar 

  12. 12

    Cvek M . A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture. J Endodont 1978; 8: 232–237.

    Article  Google Scholar 

  13. 13

    Oikarinen K, Lahti J, Raustia A M . Prognosis of permanent teeth in the line of mandibular fractures. Endod Dent Traumatol 1990; 6: 177–182.

    Article  Google Scholar 

  14. 14

    Glendor U, Halling A, Andersson L, Eilert-Petersson E. Incidence of traumatic tooth injuries in children and adolescents in the county of Västmanland, Sweden. Swed Dent J 1996; 20: 15–28.

    PubMed  Google Scholar 

  15. 15

    Jagger R G, Milward P J . The bimaxillary mouthguard. Br Dent J 1995; 178: 31–32.

    Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to H. Tagar.

Additional information

Refereed Paper

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Tagar, H., Djemal, S. Oral surgery II: Part 1. Acute management of dentoalveolar trauma. Br Dent J 223, 407–416 (2017). https://doi.org/10.1038/sj.bdj.2017.805

Download citation

Further reading