Dental injuries

Dental injuries

The first permanent teeth usually erupt around the age of 6 /uni00A0 years; usually lower incisors are followed by upper incisors. Between the ages of 6 and 13, the primary (deciduous) denti tion is expected to be exfoliated and replaced by permanent (adult) teeth. Fractures of the teeth may involve enamel only or enamel in combination with dentine with or without pulp exposure. Exposed dentine and pulp can be exquisitely painful and may benefit from a simple temporary dental dressing. Avulsed primary teeth should not be reimplanted. Avulsed adult teeth are best reimplanted into the socket immediately after the injur y . However, this is generally not possible during prehospital care , and therefore the tooth should ideally be stored in a suitable medium such as milk, saliva or normal saline until expertise is available. The reimplanted tooth needs to be splinted to other teeth with wire and a composite resin material for 2 weeks (sometimes a custom-made splint can be made instead), and the patient treated with antibiotics, ed by - - chlorhexidine mouthwash and a tetanus vaccine booster as appropriate. Adult luxated (displaced) teeth mostly require repositing and splinting for 4 weeks. A dentoalveolar fracture (part of the jawbone that includes the teeth) is repositioned and supported with a dental splint for 4 weeks. Luxated primary teeth are generally tr eated conservatively , or extracted if they are inter - fering with occlusion. All dental injuries should be followed up by a dentist for splint removal or monitoring and dental treatment as appro - priate. Summary box 31.12 - Dental injuries /uni25CF /uni25CF /uni25CF

Figure 31.18 A three-dimensional reformatted CT scan demonstrat

ing extensive midface and mandibular fractures (endotracheal and intracranial pressure tubes in situ ). It is important to account for all missing teeth and/or dental fragments – a chest radiograph may be indicated An avulsed adult tooth should be reimplanted into the socket as soon as possible or stored in milk, saliva or normal saline All dental injuries should be followed up by a dentist

Dental injuries

The first permanent teeth usually erupt around the age of 6 /uni00A0 years; usually lower incisors are followed by upper incisors. Between the ages of 6 and 13, the primary (deciduous) denti tion is expected to be exfoliated and replaced by permanent (adult) teeth. Fractures of the teeth may involve enamel only or enamel in combination with dentine with or without pulp exposure. Exposed dentine and pulp can be exquisitely painful and may benefit from a simple temporary dental dressing. Avulsed primary teeth should not be reimplanted. Avulsed adult teeth are best reimplanted into the socket immediately after the injur y . However, this is generally not possible during prehospital care , and therefore the tooth should ideally be stored in a suitable medium such as milk, saliva or normal saline until expertise is available. The reimplanted tooth needs to be splinted to other teeth with wire and a composite resin material for 2 weeks (sometimes a custom-made splint can be made instead), and the patient treated with antibiotics, ed by - - chlorhexidine mouthwash and a tetanus vaccine booster as appropriate. Adult luxated (displaced) teeth mostly require repositing and splinting for 4 weeks. A dentoalveolar fracture (part of the jawbone that includes the teeth) is repositioned and supported with a dental splint for 4 weeks. Luxated primary teeth are generally tr eated conservatively , or extracted if they are inter - fering with occlusion. All dental injuries should be followed up by a dentist for splint removal or monitoring and dental treatment as appro - priate. Summary box 31.12 - Dental injuries /uni25CF /uni25CF /uni25CF

Figure 31.18 A three-dimensional reformatted CT scan demonstrat

ing extensive midface and mandibular fractures (endotracheal and intracranial pressure tubes in situ ). It is important to account for all missing teeth and/or dental fragments – a chest radiograph may be indicated An avulsed adult tooth should be reimplanted into the socket as soon as possible or stored in milk, saliva or normal saline All dental injuries should be followed up by a dentist

Dental injuries

The first permanent teeth usually erupt around the age of 6 /uni00A0 years; usually lower incisors are followed by upper incisors. Between the ages of 6 and 13, the primary (deciduous) denti tion is expected to be exfoliated and replaced by permanent (adult) teeth. Fractures of the teeth may involve enamel only or enamel in combination with dentine with or without pulp exposure. Exposed dentine and pulp can be exquisitely painful and may benefit from a simple temporary dental dressing. Avulsed primary teeth should not be reimplanted. Avulsed adult teeth are best reimplanted into the socket immediately after the injur y . However, this is generally not possible during prehospital care , and therefore the tooth should ideally be stored in a suitable medium such as milk, saliva or normal saline until expertise is available. The reimplanted tooth needs to be splinted to other teeth with wire and a composite resin material for 2 weeks (sometimes a custom-made splint can be made instead), and the patient treated with antibiotics, ed by - - chlorhexidine mouthwash and a tetanus vaccine booster as appropriate. Adult luxated (displaced) teeth mostly require repositing and splinting for 4 weeks. A dentoalveolar fracture (part of the jawbone that includes the teeth) is repositioned and supported with a dental splint for 4 weeks. Luxated primary teeth are generally tr eated conservatively , or extracted if they are inter - fering with occlusion. All dental injuries should be followed up by a dentist for splint removal or monitoring and dental treatment as appro - priate. Summary box 31.12 - Dental injuries /uni25CF /uni25CF /uni25CF

Figure 31.18 A three-dimensional reformatted CT scan demonstrat

ing extensive midface and mandibular fractures (endotracheal and intracranial pressure tubes in situ ). It is important to account for all missing teeth and/or dental fragments – a chest radiograph may be indicated An avulsed adult tooth should be reimplanted into the socket as soon as possible or stored in milk, saliva or normal saline All dental injuries should be followed up by a dentist