Assessment and Prevention Of Traumatic Injuries Notes

Assessment Of Traumatic Injuries

Patient’s History

• Medical
• Dental
• Injury
  • How injury occurred
  • Where injury occurred
  • When the injury occurred.

Read And Learn More: Endodontics Notes

Check if Present and Describe

• Loss of consciousness
• Orientation to person, place, and time
• Hemorrhage/bleeding from nose/ears/oral cavity
• Nausea
• Vomiting
• Headache
• Amnesia
• Spontaneous dental pain
• Pain on medication

Extraoral Examination

• Abrasions/contusions/lacerations/ecchymosis
• Asymmetry
• Bones
  • Mobility
  • Crepitus
  • Tenderness
• Swelling
• Hemorrhage
• Presence of foreign bodies
• Check whether any injury to lips, cheeks, nose, ear, and eyes

TMJ Assessment

• Deviation
• Tender on palpation
• Intraoral opening whether restricted or not
• Deflection
• Pain on opening

Intraoral Examination (Check Any Injury Present)

• Buccal mucosa
• Gingiva
• Tongue
• The floor of the mouth
• Palate
• Periodontal status

Occlusion

• Classifiation
• Molar
• Canine
  • Overjet
  • Overbite
• Crossbite; deviation
• Teeth
• Color
• Mobility (mm)
• Pain
  • On percussion
  • Response to cold
  • On biting
• Pulp testing
  • Electrical
  • Thermal
• Pulp exposure
• Size
• Appearance
• Infraction
• Crown fracture/root fracture
• Luxation
  • Direction
  • Extent
• Avulsion
  • Extraoral time
  • Storage medium
• Carries/previous restorations

Radiograph

• Pulp size
• Periodontal ligament space
• Crown/root fracture
• Periapical pathology
• Alveolar fracture
• Foreign body

Photographs

Treatment

• Repositioning and stabilization
• Soft tissue management
• Pulp therapy
• Medications
• Instructions
  • Follow-up
  • Diet
  • Medicines
  • Complications

Prevention Of Traumatic Injuries

Children with untreated trauma to permanent teeth often exhibit greater impacts on their daily living than those without any traumatic injury. The incidence of dental and orofacial trauma is more in sports affecting the upper lip, maxilla, and maxillary incisors. The use of a mouth guard may protect the upper incisors.

However, studies have shown that even with a mouth guard in place, 25%of dentoalveolar injuries still occur. A dental expert may be able to alter certain risk factors such as the patient’s dental anatomy and occlusion. The frequency of dental trauma is significantly higher for children with increased overjet and insufficient lip coverage.

Instigating preventive orthodontic treatment in early to mixed dentition of patients with an overjet >3 mm has been shown to prevent traumatic injuries to permanent incisors. Although some sports-related traumatic injuries are unavoidable, most can be prevented by means of helmets, face masks, and mouth guards. These appliances reduce both the frequency and severity of dental and orofacial trauma.

The mouth guard has been used as a protective device in sports like boxing, soccer, wrestling, and basketball. The mouth guard also referred to as a gum shield or mouth protector, is “a resilient device or appliance placed inside the mouth to reduce oral injuries, particularly to teeth and surrounding structures.”

Functions of Mouth Guard

• Protect the lips and intraoral structures from bruising and laceration
• Act as a cushion and distribute forces so that crown fractures, root fractures, luxation, and avulsions are avoided
• Protect jaw from fracture and dislocation of the mandible
• Protect against neck injuries
• Provide support for edentulous space
• Prevent the teeth in opposing arches from violent contact