Clinical practice - Dental trauma

Approximately 50% of children under the age of 15 are victims of various kinds of injuries in the orofacial region. Post-traumatic complications may occur, including crown discolouration, cervical root fracture, ankylosis, root resorption and tooth loss. The most severe complication after dental injury in primary dentition can affect the developing permanent tooth germ, and various consequences may be seen several years later when the permanent tooth erupts. In the permanent dentition, the most severe dental injury affects the surrounding alveolar bone structure and will lead to loss of the tooth. Current literature emphasises that awareness of appropriate triage procedures following dental trauma is unsatisfactory and that delay in treatment is the single most influential factor affecting prognosis. What should a paediatrician know, and more importantly, how should he/she advise parents and caretakers? In an emergency situation such as tooth avulsion, reimplantation within 30 min is the best treatment option at the site of the accident. If reimplantation of the tooth is impossible, milk, saline or even saliva are the preferred transport media. The prognosis for an avulsed tooth depends upon prompt care, which is a determinant factor for successful treatment of the traumatised tooth. In all other dental trauma cases, it is important to refer the child to a paediatric dentist, to follow up the healing process and reduce late post-traumatic complications. With timely interventions and appropriate treatment, the prognosis for healing following most dental injuries is good. In conclusion, it is important that paediatricians are able to inform parents and caretakers about all possible and long-lasting consequences of different dental injuries.