DENTAL TRAUMA - PRIMARY TEETH

Do not reimplant primary teeth (prevents secondary tooth development)
Most common injuries are loosening of teeth. Crown and root # are rare
Parents may be required to hold the child.
Consider any treatment of the primary teeth upon the permanent successor
Advise parents about 40% of trauma to primary dentition will damage permanent successor. It depends on developing stages of the permanent tooth
Splinting primary teeth is extremely difficult (if in doubt extract the tooth)
Refer to dental surgeon for full assessment

Injury	Definition	Management
Concussion	Injury to supporting tissues of the tooth, without displacement	Reassurance and soft diet
Subluxation (Most common)	Partial displacement, loosening of a tooth without displacement	Extract (if tooth near exfoliation) Soft diet (1 week)
Luxation	Displacement of tooth (laterally, labially, or palatally)	Extract (If tooth at risk of being aspirated, interferes with occlusion or displaced forward risking damage to underlying permanent tooth) Soft diet (1 week)
Intrusion	Displacement of tooth into its socket (often accompanied by # of alveolar bone)	Extract (if OPG shows tooth has been forced into the permanent tooth follicle)
Extrusion	Partial displacement of tooth out of its socket	Extract (if > 1 -2 mm)

FRACTURES

Crown # (Rare)	Refer to dental surgeon
Root #	Extract (If crown is displaced or loose) Soft diet and refer to dental surgeon

Dr George Chu BDSc MBBS
Ed: Dr. Derek Louey MBBS FACEM