The document discusses traumatic injuries to primary teeth. It notes that 31-40% of boys and 16-30% of girls will suffer some dental trauma by age 5. The maxillary anteriors are most commonly affected and concussions, subluxations and luxations are the most common injuries. Trauma is typically caused by falls during play as young children have incomplete coordination. Predisposing factors include protruding upper incisors and insufficient lip closure. The document outlines the different types of injuries to the tooth, periodontal tissues, supporting bone, gingiva and oral mucosa that can occur. It provides details on the dental and medical history that should be obtained and examinations that should be performed when evaluating a traum

1. TRAUMATIC INJURIES TO PRIMARY TEETH
By
Dr. Sumaiya Hassan
(MDS trainee – Department of Operative
Dentistry)
(DIDC – DUHS)

2. Epidemiology of Dental Trauma
• At 5 years, 31-40 % boys and 16-30 % girls will have suffered some dental
trauma.
• At 12 years, 12-33 % boys and 4-19 girls will have suffered some dental
trauma.
• Boys affected twice as often as girls.
• Maxillary anteriors are the most affected teeth.
• Concussions, subluxation and luxation are the commonest injuries in
primary dentition.

3. Etiology of Dental Trauma
• In primary teeth: Incompletely developed coordination leading to fall
in and around home.
• In permanent teeth: Falls and collisions during outdoor activities.
• Examples: Sports injuries, road traffic accidents, child abuse
• Types: Direct trauma, indirect trauma

4. Predisposing factors
• Protruded upper incisors
• Insufficient lip closure

5. Injuries To The Tooth
• Enamel infarction
• Enamel fracture
• Enamel – dentine fracture
• Complicated crown fracture
• Uncomplicated crown – root fracture
• Complicated crown root fracture
• Root fracture

6. Injuries To The Periodontal Tissues
• Concussion
• Subluxation
• Extrusive luxation
• Lateral luxation
• Intrusive luxation
• Avulsion

7. Injuries To The Supporting Bone
• Comminution of socket wall
• Fracture of socket wall
• Fracture of alveolar process
• Fracture of jaw bones

8. Injuries To Gingiva And Oral Mucosa
• Laceration
• Contusion
• Abrasion

9. Dental And Medical History
• When, where, how?
• Lost teeth fragments?
• Headache, vomiting, amnesia?
•Bleeding disorders?
• Drug allergies?
• Tetanus immunization status?
• Rheumatic fever?

10. Extraoral Examination
• General examination (look for signs of shock e.g. pallor, cold skin,
irregular pulse, hypotension)
• Facial swelling, bruises, lacerations
• Limitation of mandibular movement or mandibular deviation

11. Intraoral Examination
• Inspection (Laceration, abrasion, lip swelling, occlusal abnormality,
fractured or cracked crowns, tooth color change)
• Palpation (mobility of tooth or alveolar process)
• Percussion ( dull note?)

12. Treatment Of Traumatized Primary Teeth
Uncomplicated crown fracture
Complicated crown fracture
Crown – root fracture
Root fracture
Concussion
Subluxation
Extrusive luxation
Enameloplasty, restoration
Pulpectomy, obturation with ZnO/ Eugenol;
extraction
Extraction
Remove coronal necrotic fragment
Occlusal relief, analgesics
Soft diet, follow up; extraction
Extraction
Intrusive luxation Palatal displacement  extraction; buccal
displacement followup for spontaneous
reeruption
Avulsion No treatment (No replantation, no space mantainer)