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- Loss or fracture of a tooth and/or supporting bone and tissue due to trauma; can result in shifting of remaining teeth, loss of teeth, loss of alveolar bone, and displaced or nonunion of maxilla and/or mandible, resulting in functional and aesthetic deformities which can be difficult to correct
- It is not a disease but a consequence of a sudden, unexpected, circumstantial, accident, or impact injury.
- Systems affected: oral cavity, ENT
- Dental injuries constitute 5% of all injuries worldwide and as many as 17% in preschool children (1,2).
- 92% of oral injuries are tooth injuries, 28% have soft tissue injury, and 6% jaw fractures (2).
- More prevalent in high-risk populations: children, special needs/handicapped individuals, athletes, military personnel, elderly (2)
- Traumatic dental injuries can occur from malocclusion, falls, sports injuries, accidents, assault, dangerous environmental conditions, risk-taking behaviors, oral piercings, or a combination (2,3).
- Male > female (2:1) (3)
Etiology and Pathophysiology
Direct force sufficient to overcome the bond between the tooth and periodontal ligament within the alveolar socket or disruption of enamel and dentin and/or pulp; force against maxilla or mandibular arch great enough to cause fracture
- Physical and intellectual disabilities, any age (2)
- Contact sports without proper protective equipment (i.e., helmets, face guards, mouth guards)
- High-risk sports (e.g., football, boxing, wrestling, soccer, baseball, hockey, bicycling, skateboarding) (2)
- Age: youth <12 years (2)
- Tongue/mouth piercings (3)
- Prior dental trauma
- Male gender (1,2)
- Personal and social education aimed at prevention/early intervention (2,3)
- School policies against bullying and violence
- Mouth guards and helmets. Custom mouth guards are better than boil and bite guards which are better than stock guards (3).
- Avoid tongue and orofacial piercings.
- Wear seat belts.
- Physical environmental changes. Monitor home for slippery areas; childproof house with gates, pad sharp table edges (4,5)
Commonly Associated Conditions
- Tooth loss can cause loss of space in dental arch.
- Malocclusion causing functional problems; flared upper anterior teeth (3)
- Trauma to dentition resulting in pulpitis, which causes necrosis of the pulp
- Child or partner abuse: Be alert for history inconsistent with injuries (3,4).
- Contusion to temporomandibular joint
- Traumatic brain injury (2)