An audit of the time to initial treatment in avulsion injuries

Abstract –  The prognosis of avulsed teeth depends on prompt and appropriate treatment. Good outcome requires education of the general public and non-dental professionals. Aim:  Retrospective observational survey of case records of avulsion injuries attending a dental hospital trauma clinic. Method:  Data collected included: hospital number, date of birth, gender, source of patient’s referral, date of trauma, number of avulsed teeth, place of initial presentation, storage, hours till initial presentation, and initial treatment. Results:  One hundred and twenty teeth with avulsion were identified in 75 children. The mean age of the patients was 9.8 years (SD = 2.3 years) at the time of trauma with avulsions recorded in 44 (58.7%) boys and in 31 (41.3%) girls. Only 51 (42.5%) teeth were stored in an appropriate medium before attendance at any site and only 48 (40%) of the teeth were seen within 1 h. 83.3% received emergency treatment at general hospital, 89.7% in dental practice and 92.9% at dental hospital. Conclusions:  A minority of avulsion injuries were seen within the first hour and a minority were in appropriate storage medium at presentation. Geographical location plays a huge role in the time taken to reach secondary care. However, improving public and non-dental professional knowledge about tooth storage in avulsion injuries is critical to long-term prognosis of the teeth