Special considerations in paediatric dental trauma

Traumatic dental injuries (TDIs) in the paediatric population are common and frequently seen in general dental practice. The management of TDIs can be challenging and, in most cases, the General Dental Practitioner is tasked with the initial assessment and emergency treatment. Patients and their families typically attend with elevated levels of distress, which is complicated by the limited dental experience of some children. Behaviour management is essential and helps prepare patients for dental care at both their emergency and follow-up appointments. Early and accurate diagnosis in combination with appropriate treatment contributes to favourable outcomes for traumatised teeth. Early discussions with or referral to paediatric dental teams for management of complex TDIs is encouraged, however shared follow-up care is beneficial over the long-term. In specific cases, initial dental treatment can be delayed by a few days to a subsequent appointment, allowing the dental team to book sufficient time for the treatment and for the patient and their families to prepare. Education of the patients and adults with parental responsibility is essential to manage expectations, explain likely complications and encourage attendance for long-term follow-up visits. This paper discusses the management of paediatric patients to aid the primary care practitioner in providing effective immediate and long-term care

Tiny teeth, big challenges: dental trauma in the primary dentition

Paediatric dental trauma is a common occurrence internationally and its presentation in the primary dentition creates additional challenges. Beyond the dental implications, patients and families experience significant distress which impacts their ability to engage with treatment or access services. Patients in the primary dentition often have limited dental experience and are unlikely to be acclimatised to treatment. Compared to their adolescent peers, their ability to express themselves comprehensively or participate with verbal communication is reduced. The use of non-verbal behaviour management techniques is therefore crucial. A positive dental experience will contribute to good cooperation in the future. Examination and treatment can be challenging, and management significantly differs between the primary and permanent dentition. Involvement with a child-orientated dental team is encouraged when appropriate, due to their expertise and access to sedation and general anaesthetics. In addition to the consequences of trauma to the primary dentition, there is also risk to the unerupted permanent successors. The likelihood of this damage can be predicted by the age of the child and nature of the traumatic injury. Parents should be supported and advised on oral hygiene, analgesia and understand the potential future consequences. This paper provides an overview of the management of dental trauma in the primary dentition