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Dental Emergencies


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Dental Emergencies
Dental Emergencies
Describe the Ellis classification
Class 1: involves enamel only. Class 2: involved dentin and required intervention. Class 3: Exposure of pulp. Required intervention
Define concussion
injury to the supporting structures of a tooth with clinical tenderness to percussion but no mobility
Define subluxation
injury to the attchment apparatus resulting in mobility without clinical or radiographic evidence of dislodgment of tooth.
Know how to preserve an avulsed tooth, what are acceptable preservation medias and what to avoid while handling the tooth
Reimplantation must be done withing 2-3 hours. Rinse in saline to remove debris. Saline, milk or commercial preparation of Hank solution are ok.
Describe the difference in treating primary vs. permanent teeth with the same injury.
repositioning or reimplanting primary teeth risks injurying underlying permanent teeth and is avoided.
Be able to describe what other injuries must be considered in the setting of dental trauma
alveolar ridge fractures, pulp canal obliteration, pulpal necrosis, internal exteral resorption of root, ankylosis and integrity of maxilla and madible is important
What is Ludwig's angina
cellulitis involving inflammation of tissues in floor of mouth, under tongue. It occurs following infection of teeth roots(abscess) or after mouth injury. Swelling occurs rapidly and may block airway or prevent swallowing of saliva
When would you seek an immediate Dental consult
fractures of a tooth, treatment based on vitality of tooth and, the proximity to the pulpal tissue. When root compromises the attachment apparatus and a dentist is needed to adequately restore tooth to function.
Define and explain Tx for Concussion of tooth
Injury to supporting structures of tooth with tenderness to percussion but no mobility. Analgesics may be required.
Define and explain Tx for subluxation of tooth
injury to support structures resulting in mobility without evidence of dislodgement of the tooth. Treat as concussion with soft diet, dental referral to confirm diagnosis.
Define and explain Tx for Extrusive luxation
partial avulsion or dislodgment from alveolar bone. Treat by repositioning tooth to original position (may require anesthetic), temporary splinting (Coe-Pak), dental/oral surgeon consult.
Define and explain Tx for Lateral luxation
Dislodgment of tooth laterally with concomitant fracture of alveolar bone. Treatment: Same as extrusive.
Define and explain Tx for Intrusive luxation (Impaction injury)
most serious secondary to significant damage to alveolar socket and periodontal ligaments. Treatment: Dental consult (usually tooth allowed to reerupt on its own or orthodontically extrude the tooth over 3 – 4 weeks).
Define and explain Tx for Avulsions
Total displacement of tooth from it’s socket. Accounts 16 % dental injuries. Treatment: Rinse with sterile NS or water to remove debris. Do not scrub root. Reimplant tooth immediately. If unable, place in milk, NS, or commercial tooth preservative (Hank’s solution, Save-A-Tooth). X-ray if avulsed tooth not recovered to rule out aspiration. Dental consult.
Define Elis Class I, II, III fracture

I: involved enamal only. II: involves dentin. III: expose pulp

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