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Review of the Dental Trauma Guide; an interactive guide to evidence-based trauma management
Peter F Daya Sophy K Barberb
aDepartment of Paediatric Dentistry, Leeds Dental Institute and Bradford District Care Trust Salaried Dental Service, UK
bDepartment of Orthodontics, Leeds Dental Institute and Pinderfields Hospital, Wakefield Dental Service, UK
The complexities of dental trauma
Traumatic dental injuries are common, with between 6-34% of children in the UK aged 8-15 experiencing damage to their permanent teeth.1-3 Over three quarters of all traumatic oral injuries occur in childhood.4
For the clinician providing the initial emergency care the experience can be extremely stressful as often the patient is being seen as an emergency between other waiting patients and is not familiar to the clinician. The patient will be upset and in pain, and paediatric patients may be inexperienced with dental treatment and anxious. Additionally parents are frequently upset or even absent if the accident occurred away from home. Furthermore, traumatic dental injuries represent a complex diagnostic problem with a multitude of treatment options to choose from. For example, there are nine different kinds of fractures and six luxation injuries which can combine in 54 different ways; each resulting injury has specific treatment demands and prognoses with respect to pulp and periodontal healing. The management can be further complicated by trauma to multiple teeth, with different injuries, requiring treatment prioritisation. It is important to get this right, because providing appropriate initial emergency care significantly improves prognosis.5
Dental trauma almost always involves the upper anterior teeth6 and therefore can have a considerable effect on dental and facial aesthetics. This frequently coincides with adolescence and can have a significant impact for some children on their quality of life.7 Furthermore there are financial implications to health services and families in providing acute and follow-up care for such injuries.8,9 Finally there is amongst general practitioners the reported expectation that acute care for traumatic dental injuries lies within their remit and skill mix.10
It is therefore difficult for clinicians to keep fully updated on the evidence based
Figure 1 The layout of the website with the different injuries listed down the left hand side. When one of these injuries is tapped, a drop-down list detailing the description, etiology, diagnosis, treatment, prognosis and references...