Emergency Management of Dental Traumas: Avulsions
|9307||January 14, 2013||1|
One of the most common oral injuries that occur in the child or adolescent involves the avulsed tooth. There has been an increase in the numbers of these injuries worldwide to sports activities, and some of the newer recreational activities (skate-boarding, trampoline jumping etc). Worldwide there are 5.8 million cases of trauma per year. Male patients are 2/3 of victims, hospitalizations have increased thirty-fold and emergency room visits have increased 300-fold.
Although this is a common problem for all types of dental practices, many injuries occur after hours or on weekends when most dental practices are shut. Therefore many cases present to the Emergency Room, where there are no dental staff present. It is incumbent on the medical staff to have an understanding on how to diagnose dental injuries, manage them and make the appropriate referral to a dental practitioner.
There are several injuries that can occur to the oral area (soft tissue, fractures to the teeth, luxations, avulsions), this first resource will focus on how to deal with avulsions. An avulsion of a tooth occurs when the tooth gets knocked out the socket. Typically this occurs to the central incisors, and the maxillary teeth are affected more than the mandibular teeth. The objectives of the resources developed (powerpoint, problem based learning case and video) are to teach the student/practitioner how to provide first-line management for stabilizing oral injuries, specifically the avulsed tooth, to the point of referral.
Chase I, Karimbux N, Isong I, Freer Z. Emergency Management of Dental Traumas: Avulsions. MedEdPORTAL Publications; 2013. Available from: https://www.mededportal.org/publication/9307 http://dx.doi.org/10.15766/mep_2374-8265.9307
Contains time-sensitive information that will likely be inaccurate, obsolete, or irrelevant by November 30, 2015
Contains Information Suitable for Patient Education
- To understand what the prevalence and incidence and predisposing factors of avulsion injuries are in the child and adolescent
- To experience a case scenario that helps them work through the problem of diagnosing a clinical situation and how to manage the situation.
- To learn a step-by-step guide to re-implanting and splinting an avulsed tooth.
- To be able to give post-operative instructions and the appropriate referral/time-line for referral.
- Tooth Avulsion (MeSH), Replantation (MeSH), Splinting, Permanent Teeth, Building Oral Health Capacity (BOHC) Collection, Trauma
- Emergency Medicine
Advanced Dental Education
Assessment, Diagnosis & Treatment
- Advanced Dental Education
Knowledge for Practice
Practice-based Learning & Improvement
Evaluation of Clinical Performance
Problem-based Learning (PBL)
- Clinical Exam
- Dental Student
Professional School Post-Graduate Training
Authors & Co-Authors
Isabelle Chase, DDS
Children's Hospital Boston
Nadeem Karimbux, DMD
Harvard School of Dental Medicine
Harvard School of Dental Medicine
Inyang Isong, MD
Harvard School of Medicine
Sponsorship or Funding Source
This project is also sponsored in part by funding from the Health Resources and Services Administration/Maternal Child Health Bureau grant #U44MC20223.
Effectiveness and Significance
The power point presentation was presented to a small sample of physicians. Feedback was obtained and incorporated into the final presentation. The main issue with the original presentation was the lack of definition of dental terminology/concepts that are not acquired in medical school training. Clinical photos and radiographs were added to help clarify terminology and the power point.
The significance of this module is that it is comprehensive but succinct. It is a novel interdisciplinary presentation of the topic based upon the most current treatment guidelines in publication and incorporates several modalities to optimize learning. In addition, the instructor's guide for the entire resource coupled with the tutorial guide for the problem based case make it a useable teaching tool. Learning issues included with the problem based case afford the instructor a framework for evaluating knowledge acquisition.
Special Implementation Guidelines or Requirements
In order for the powerpoint to be used in a group a computer will be necessary and ideally AV support with a projector. In addition, to facilitate a team-based learning session, a room will be needed where members can ideally sit around a table to discuss, along with a white- or chalkboard to present learning issues.
The power point requires approximately 60 minutes for presentation. The video is an additional 10 minutes. The problem based case takes approximately 2-3 hours to complete.
Although one assumes that basic terminology in their field of interest/study is known by all health professionals, this is not the case. It is important to present the resource to other people both within and outside of the intended audience to ensure that presentation is well thought out, flows nicely, and that basic terminology is defined.
This information is made available under the Creative Commons license.