Original Publication
Open Access

Protecting All Children's Teeth (PACT): Oral Injury

Published: October 9, 2013 | 10.15766/mep_2374-8265.9577

Included in this publication:

  • Instructor's Guide.doc
  • PACT-Oral_Injury.ppt

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Protecting All Children's Teeth (PACT) was created by the AAP Oral Health Initiative to educate medical students, residents, pediatric primary care providers, and others interested in infant, child, and adolescent health about the importance of oral health in overall health. The curriculum provides in depth coverage of child oral health, oral health guidance, and preventive care to increase comfort in recognizing dental disease and conditions and communicate with dental professionals. The 13 modules of the PACT training program comprehensively address oral health promotion, disease prevention, diagnosis, and treatment of oral health disease in children.

Dental injuries are very common, and up to 30% of children injure their primary teeth. These injuries become common again in the mid-elementary school years (ages 8 to 10) as children join sports teams and become more independently active outdoors. In adolescence, motor-vehicle accidents and assault become increasingly important in the epidemiology of dental injury. Almost half of all children will incur some type of tooth damage by the time they reach adolescence, so becoming comfortable with a general approach the to evaluation and management or oral injury is important for all pediatric primary care providers.

The PACT Oral Health Curriculum has been in use since 2007 by physicians in training at the medical school and residency levels, as well as those in clinical practice. The content has been used by Pediatric, Family Medicine and Emergency Medicine physician training programs, as well as by Physician Assistants, Nurse Practitioners, Nurses, Dentists and Dental Hygienists in training and in clinical practice.

The AAP is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AAP designates the PACT educational activity for a maximum of 11.0 AMA PRA Category 1 Credits™.

Educational Objectives

  1. Describe the incidence and epidemiology of dental injury in the United States.
  2. Outline a proper examination following an oral injury.
  3. List and describe the 7 categories of tooth injury, their basic management, and possible sequelae.
  4. Discuss in detail the proper management of an avulsed tooth.
  5. Provide appropriate anticipatory guidance for oral injury prevention.
  6. Compare and contrast the 3 basic types of mouth guards and summarize the AAPD recommendations on mouth guard use in athletics. As this presentation is part of a complete oral health curriculum, educators and learners are encouraged to view the additional 12 courses in power-point or on-line format.

Author Information

  • Melinda Clark, MD: Albany Medical Center
  • David Krol: Robert Wood Johnson Foundation

None to report. 

The web-design of the PACT program was funded by the AAP Oral health Initiative, with support from the Maternal and Child Health Bureau (MCHB).

Prior Presentations
None to report.


Clark M, Krol D. Protecting all children's teeth (PACT): oral injury. MedEdPORTAL. 2013;9:9577. https://doi.org/10.15766/mep_2374-8265.9577

This publication is co-sponsored by the American Dental Education Association.