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.


This lecture-based resource reviews oral injury 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 to the evaluation and management of oral injury is important for all pediatric primary care providers. This resource is a part of Protecting All Children's Teeth (PACT), a series created by the American Academy of Pediatrics’ 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 series provides in-depth coverage of child oral health, oral health guidance, and preventive care to increase comfort in recognizing dental disease and conditions and communicating with dental professionals. This resource 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. As this presentation on oral injury is part of a complete oral health curriculum, educators and learners are encouraged to view the additional 12 courses.

Educational Objectives

By the end of this resource, learners will be able to:

  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 seven 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 three basic types of mouth guards and summarize the American Academy of Pediatric Dentistry recommendations on mouth guard use in athletics.

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.