Description

Loss or fracture of a tooth and/or supporting bone due to trauma. Can result in shifting of remaining teeth, loss of teeth, loss of alveolar bone, and displaced or nonunion of maxilla and/or mandible, resulting in functional and aesthetic deformities difficult to correct.

Epidemiology

• Dental injuries of the teeth, supporting bone, and surrounding soft tissue constitute 5% of all physical injuries and as high as 18% in preschool children (1,2).
• Causes: Falls/Sports, 63%; assault, 17%; auto or motorcycle accidents, 2%
• Male > Female (2–3:1)

• Prevalence: 5% of all school-age children; 7–13% in primary dentition, 1–16% in permanent dentition
• Affects 13% of population <12 years

Risk Factors

• Physical and mental disabilities
• Contact sports without wearing proper protective equipment (i.e., helmets, mouth guards)
• High-risk sports include football, boxing, wrestling, soccer, baseball, hockey, bicycling, and skateboarding
• Age: Youth <12 years (3)
• Tongue/Mouth piercings
• Prior dental trauma
• Male gender (3)

General Prevention

• Mouth guards and helmets. Custom mouth guards are better than boil and bite, which are better than stock guards.
• Avoid tongue piercings.
• Wear seat belts while in the car.
• Monitor home for slippery areas.
• Childproof house with gates, and pad sharp table edges.

Pathophysiology

Direct force sufficient to overcome the bond between the tooth and periodontal ligament within the alveolar socket or disruption of enamel and dentin; force against maxilla or mandibular arch great enough to cause fracture

Commonly Associated Conditions

• Tooth loss can cause loss of space in dental arch.
• Malocclusion causing functional problems
• Trauma to dentition resulting in pulpitis, which causes necrosis of the pulp
• Child abuse: Be alert for history inconsistent with injuries (1).