Paeds Cases · ent-hearing-and-oral-health
Dental trauma and avulsed teeth — structured clinical encounter
Structured encounter testing the approach to an eight-year-old boy who has just knocked out a permanent upper central incisor on the playground and has brought the tooth wrapped in a tissue: the scene history and prognostic factors, the IADT 2020 immediate first-aid and storage media, the definitive dental management of replantation, flexible splinting, root canal treatment and antibiotics, and the complications of root resorption, with a pivot to a three-year-old who has knocked out a primary incisor representing the never-replant-a-primary-tooth rule and the safeguarding consideration.
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You are the paediatric registrar in the emergency department. You have ten minutes to assess this eight-year-old boy who has just knocked out a permanent upper central incisor, and to present your assessment and management plan to the examiner. You are expected to take the scene history that establishes the prognosis, examine the mouth and the whole child, recognise the time-critical emergency, and outline the immediate first-aid and definitive management. The examiner will then release a second scenario of a three-year-old who has knocked out a primary incisor, and will ask you to state the rule and the safeguarding consideration. [1]
References8ShowHide
- [1]Fouad AF; Abbott PV; Tsilingaridis G; Cohenca N; et al International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol, 2020.PMID 32460393
- [2]Bourguignon C; Cohenca N; Lauridsen E; Flores MT; et al International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dent Traumatol, 2020.PMID 32475015
- [3]Day PF; Flores MT; O'Connell AC; Abbott PV; et al International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dent Traumatol, 2020.PMID 32458553
- [7]Pohl Y; Wahl G; Filippi A; Kirschner H Results after replantation of avulsed permanent teeth. III. Tooth loss and survival analysis. Dent Traumatol, 2005.PMID 15773889
- [8]Kahler B; Hu JY; Marriot-Smith CS; Heithersay GS Splinting of teeth following trauma: a review and a new splinting recommendation. Aust Dent J, 2016.PMID 26923448
- [9]Ballal V; V J Storage media. Br Dent J, 2011.PMID 21869779
- [11]de Gregorio C; Tewari N Management of Complications in Dental Traumatology. Dent Traumatol, 2025.PMID 39578670
- [12]Mele F; Introna F; Santoro V Child abuse and neglect: oral and dental signs and the role of the dentist. J Forensic Odontostomatol, 2023.PMID 37634173