Mostrando entradas con la etiqueta Dental Emergency. Mostrar todas las entradas
Mostrando entradas con la etiqueta Dental Emergency. Mostrar todas las entradas


CLINICAL CASE : Brain abscess secondary to a dental infection in an 11 year old child

Clinical Case

A primary molar dental abscess was implicated as the cause of a brain abscess in an 11-year-old boy.

This case report describes the neurological signs and symptoms, and acute management of a brain abscess in a child.

A brain abscess is provisionally diagnosed from the patient’s medical history, as well as the presence of signs and symptoms such as fever, headache, nausea, vomiting, focal neurological deficit, altered mentation, speech alterations, papillary edema, and neck stiffness or seizures.

A definitive diagnosis of brain abscess is confirmed through imaging.

The dental source of infection is identified by the exclusion of more probable foci such as the ears, heart, lungs, eyes or sinuses.

Read Also: EMERGENCY : Multidisciplinary approach in the immediate replantation of a maxillary central incisor

Introduction : Dental abscesses and facial cellulitis put dentists on alert for potentially life-threatening conditions such as sepsis or airway obstruction, but the risk of a brain abscess is a complication of odontogenic infection that dentists rarely consider.

This report describes the case of an 11-year-old boy whose brain abscess and associated neurological signs were most likely attributable to an abscessed primary molar.

The description of the neurological signs and symptoms, and the history and management of this case will inform dentists about the real possibility of a brain abscess of dental origin.


°Canadian Dental Association
°Dr. Hibberd / Dr. Nguyen


CLINICAL CASES : Crown-Root Fractures in Primary Teeth

Emergency Pediatric Dentistry

Crown-root fractures involve enamel, dentin and cement.

These are not usually found in primary dentition, and approximately 2% of all types of traumatic dental injures (TDI).

Frequently, this kind of dental trauma spreads to the subgingival or intraosseous level, which complicates the establishment of the extent and direction of fracture lines, even with the assistance of radiographic examination.

Read Also: Clinical Management of Regional Odontodysplasia. Clinical Case

The difficulty of tooth maintenance and periodontal health require an interdisciplinary approach to enable the appropriate treatment of this type of TDI.

Crown-root fractures in primary teeth are singular events with wide variations of fracture patterns and that making the correct diagnosis and treatment plan can be complex.

In addition, there have been very few reports regarding this type of trauma and studies that describe the best approaches for each situation are necessary to enable dentists to make the best treatment decision.

Therefore, the aim of the present study was to present a case series of crown-root fractures in primary teeth of patients who were followed-up until the eruption of permanent successor teeth.


Fuente :
Autores : Vanessa Polina Pereira da Costa , Luisa Jardim Correa Oliveira , Denise Paiva Rosa , Mariana Gonzalez Cademartori , Dione Dias Torriani(in memoriam)


EMERGENCY : Multidisciplinary approach in the immediate replantation of a maxillary central incisor

Emergency Pediatric Dentistry

This report proposes a discussion of the various peculiarities of a tooth 21 replantation in a 9-year-old patient and describes different treatment facets and a 6-year follow-up of the case.

The splint was maintained for a 3-month period. After a 10 year therapy with calcium hydroxide to control inflammatory resorption, the final canal obturation was performed 18 months after trauma with mineral trioxide aggregate.

Two years after replantation, the orthodontic treatment had been initiated and 5 years after avulsion, whitening of tooth 21 was also done.

Clinical and radiographic follow-up at regular intervals revealed that the treated tooth was still functional, showing normal mobility, resorption stabilization, and normal appearance of the bone tissue and lamina dura, testifying the treatment has been so far successful.

Read Also: ORAL REHABILITATION of a child with dentinogenesis imperfecta

The possibility of submitting avulsed teeth to other dental treatments once, there is close professional monitoring by controlling the risks and benefits of each therapy, as well as the patient's cooperation, extra-oral time, and storage media for transport to the dentist among other details is emphasized.

Introduction : Avulsion, which involves total tooth displacement from its socket, causing rupture of periodontal fibers, is a true emergency case.


°Multidisciplinary approach in the immediate replantation of a maxillary central incisor - A six and a half year follow-up
°Cristina Braga Xavier, Beatriz Farias Vogt, Giselle Daer Faria, Leandro Calcagno Reinhardt, Elaini Sickert Hosni, Josué Martos


EMERGENCY : Reimplantation of avulsed dry permanent teeth after three days


Avulsion is a traumatic injury which results in loss of the tooth from the alveolus, while reimplantation is the technique of reinserting an avulsed tooth into the alveolus or tooth socket after its loss.

The success of reimplantation depends on many factors among which are the time lapse before the tooth is reimplanted in the socket and the storage medium of the avulsed tooth.

Other factors which may affect the success of reimplantation include the condition of the tooth, particularly the periodontal ligament tissue remaining on the root surface, sex, age, type of tooth reimplanted, stage of root formation, type of cleansing procedure following contamination of the root surface, duration of splinting, and the use of antibiotics.

With favorable conditions such as the periodontal ligament remaining on the root surface, the tooth stored in adequate storage medium for not more than 60 minutes, and immediate reimplantation after the accident, the tooth may be retained for as long as 5 to 10 years and few for a lifetime, but some fail soon after reimplantation.

Read Also: ORAL SURGERY : Guideline on Pediatric Oral Surgery

Unfavorable conditions include teeth out of the mouth for more than 6 hours in no storage media and without periodontal ligament on the root surface.

In such cases, the reimplanted tooth fails with subsequent loss of the tooth.

This is because dry storage affects pulp revascularization and survival of the periodontal ligament cells along the root surface resulting in either replacement resorption or loss of the tooth.


°Nigerian Journal of Clinical Practice
°IN Ize-Iyamu, BDO Saheeb


DENTAL TRAUMA : Guideline on Management of Acute Dental Trauma

Dental Trauma

The American Academy of Pediatric Dentistry (AAPD) intends these guidelines to define, describe appearances, and set forth objectives for general management of acute traumatic dental injuries rather than recommend specific treatment procedures that have been presented in considerably more detail in textbooks and the dental/medical literature.

Facial trauma that results in fractured, displaced, or lost teeth can have significant negative functional, esthetic, and psychological effects on children.

Dentists and physicians should collaborate to educate the public about prevention and treatment of traumatic injuries to the oral and maxillofacial region.

The greatest incidence of trauma to the primary teeth occurs at 2 to 3 years of age, when motor coordination is developing. The most common injuries to permanent teeth occur secondary to falls, followed by traffic accidents, violence, and sports.

All sporting activities have an associated risk of orofacial injuries due to falls, collisions, and contact with hard surfaces.

Read Also: ORAL MEDICINE : How to manage a pediatric patient with oral ulcers

The AAPD encourages the use of protective gear, including mouthguards, which help distribute forces of impact, thereby reducing the risk of severe injury.

Dental injuries could have improved outcomes if the public were aware of first-aid measures and the need to seek immediate treatment. Because optimal treatment results follow immediate assessment and care,18 dentists have an ethical obligation to ensure that reasonable arrangements for emergency dental care are available.

The history, circumstances of the injury, pattern of trauma, and behavior of the child and/or caregiver are important in distinguishing nonabusive injuries from abuse.


°Guideline on Management of Acute Dental Trauma


EMERGENCY : Managing Patients With Primary Incisor Root Fracture


Injury to a primary incisor following a traumatic injury. Diagnosis of a root fracture may be suspected but must be confirmed radiographically.



Incidence of primary tooth trauma is greatest when motor coordination is developing, around 2–3 years of age.

More Likely to Occur

° Protrusive incisors are more susceptible to dentoalveolar trauma.

° Root fractures are uncommon in the primary dentition. Due to the plasticity of alveolar bone, luxation injuries are more common in the primary dentition.


The coronal tooth fragment may be absent, mobile, displaced or display normal physiologic mobility.


° Pain may or may not be reported.

° Inability to occlude or discomfort with occluding if the coronal fragment is displaced or mobile.


Based upon radiographic findings, a root fracture diagnosis is confirmed.

° Occlusal film(s): root fracture visualized, most commonly seen in the middle or apical third

Read Also: ORTHODONTIC : Malocclusion in Down syndrome - a review

Differential Diagnosis

° Avulsion or complete intrusion, if the coronal fragment is not visible clinically

° Luxation, if the coronal fragment is displaced

° Subluxation, if the coronal fragment is mobile but not displaced

° Concussion, if the coronal fragment is neither mobile nor displaced


°Canadian Dental Association
°Jennifer MacLellan, DDS, MSc, Cert Ped, FRCD(C)


Consequences of dental trauma to the primary teeth on the permanent dentition

Dental Trauma

Dental trauma to primary teeth or to the jaws may cause disorders on the development of permanent successor teeth.

The alterations may either occur at the time of accident or be caused by post-traumatic consequences.

Objective: The aim of this paper is to present cases of alterations on permanent dentition following dental trauma to primary teeth.

Case reports: Three cases are presented in this paper. The severity of the post-traumatic sequels shown by the permanent teeth kept a direct relationship with the extent of the impact and patient’s age at the accident.

These sequels resulted in whitish or brownish opacities, enamel hypoplasia, root dilacerations, and total arrest of root development.

Read Also: ENDODONTIC treatment for children

Conclusion: It can be concluded that the protocols for patients who had experienced dental trauma must observe a systematic clinical and radiographic follow-up as well as alternatives of treatment for the primary and permanent teeth involved.

Prognostics and treatments related to the sequels in permanent teeth may be obtained from a close analysis of clinical and radiographic aspects, avoiding more damages to the stomatognathic system.


° Authors : Miranda et al. - Consequences of dental trauma to the primary teeth on the permanent dentition


DENTAL EMERGENCY : Pediatric expert tips

Dental Emergency

Injuries to children’s teeth can be very distressing for children as well as their parents.

Dental trauma may occur as a result of a sports mishap, an altercation, a fall inside of the home, or other causes.

Prompt treatment is essential for the long-term health of an injured tooth.

Obtaining dental care within 30 minutes can make the difference between saving or loosing a tooth.

Approximately 30% of children have experienced dental injuries.

Injuries to the mouth include teeth that are: knocked out, fractured, forced out of position, pushed up, or loosened. Root fracture and dental bone fractures can also occur.

Read Also: ORAL PATHOLOGY : Residual Neonatal Teeth: A Case Report

Youtube / East Tennessee Children's Hospital


How do I Manage a Patient with Intrusion of a Permanent Incisor?


Intrusion of a permanent incisor

Intrusive luxation (intrusion) is the displacement of the tooth into the alveolar bone along the axis of the tooth and is accompanied by comminution or fracture of the alveolar socket.

According to the degree of clinical displacement, intruded teeth may be classified into 3 categories: mild intrusion (< 3 mm), moderate intrusion (3–6 mm) and severe intrusion (> 6 mm).

a. Most common in children between age 6 and 12.
b. More common in boys than girls.
c. Intrusion of a permanent incisor is a rare injury. However, the following are the most common intrusion injury patterns.
c.1 Intrusion without additional injury, intrusion without crown fracture, intrusion without crown–root fracture or root fracture.
c.2 Intrusion of one or more teeth.

Read Also: ORAL REHABILITATION : Stainless steel crown prep on a primary molar

Axial displacement into the alveolar bone. Sometimes the tooth may not be clinically visible.
The tooth is nonmobile.
Percussion may give a high, metallic, ankylotic sound.
Sensitivity test usually gives negative result.

Pain is not usually associated with intrusion of a permanent tooth.


° Akanksha Srivastava, BDS, MSc / Nidhi Gupta, BDS, MDS / Annie Marleau, DMD / Kelvin I. Afrashtehfar, DDS, FADI


What to do when your child has a dental emergency

Dental Emergency

An adult going through a dental emergency is, in all likelihood, in a world of pain.

Can you imagine if something like that happened to your child?

No parent wants their kids to suffer in any way, but accidents do happen, and children are likely to experience a dental emergency because of their activities on the playground and on the playing field.

So what do you need to do in case your child suffers a dental emergency? Let’s take a look at some of the more common dental emergencies among kids and find out what you have to do to spare your child from pain or severe dental damage.

1. Broken or fractured teeth. Kids run, jump, and sometimes, play rough. With such activities, children can be prone to breaking or fracturing their teeth with one misstep.

If such an accident takes place, find the piece of the tooth that broke off and put it in a glass of cold milk or water. Have your child rinse off his or her mouth with warm water to make sure there are no tiny fragments left inside that may injure your child’s mouth.

Of course, you should take your child to the dentist immediately.

Read Also: CLINICAL CASE : Brain abscess secondary to a dental infection in an 11 year old child

2. Knocked-out permanent tooth. Your child could have a permanent tooth knocked out on the playground. Find the tooth as quickly as you, pick it up by the crown and not the roots, and rinse it with cold water.

The tooth can still be re-implanted within 30 minutes or so, so make sure you preserve it by soaking it in a cup of cold milk or water while you’re en route to your emergency dentist.

3. A toothache. Toothaches are common, but watching your child cry out in pain is absolutely heartbreaking. To ease your child’s pain, have him or her gargle a warm salt water solution.

You may also want to take a closer look inside your child’s mouth to see if there’s an object stuck between teeth or if the gums are swollen. Schedule a visit to the dentist the soonest possible time to find out what’s causing the toothache and relieve it at once.

Whatever dental emergency your child is facing, always remember that your job is to take steps that will provide your child temporary relief.

Treating the problem will be entirely up to the dentist, whose office you should bring your child to right away in cases of dental emergencies.
By Stephanie McGuire


DENTAL EMERGENCY : Primary Tooth Injury and Emergency Extraction

Dental Emergency

A dental emergency is basically any situation occurring where the child has an injury or possible infection of the tooth, mouth, or jaw.

Severe swelling, trauma, or visible injuries are all examples of what could be potential issues.

Often young children have accidents and may chip or lose a baby tooth. Since baby teeth are not permanent, the doctor will likely evaluate for other injury and allow the permanent tooth to erupt.

If your child loses a permanent tooth, try to carefully pick it up by the top part of the tooth and do not disturb any roots that could be attached.

Clean the tooth with whole milk and try to make it to the dentist quickly so the likelihood of the tooth being re-implanted is greater.

Read Also: EMERGENCY : Managing Patients With Primary Incisor Root Fracture

Growing up, most of us have had one or more of these myofunctional problems, which may have been the cause of incorrect dental and facial development.

Youtube / Larry Mellick


DENTAL EMERGENCY : Traumatic Dental Injuries: Examination, Diagnosis, and Immediate Care

Dental Emergency

It is well documented that the majority of traumatic dental injuries occur in children.

Thus, in a Swedish study, 83% of all individuals with acute dental trauma were younger than 20 years of age.

Injuries to primary or permanent teeth can appear rather severe, particularly when associated with trauma to supporting tissues.

The situation is distressing for both the child and parents.

It is important that the dentist and the other members of the dental team are well prepared to meet the many complex and challenging problems in the care of dental emergencies.

Read Also: CLINICAL CASES : Crown-Root Fractures in Primary Teeth

The dental team must:

· Be aware of and understand the anxiety of both children and parents.

· Reduce the stress and anxiety by remaining calm and reassuring.

· Educate and train all members of the team treating traumatic dental injuries to possess adequate knowledge and skills to make an accurate diagnosis, and to perform appropriate and prompt emergency treatment.

· Reduce pain as much as possible. Always consider the use of local anesthetics analgesics and conscious sedation.

Eva Fejerskov Lauridsen, Simon Storgård Jensen, and Jens O. Andreasen


EMERGENCY : Medical emergencies in pediatric dentistry

Medical emergencies that are life threatening can occur in dental practice. 

Complications may arise because of an underlying disease or a reaction to medication. Reactions to medications may be allergic and toxic. 


The most common reactions are toxic reactions to local anesthetics, whereas allergies occur mainly as a consequence of the application of antibiotics, usually penicillin. 

In response to stress, vasovagal syncope typically occurs. Other causes may be related to an underlying disease-specific pathology (such as acute asthma attack, diabetic ketoacidosis, hypoglycemia, or seizures) or accidents (aspiration of a foreign body causing obstruction of the respiratory system). 

For all the above conditions, guidelines have been established that need to be known. If complications occur or necessary measures are not taken, it can lead to cardiac and respiratory arrest. 

°Medical Emergencies in Pediatric Dentistry
°Dubravka Negovetić Vranić / Josipa Jurković / Jesenka Jeličić / Antonija Balenović / Gordana Stipančić / Ivana Čuković-Bagić


DENTAL TRAUMA : Post-traumatic impaction of maxillary incisors: diagnosis and treatment

Trauma to oral and facial structures is a significant problem that may have serious medical, esthetic and psychologic consequences on both children and their parents. 

Studies have shown that approximately 30% of all children under the age of 7 years experience injuries to ≥ 1 of their primary incisors and that most serious injuries to primary teeth occur between the ages of 1 and 3 years. 


This high incidence is related to the passage to the upright posture, the early stages of walking, a lack of motor coordination and the unconsciousness of the child. 

The majority of the trauma occurs as a result of fall accidents at home or during sporting activities. 
According to gender, boys were injured more frequently in all age than girls (2) and owing to their exposed position in the dental arch, the upper central incisors are the teeth most commonly affected by traumatic injury in both primary and permanent dentition. 

Valeria Paoloni, DDS, Chiara Pavoni, DDS, Manuela Mucedero, DDS, Patrizio Bollero, DDS, PhD, Giuseppina Laganà, DDS, and Paola Cozza, MD, DDS, MS