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Rudolph's PediatricsRudolph's Pediatrics

Section 20. Disorders of the Oral Cavity > 

Chapter 375. Dental Emergency Care

Orofacial Trauma

Howard L. Needleman and Brian Grove
Topics Discussed: burns, electric; dental emergency; dental enamel; dental pulp exposure; dentin; genital warts; lip laceration; loosening of tooth; maxillofacial injury trauma; mouth injury; mouth protectors; oral cavity; oral soft tissues; sexual abuse of child; soft tissue injuries; superficial injury of mouth; tongue laceration; tooth avulsion; tooth avulsion management; tooth fracture management; tooth fractures; tooth injuries; tooth replantation.
Sections: Orofacial Pain and Infection, References.
Excerpt:"Trauma to children's teeth is a very common event.1 The prevalence of these injuries varies depending on the population studied and the types of injuries reported. Studies indicate that as many as 46% of children sustained traumatic injuries to their primary or permanent teeth during childhood.2-4 Approximately 2% of children sustain such injuries annually.5 The majority of the injuries occur to the maxillary incisors due to their prominence in the dentition. Displacement injuries are more common in the primary dentition, because supporting bone in younger children is more flexible and pliable, while fractures are more common in the permanent dentition. Trauma to the soft tissues of the oral cavity can be caused by physical, chemical, or electrical insults. Soft tissue injuries consist of abrasions, lacerations, contusions, ecchymoses, hematomas, and burns. Oral lacerations should be examined carefully for the presence of foreign bodies, especially in the presence of fractured teeth (eFig. 375.4A,B). A radiograph of the lesion should be done to rule out foreign bodies, as visual inspection and palpation alone are usually not sufficient (eFig. 375.5A,B). Lip lacerations require careful management to provide an esthetic closure, especially if the laceration is deep or extends through the vermilion border. Full-thickness lacerations require suturing in layers. Careful attention to anatomic alignment of the vermilion border is important. Through and through..."
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