The team approach to managing paediatric dentoalveolar trauma

1
The team approach to managing paediatric
dentoalveolar trauma

• Sheena Kotecha, John Scannell
• Birmingham Childrens Hospital

2
Outline

• Types of dentoalveolar injuries
• Trauma statistics
• Care pathway
• Teamwork in trauma management
• Summary

3
Dentoalveolar Trauma

• Hard tissue injuries
• Enamel fractures
• Enamel dentine fracture complicated/uncomplicate
  d
• Root fractures
• Soft tissue injuries
• Subluxation
• Luxation
• Avulsion

4
Enamel Dentine Fracture
5
Dentoalveolar Trauma

• Hard tissue injuries
• Enamel fractures
• Enamel dentine fracture complicated/uncomplicate
  d
• Root fractures
• Soft tissue injuries
• Subluxation
• Luxation
• Avulsion

6
Root Fracture
7
Dentoalveolar Trauma

• Hard tissue injuries
• Enamel fractures
• Enamel dentine fracture complicated/uncomplicate
  d
• Root fractures
• Soft tissue injuries
• Subluxation
• Luxation
• Avulsion

8
Lateral Luxation
9
Dentoalveolar Trauma

• Hard tissue injuries
• Enamel fractures
• Enamel dentine fracture complicated/uncomplicate
  d
• Root fractures
• Soft tissue injuries
• Subluxation
• Luxation
• Avulsion

10
Avulsion
11
Trauma Statistics

• 1062 patients between 2003-2006
• 309 with dentoalveolar injuries
• 207 male
• 102 female
• 0-3 yrs 84
• 4-7 yrs 100
• 8-11 yrs 73
• 12-15 yrs 52

12
Referral Source
13
Aetiology
14
Injury Type
15
Care Pathway

• Triage nurse
• ED doctor
• Maxillofacial SHO
• Paediatric Dentist
• Other dental speciality PDS

16
Teamwork in Avulsion

• Triage Nurse
• Telephone advice storage medium and attend ED
  asap
• Where is the tooth? mouth, swallowed, inhaled,
  lost, with patient?
• Contact ED doctor/maxillofacial SHO
• ED Doctor
• Medical History
• Assess other injuries

17
Radiology Department
18
Teamwork

• Triage Nurse
• Telephone advice storage medium and attend ED
  asap
• Where is the tooth? mouth, swallowed, inhaled,
  lost, with patient?
• Contact ED doctor/maxillofacial SHO
• ED Doctor
• Medical History
• Assess other injuries

19
Teamwork

• Dental SHO
• Assess dental injuries
• Re-implant tooth
• Splint
• Maxillofacial Technician
• Construct splint
• ED Nursing staff
• Technical assistance
• Patient management

20
Splints
21
Teamwork

• Dental SHO
• Assess dental injuries
• Re-implant tooth
• Splint
• Maxillofacial Technician
• Construct splint
• ED Nursing staff
• Technical assistance
• Patient management

22
Teamwork

• Paediatric Dentist
• Review and treat as necessary
• Referral
• Other dental speciality
• Orthodontics
• Prosthetics
• Restorative
• Oral Surgery
• PDS

23
Summary

• Patients with dentoalveolar trauma are managed by
  various health professionals
• Within the same hospital
• Between different hospitals
• Between professionals in different settings
• Relies on effective communication and teamwork.

24
Acknowledgements

• Mrs Victoria Clark
• Mr Andrew Monaghan

25
Any Questions?

• Thank you