Management Of Avulsed Teeth Research Articles

Multidisciplinary treatment of avulsed teeth case report and 6 years follow-up

Tooth avulsion is defined as the complete displacement of the tooth out of its alveolar socket. Management of tooth avulsion in the permanent dentition often presents a challenge. Replantation of avulsed teeth is the most accepted treatment approach considering esthetic and functionality. The aim of this case report is to present the multidisciplinary treatment approach and long-term follow-up of a patient (9. ♀) with avulsed maxillary central teeth.

Delayed tooth replantation after traumatic avulsion resulting in complete root resorption

Traumatic injuries of newly erupted permanent anterior teeth are common during childhood. Management of tooth avulsion in the permanent dentition often presents a challenge Replantation of the avulsed tooth can restore esthetic appearance and occlusal function shortly after the injury. This article describes the management of a 9-year-old child with an avulsed maxillary permanent incisor that had been air-dried for about 24 h. The replanted incisor retained its esthetic appearance and functionality only 1 year after replantation. In the present case, improper treatment measures such as prolonged dry conditions of the avulsed tooth before replantation, rigid splinting may explain rapid complete root resorption. Even if it is impossible to avoid resorption completely, the overall knowledge of both dentists and patients regarding immediate measures in case of traumatic dental injuries should be improved to delay the progress of resorption

Management of Avulsed Tooth: A Review

Dental avulsion is a traumatic injury characterized by the complete displacement of the tooth from its socket, with damage to the periodontal ligament, cementum, alveolar bone, gingival and pulp tissues. The best way to conduct this type of dental trauma is reimplantation. The prognosis of the tooth reimplantation depends on the existence of viable cells in the periodontal ligament and also depends on those which are able to proliferate on the damaged areas of the root. This can be achieved by the immediate reimplantation or through the storage of the tooth in an appropriate environment for further reimplantation. The avulsed tooth is both a dental and an emotional problem. The shock and pain of the injury, the loss of a tooth needed for eating, speaking and smiling often lead to emotional upheaval in-patient. Therefore to manage this is of utmost importance. The PubMed database search revealed that the reference list for management of avulsed tooth featured 22, 200 articles and for storage media for avulsed tooth featured 3920 articles. A forward search was undertaken on selected articles, author names and contemporary endodontic text.

Dental Avulsion: Are the Dentist Prepared to the Correct Management?

Purpose: This study evaluated the knowledge of dentists from the health units (HU) of Porto Alegre - Brazil, regarding the management of avulsion of permanent teeth. Methods: A questionnaire regarding treatment and preservation of avulsed teeth was utilized. Professional data were also collected. Results: The response rate was 56.41%. The mean performance rate of the dentists regarding the clinical questions was 69.3%, but 37.4% had poor performance (less than 70% correct). The greatest number of hits was where the patient comes with the already replanted teeth (89.2%); 87.3% agreed in situations where the injured child reaches two hours of trauma with the tooth in a liquid medium, however in cases that period of trauma was more than two hours and tooth was dehydrated, the professionals performance was reduced (64.9%). There was a lack of knowledge about the use of intracanal medication (error rate of 56.9%); 41% are mistaken about the period to start endodontics procedures; 32.8% did the wrong about contention of avulsed teeth and clinical and radiographs follow-up. Dentists with postgraduate performed better than those without (p = 0.011). Professionals with longer time elapsed since graduation had lower performance, as well as those who reported not being satisfied with their knowledge of dental trauma (p<0.05). Conclusions: A limited knowledge of dentists from HUs of Brazil regarding the management of avulsed teeth was found. The lack in knowledge suggests the need for implementation of continuing education programs and simulation programs on approaches to dental traumas to improve dental care offered for the population.

Efficacy of a comprehensive dental education program regarding management of avulsed permanent teeth as a valid indicator of increased success rate of treatment of avulsion in a North Indian population.

Aims:To assess whether educating the parents, teachers, and intermediate school children of Amritsar city about the emergency management of tooth avulsion was an effective method of increasing success rate of treatment of avulsion.Subjects and Methods:Self-administered questionnaires were prepared for 200 parents, teachers, and for intermediate school children to assess baseline knowledge. Sociodemographic distribution of the targeted group was carried out applying Kuppuswamy scale. Two months later, flip cards and posters were distributed to the selected sample followed by a reinforcement session conducted after 1 month in the form of slide presentations on dental trauma. After 3 months, reassessment performance was distributed to the same participants for reassessing any change in baseline knowledge. Further analysis of knowledge, attitude, and practices were carried out after 6 months. The scores based on Likert scale ranging 0-3 were obtained and put to statistical analysis to analyze efficacy of this program 12 months from baseline data.Results and Conclusion:Wilcoxon signed ranked test was applied to nonparametric data to study the knowledge before and after education was carried out. There was a significant change in the knowledge level of children, teachers, and parents after the campaign and teachers showed more positive change in the practice of emergency management of tooth avulsion, endorsing the fact that comprehensive dental education programs targeting school teachers and children can change the perspective of individuals toward treatment needs for dental trauma involving avulsion.

General dentists knowledge about the emergency management of dental avulsion in Yemen

Objective: The objective of this research was to investigate the knowledge of general dentists about the emergency management of dental avulsion in Sana'a, Yemen. Materials and Methods: A questionnaire containing nine questions about emergency management of avulsed teeth was distributed among 416 general dental practitioners working in different private dental hospitals and clinics of Sana'a among them 272 was responded. Results: Among the studied group, (44%) said that an avulsed permanent tooth cannot be replanted. Sixty-eight percent of the responded informed that they use rigid splint for avulsed tooth and 29% said that semi-rigid splint should be used. Conclusion: The results suggest that the level of knowledge on the management of dental avulsion of the general practitioners dentists in Sana'a is inadequate. An education program should be conducted to increase the knowledge of general dentists in the management of traumatic injuries to teeth.

Effect of dental health education on the management of avulsed teeth by firefighters

Aim To evaluate the effect of a dental education program for firefighters addressing knowledge on the management of avulsed teeth.

Tetracycline: a cure all?

Tetracyclines are used to treat a range of oral conditions. Their efficacy in the treatment of periodontitis is well established, and they are authoritatively recommended in the management of avulsed teeth. There is a growing evidence base to support the use of tetracycline to treat recurrent aphthous stomatitis, but its use in white spongy naevus is limited to a handful of case reports. The mechanism of action in these conditions is either unknown or indicated to be through the inhibition of matrix metalloproteinases (MMP). The use of a single agent to treat diverse oral conditions has important implications for oral medicine.

Emergency Management of Dental Trauma among Physical Education Teachers of 2 Districts in Karnataka, India.

World Health Organization theme for the year 2002 says, ‘move for health’, which emphasizes on the role of physical activity in the healthy living of an individual. During these physical activities, injuries to the face and trauma to primary and permanent teeth are common [1]. Since a high proportion of dental trauma occurres during physical education classes in school [2], it would be desirable for physical education teachers to be capable of managing such injuries. The present study aimed to assess the knowledge of physical education teachers about emergency management of dental trauma in Dakshina Kannada and Udupi districts of Karnataka, India. A self administered questionnaire was mailed to 401 physical education teachers of Mangalore and Udupi along with an informed consent form and a self addressed paid postage envelope, in the month of January 2013. A questionnaire used by Chan et al [3] was modified and made available in both English and Kannada. The first part of the questionnaire contained questions on sociodemographic details and the second part contained questions on knowledge of dental injuries and management of avulsed teeth. Reliability was assessed by test -retest method (ρ=0.8, good reliability). Only 243 questionnaires were returned, the response rate being 60.5%. Of them, 67.9% were males and 32.1% were females. About 40.7% were in the age group of 40-49 years. About 93.4% had more than 5 years of teaching experience, 99.2% had a formal teachers training and 94.2% had first aid training. However, only 24.7% of them had training regarding management of dental trauma. When asked about the treatment options for a child with broken front tooth due to injury, only 34.2% of the study participants’ said they would contact the child’s parent to take to a dentist. When asked about avulsion due to trauma, only 18.9% of the teachers responded correctly that they would place the tooth back and take the child to dentist. When asked about need for further training for management of dental trauma 81.9% responded positively. When asked whether primary teeth needs to be replanted, about 45.7% of the study participants felt that a primary tooth need not be replanted. Very few of the participants 12.3% answered correctly that the tooth should be put back into the socket without scrubbing or washing. Only 1.6% were aware that child’s mouth is the best transportation media used when taking tooth to dentist if it has not been replanted. When asked which liquid is preferred for washing an avulsed tooth, about 53.1% responded correctly as tap water. The participants were categorized based on their age as >20 years, 20-29 years, 30-39 years, 40-49 years, >50 years and based on the teaching experience as >1 year, 1 year, 2 years, 3 years, 4 years, > 5 years. There was no significant difference among the age groups and years of experience for mean knowledge scores using One way ANOVA (p=0.2 and p=0.3 respectively). Females scored better than the males for knowledge scores which was statistically significant using unpaired t test (p=0.04) Physical education school teachers should ensure a safe environment with an aim to reduce dental trauma. It is the responsibility of the physical education teachers to strongly recommend the use of mouthguards during contact sports. The level of knowledge of physical education teachers of Dakshina Kannada and Udupi districts on the management of dental trauma appears to be inadequate. It is been noticed that physical education teachers felt the need for training in the management of dental trauma as part of their training programme because most of them lacked the knowledge on management and practiced inappropriate methods, which could lead to disability or loss of tooth

An evaluation of awareness and practices regarding management of avulsed teeth among Paediatricians in a district of north India

Objective: To evaluate the awareness and practices regarding management of avulsed teeth among paediatricians in a district of north India. Methods: A multiple choice questionnaire comprising of 10 items was formulated to assess the knowledge, attitude and practices of medical professionals regarding first aid and management of “tooth loss” (Avulsion). The study involved a sample of 314 medical doctors who were either attached to the institutes or into private practice in the district of Lucknow, UP, India. Questionnaires were electronically mailed to 400 participants followed by a reminder email after fifteen days. If did not respond after 30 days, they were excluded from the study. The results are presented in percentages. Results: About one third (34.7%) of the participants had experienced children visiting to them with tooth avulsion. A large number of 62.7% participants stated that it would be wise to seek an immediate consultation with the dentist on the contrary to a small 15% who believed consultation was not required. Out of those participants who had witnessed patients reporting in their practice with avulsed tooth, 48.6% of them referred such patients to dentists immediately without intervening however, a small number of participants (17.4%) opted to place the tooth back into the socket and refer patients to dentists.

Delayed replantation after prolonged dry storage

Management of tooth avulsion in the permanent dentition often presents a challenge. Definitive treatment planning and consultation with specialists is seldom possible at the time of emergency treatment. Replantation of the avulsed tooth can restore esthetic appearance and occlusal function shortly after the injury. This article describes the management of a patient with an avulsed maxillary permanent incisor that had been air-dried for about 40 h. The replanted incisor retained its esthetic appearance and functionality 1 year after replantation, yet the long-term prognosis is not good because of progressive replacement root resorption.

Assessment of knowledge about management of tooth avulsion among 7-14 years old school children in Nalgonda, Andhra pradesh

Assessment of knowledge about management of tooth avulsion among 7-14 years old school children in Nalgonda, Andhra pradesh

Maintaining vitality of immediately reimplanted avulsed tooth: Two-year follow-up case report

Management of tooth avulsion in the permanent dentition often presents a challenge. Such injuries should be recognized and treated expeditiously because several studies support a more likely favorable prognosis with timely and appropriate initial management. This article describes the immediate management of an avulsed maxillary permanent incisor with afollow-up of 1 year.

Managing dental emergencies: A descriptive study of the effects of a multimodal educational intervention for primary care providers at six months

BackgroundClinicians providing primary emergency medical care often receive little training in the management of dental emergencies. A multimodal educational intervention was designed to address this lack of training. Sustained competency in managing dental emergencies and thus the confidence to provide this care well after an educational intervention is of particular importance for remote and rural healthcare providers where access to professional development training may be lacking.MethodsA descriptive study design with a survey instrument was used to evaluate the effectiveness of a brief educational intervention for primary care clinicians. The survey was offered immediately before and at six months following the intervention. A Wilcoxon signed rank test was performed on pre and six month post-workshop matched pair responses, measuring self-reported proficiency in managing dental emergencies. The level of significance was set at p < 0.001. Confidence intervals (CI) were calculated for participants who scored an improved proficiency.ResultsThe educational intervention was associated with a significant and sustained increase in proficiency and confidence to treat, especially in oral local anaesthesia, management of avulsed teeth and dental trauma, as reported by clinicians at six months after the education. This was associated with a greater number of cases where dental local anaesthesia was utilised by the participants. Comments from participants before the intervention, noted the lack of dental topics in professional training.ConclusionsThe sustained effects of a brief multimodal educational intervention in managing dental emergencies on practice confidence and proficiency demonstrates its value as an educational model that could be applied to other settings and health professional groups providing emergency primary care, particularly in rural and remote settings.

Can a four-hour interactive workshop on the management of dental emergencies be effective in improving self reported levels of clinician proficiency?

Management of dental emergencies is a clinical problem facing many primary care providers who have often received little training in this area. This study evaluated the impact of a four-hour interactive workshop on clinicians' self reported proficiency in managing common dental emergencies. A descriptive study design using a questionnaire type survey instrument was used to evaluate the effectiveness of a brief interactive workshop. The workshop positively impacted proficiency, especially in oral local anaesthesia, management of avulsed teeth and dental trauma. Open comments from participants focused on the lack of dental topics in professional training. Further education is required in the management of dental emergencies such as odontogenic infections, dental local anaesthesia, trauma, intra-oral haemorrhage and in dental nomenclature. An effective interactive workshop intervention employing blended instructional techniques may help improve the management of dental emergencies and patient outcomes.

Knowledge regarding emergency management of avulsed teeth among elementary school teachers in Jaboatão dos Guararapes, Pernambuco, Brazil

The purpose of the present study was to assess the knowledge regarding emergency management of tooth avulsion among elementary schoolteachers in the city of Jaboatão dos Guararapes, Pernambuco, Brazil. A total of 338 teachers answered a questionnaire with items on emergency procedures following tooth avulsion. The majority of teachers (89.1%) had received no previous orientation regarding management of dental trauma and 81.4% had not witnessed an accident in which tooth avulsion had occurred. If an avulsed tooth had fallen to the ground, 84.3% of the teachers said they would pick it up, and 67.8% of them stated that they would clean it with water or some other liquid. A total of 33.1% said that they would take the student with the tooth in hand to a dental office. Of the respondents 88.5% would seek professional help immediately; 85.2% stated they would be unable to reimplant the avulsed tooth; and 39.3% would store the tooth in water. A lack of technical information was observed among teachers regarding management of tooth avulsion. Educational campaigns at schools are necessary to modify the behavior of the teachers with regard to management of tooth avulsion. Further studies should be carried out for the assessment of teachers who have participated in educational campaigns to make the treatment of dental trauma a matter of public interest.

Laypeoples’ preferred sources of health information on the emergency management of tooth avulsion

When planning nationwide information campaigns on the emergency management of tooth avulsion, the populations' preference to different modes of information delivery should be taken into consideration. We currently lack information on that. The aim of this study was, therefore, to assess laypeoples' preferred sources of information on the emergency management of tooth avulsion. This was a joint study undertaken by experts in media and experts in dental traumatology. Interview-assisted questionnaires were conducted on a sample of 579 adults from Kuwait. Subjects were asked to choose their three preferred sources of information on the emergency management of tooth avulsion. Subjects' responses and sociodemographic data were registered. The data were descriptively analyzed, and a chi-square test was used to assess the relation of the subjects' preferences to their registered demographics. The Internet, health care professionals, and TV were the three most preferred sources of information on the emergency management of tooth avulsion across all groups, regardless of the sociodemographic characteristics. Younger adults, singles and subjects with higher education significantly preferred the Internet. Older adults preferred TV. Family was a preferred source in geographic districts populated with extended families, while friends were a preferred source in geographic districts populated by expatriates. Younger people and those with higher education can be effectively targeted through the Internet, while it is more effective to target older people through TV. Information, on tooth avulsion management, given by health care professionals is preferred across all population segments.

Complete root resorption after reimplantation of maxillary central incisor - A case report

Avulsion is the total displacement of tooth from its socket. It usually occurs after severe traumatic injury. Management of tooth avulsion in the permanent dentition often presents a challenge. Definite treatment planning and consultationwith specialists is seldom possible at the time of emergency treatment. Reimplantation of the avulsed tooth can restore esthetic appearance and occlusal function shortly after the injury. But post traumatic root resorption canprogressively occur, resulting in permanent loss of the traumatized tooth. This article presents the same type of post operative complication because of delayed reimplantation. The reimplanted central incisor retained its esthetic appearance and function for 6 years. The long-term prognosis was not good because of progressive replacement root resorption.

Knowledge and Attitude of Primary School Teachers toward Tooth Avulsion and Dental First Aid in Davangere City: A Cross-sectional Survey.

Aim of the study Traumatic dental injuries including avulsed tooth is a tragic and ignored problem among school children. As children spend much of their time in schools, school teachers form the group who commonly supervise the physical activity of the children, so awareness about avulsed tooth emergency management among school teachers is an important concept for long-term success and to prevent its future consequences. The purpose of this study was to assess the knowledge and attitude regarding tooth avulsion and dental first aid among primary school teachers in Davangere city.MethodsThe study was performed by administering a self-designed questionnaire on a sample of 300 primary school teachers.ResultsSixty-eight percent of the school teachers (government, semi-aided and aided schools) admitted the possibility of an avulsed tooth to be replanted and thirty-two percent had no idea on tooth replantation and only twenty-three percent of the teachers knew the procedures taken in cases of avulsed teeth. Seventy-seven percent of all teachers did not feel the possibility of tooth replantation.ConclusionThere is poor knowledge in the management of avulsed teeth among the school teachers of Davangere city. They do not feel capable of replanting an avulsed tooth. As one of the child supervisors, all the school teachers should have the basic knowledge to recognize oral emergencies and regarding conservation of avulsed teeth to prevent its consequences in the child’s future.

Impact of educational posters on the lay knowledge of school teachers regarding emergency management of dental injuries

The purpose of this study was to investigate the knowledge of school teachers about the emergency management of dental trauma, after an educational poster campaign. A total of 1000 questionnaires were sent to 100 schools in the area where the poster had been distributed. This was compared to another 100 schools (1000 questionnaires) in an area, Where the poster had not been distributed. The questionnaire surveyed demographic data, basic knowledge of emergency management of tooth fracture, luxation and avulsion injuries. A total of 511 questionnaires were returned (25.5%) and analyzed. Results showed differences between the two assessed areas. Teachers, who worked in the area with poster distribution, had better knowledge in handling tooth injuries. For the management of tooth fractures the portion of teachers, who knew the correct handling procedure, was 78.9% (area with poster campaign) vs 72.1% (area with no poster campaign), for the management of tooth luxation it was 87% vs 84% and for the management of tooth avulsion it was 71% vs 54%. In the area with the poster campaign 49% (n = 90 out of 185) of the teachers stated to have gained some knowledge about this topic beforehand. Out of these, 75 teachers (75/90 = 83%), had gained their information from the educational poster. Out of the 75 teachers, who had seen a poster on this topic, 68 (68/75 = 91%) would have managed such an emergency correctly. The present study shows the positive effect of educational poster campaigns. It therefore should encourage professionals in this field to embark on similar projects.