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In all 50 states, the District of Columbia, and the Commonwealth of Puerto Rico, pediatricians, dental professionals, and other physicians are mandated to report suspected cases of abuse and neglect to social service or law enforcement agencies. The purpose of this clinical report is to review the oral aspects of abuse and dental neglect in children and the role of pediatricians, dental professionals, and other physicians in evaluating such conditions. This clinical report addresses recommendations on the evaluation of bite marks, as well as perioral and intraoral injuries, infections, and diseases that may raise suspicion for child abuse or neglect. Some physicians may have received less education pertaining to oral health, dental injury, and oral disease. These physicians may not detect the mouth and gum findings possibly related to abuse or neglect as readily as abuse injuries involving other areas of the body. Therefore, pediatricians, dental professionals, and other physicians are encouraged to collaborate to increase the prevention, detection, and treatment of these conditions in children., (Copyright © 2024 by the American Academy of Pediatrics.)

This paper aims to aid clinicians in the assessment and immediate management of dental trauma displacement injuries to permanent teeth. Long term sequelae, the impact of such injuries, and the evidence-base for managing these are discussed.Clinical cases are provided to illustrate management challenges and highlight where further evidence-based guidance is needed. The role of the general dental practitioner in the immediate management and follow-up of traumatic dental injuries is outlined and sequelae, worthy of potential referral, described., Competing Interests: Conflict of interestThe authors declare that there is no conflict of interest.

Traumatic dental injuries (TDIs) in the paediatric population are common and frequently seen in general dental practice. The management of TDIs can be challenging and, in most cases, the General Dental Practitioner is tasked with the initial assessment and emergency treatment. Patients and their families typically attend with elevated levels of distress, which is complicated by the limited dental experience of some children. Behaviour management is essential and helps prepare patients for dental care at both their emergency and follow-up appointments. Early and accurate diagnosis in combination with appropriate treatment contributes to favourable outcomes for traumatised teeth. Early discussions with or referral to paediatric dental teams for management of complex TDIs is encouraged, however shared follow-up care is beneficial over the long-term. In specific cases, initial dental treatment can be delayed by a few days to a subsequent appointment, allowing the dental team to book sufficient time for the treatment and for the patient and their families to prepare. Education of the patients and adults with parental responsibility is essential to manage expectations, explain likely complications and encourage attendance for long-term follow-up visits. This paper discusses the management of paediatric patients to aid the primary care practitioner in providing effective immediate and long-term care.

Traumatic dental injuries pose a variety of complex ongoing issues to the dental practitioner. As dental injuries are commonly experienced at a young age, the treatment often takes place during adolescence or early in adulthood years at crucial development stages and very early in the life of the permanent successor. Therefore, the ability to correctly diagnose the injury, and follow an appropriate management plan should increase practitioners' ability to improve both the outcomes of dental trauma and long-term prognosis of the tooth.The consequences of dental trauma can be explored by taking into consideration the type of injury, which enables an assessment of the degree of insult to the pulpal tissues, neurovascular bundle, periodontal ligament and cemental cells. This has a direct influence on post-trauma complications. Early intervention, where indicated, and appropriate follow-up utilising international guidelines is imperative to identify changing diagnoses and act accordingly. This review paper will discuss the classification of traumatic injuries and their associated outcomes with management strategies for emerging disease including potential endodontic and restorative complexities and when to refer to secondary care., Competing Interests: Declaration of conflicting interestsThe authors declare that there is no conflict of interest.

Background/aims: Traumatic dental injuries (TDI) are one of the most commonly encountered dental health complications. In order to standardize the evaluations and compare the findings of TDI, a carefully defined dental trauma index may serve as a good tool for the correct recording of dental trauma. A new dental trauma index, the Modified Eden & Baysal dental trauma index (MEBTI), has been introduced. It is an expanded index to record soft tissue injuries in addition to dental injuries. The aim of this study was to assess the validity and reliability of the MEBDTI., Materials and Methods: The archival data of 20 patients with different traumatic injuries were selected. A web-based form including the radiographs and photographs of selected cases was created. Following a training session, 12 dentists with a minimum of 10 years of clinical experience were asked to score the cases using the MEBDTI on an online form. The Kolmogorov-Smirnov test was used to test the normality. The Kruskal-Wallis Test was used for intergroup comparisons. Inter-observer agreement was investigated by reliability analysis. The intraclass correlation coefficient (ICC) was used to evaluate the agreement among observers. The Chi-Square test of independence was used to determine if there is a significant relationship between two nominal variables (p < .05)., Results: The rate of correctly assessing the alveolar bone fracture was 96.9% followed by apex maturity (92.7%), root fracture (85.4%), luxation injury (76.5%), crown fracture (76.2%), and soft tissue injury (50%). Considering all parameters, the soft tissue injuries were statistically different in terms of the answers given by the 12 dentists (p < .05)., Conclusion: The accuracy of the scores of participants was high and in accordance with each other except for the identification of soft tissue injuries. In favor of this novel index, the data on dental trauma cases could be recorded practically and reliably., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Dental and oral injuries are a common occurrence in sport. Initial evaluation should always begin with an assessment of the patient's airway, breathing, circulation, as well as identification of associated injuries. Tooth avulsions are the only true dental emergency. Oral lacerations frequently do not require repair; however, special attention should be paid to lip lacerations involving the vermillion border. Most tooth and oral lacerations can be treated on the field with urgent referral to a dentist., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: To assess paediatric emergency department (PED) health professionals' confidence, experience and awareness in managing traumatic dental injuries (TDIs)., Design: A cross-sectional online survey., Setting: PED at Alder Hey Children's Hospital and Birmingham Children's Hospital., Results: 94 ED health professionals responded. One-third of responders (n=26) encounter children with dental trauma daily or weekly. TDI teaching during undergraduate training was received by 13% (n=12) of responders, and 32% (n=30) had never received training. Responders thought they would benefit from online resources and regular teaching on paediatric TDIs, in addition to an easy-to-use decision-making tool to signpost families.ED health professionals' confidence in giving advice to families following a TDI, and in recognising types of TDIs, was notably low; -79 and -76 Net Promotor Score, respectively.Responders' awareness of how to recognise and manage TDIs was varied. Majority were aware of the need to attempt to reimplant an avulsed permanent tooth, and the need to refer a child presenting with a complex permanent tooth injury to the oncall dentist. However, very few responders commented on the importance of follow-up. Responders also raised concerns about the lack of dental services to treat TDIs in children., Conclusions: There is a need to enhance dental trauma teaching for all ED health professionals who encounter TDIs to increase their confidence and enable them to triage and advise patients appropriately. Additionally, increased signposting for families to the appropriate service could in turn improve outcomes and experience for children who experience a TDI., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Background: Current evidence suggests traumatic dental injuries can be difficult to manage in primary care due to uncommon occurrence and challenging patient presentations. Such factors may contribute to general dental practitioners lacking experience and confidence in the assessment, treatment and management of traumatic dental injuries. Furthermore, there are anecdotal accounts of patients presenting to accident and emergency (A&E) services with a traumatic dental injury, which could be placing avoidable strain on secondary care services. For these reasons, a novel primary care-led dental trauma service has been established in the East of England., Methods: This brief report shares our experiences of establishing this dental trauma service, titled 'Think T's'. It aims to provide effective trauma care across an entire region by a dedicated team of experienced clinicians from primary care settings to reduce inappropriate attendance to secondary care services and upskill colleagues in dental traumatology., Findings and Conclusions: Since its inception, the dental trauma service has been public-facing and has managed referrals from a range of sources which include general medical practitioners, A&E clinicians and ambulance services. The service has been well received and has been seeking to integrate with the Directory of Services as well as NHS 111., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

The aim of this paper is focused on expanding medical students' knowledge and understanding of a non-core curricular subject not normally offered in the medical curriculum. The critical juncture explored how to introduce a health-related subject into medical education that complements without competing for space/time in medical students' core studies. Using dental trauma as an example, this paper supports the opportunity for medical students to learn online about managing dental injuries and to raise their awareness of the need for accurate diagnosis and treatment of traumatic dental injuries before they graduate as medical doctors., (© 2022 The Author. Dental Traumatology published by John Wiley & Sons Ltd.)

Background: Many patients are taken to the emergency room for dental trauma treatment, but studies reveal that medical professionals do not feel confident in diagnosing and treating children with traumatic dental injuries. The purpose of this study was to determine if a clinical decision support tool (CDST) would improve dental trauma knowledge of primary teeth in medical students and pediatric dentists. Another purpose was assessing effectiveness of print and mobile app CDSTs., Methods: Medical students (n = 100) and pediatric dentists (n = 49) were given a pretest to assess baseline dental trauma knowledge. All subjects were randomly assigned to 1 of 3 groups for the posttest: no CDST, print CDST, and mobile app CDST. Test scores and total time spent on each test were recorded and analyzed., Results: Compared with medical students, pediatric dentists scored significantly higher in both pretest (8.57 ± 0.96 vs 4.20 ± 1.58; P < 0.001) and posttest (8.37 ± 1.09 vs 4.96 ± 1.99; P < 0.001). There was no significant difference in time spent to complete the 2 tests between both groups. Medical students and pediatric dentists who utilized the mobile app CDST had scored highest (P = 0.028) but took the longest time (P < 0.001) on the posttest., Conclusions: Both print and mobile app CDSTs improved diagnosing and managing traumatic dental injuries in primary dentition significantly compared with those without aid. Medical students with CDSTs showed significant improvement in managing primary dental trauma; therefore, it is recommended for better, more accurate diagnosis and treatment in patients., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Aim: Accurate records of traumatic dental injuries are important for clinical management and data collection for research. Soft tissue injuries often accompany dental trauma and should be appropriately recorded. The Eden Baysal Dental Trauma Index (EBDTI) provides an easy recording system of useful information about traumatic dental injuries on a tooth basis. The aim of this study was to extend the EBDTI index to record soft tissue injuries in a concise format and to approve the face and content validity of this version as the modified EBDTI (MEBDTI)., Materials and Methods: An extension to EBDTI was developed by adding superscript numbers from 0 to 8 to represent soft tissue injuries related to dental trauma. The Rand e-Delphi method was used to evaluate this version of the index. A definition and two statements about the index were sent to 15 international panel experts to be assessed independently on a 9-point Likert scale where 1 represented "total disagreement," and 9 indicated "total agreement." The panel needed to reach a 75% consensus for validation. A numerical code was suggested using zero to depict no soft tissue injury; 1-4 to record extra-oral injuries; and 5-8 to record intra-oral injuries (for example, gingiva, frenulum, and palate). Traumatic dental injury of the tooth/teeth is recorded using EBDTI in square brackets, and soft tissue codes are used as superscript numbers outside the brackets on a patient basis., Results: The panel reached a consensus on the definition (86.7%) and two statements (86.7% and 93.3%) in one round. Various cases are presented to demonstrate the application of the index., Conclusion: The Modified Eden Baysal Dental Trauma Index was developed to record soft tissue. injuries on a patient basis and was approved for face and content validity., (© 2021 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

Facial and dental-related trauma is common in the pediatric population. Appropriate evaluation and management techniques should be followed. Initial evaluation of the medical condition of the patient should be completed with acute management of any medical-related problems as a priority. ABCDEs of pediatric trauma should be followed and a thorough head and neck and oral examination completed with appropriate imaging if indicated. Newer dental trauma treatment protocols developed by the International Association of Dental Traumatology should be followed for best outcomes. Pediatric traumatic dental injuries generally have good prognosis by attempting to retain and stabilize teeth., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background/aims: Traumatic dental injuries (TDI) are complex problems where lack of proper care may result in serious complications. The need to improve the management of TDI is a frequently addressed concern. Methods of improvement in their diagnosis and management are continuously evolving. The interactive Internet tool, the Dental Trauma Guide (DTG), helps to simplify diagnostic and management dilemmas. However, it is not a freely available tool. The aim of the current study was to assess the knowledge and diagnostic skills of undergraduate dental students with access to the DTG compared with students without such access, in order to validate and promote this tool in dental education., Materials and Methods: Two groups of students were randomly selected where one group of final year dental undergraduate students were exposed to lectures, demonstrations, discussions and tutorials on the management of TDI according to the standard undergraduate curriculum in Sri Lanka. Another test group of 21 students were provided with access to DTG during their training in paediatric dentistry. At the end of the study period, students were assessed on their knowledge of TDI using MCQs (Multiple Choice Questions) and OSCEs (Objective Structured Clinical Examination), based on the DTG., Results: The students with access to the DTG were more knowledgeable in providing the correct answers to three out of the seven OSCE questions. Evaluation based on the MCQs did not reveal a significant difference (p = .913). However, users of the DTG showed a statistically significant difference with better overall knowledge based on their answers (p = .028). Following this period of evaluation, all of the students were provided with access to the DTG to supplement their learning experience., Conclusion: The Dental Trauma Guide is a useful supplementary tool for undergraduate students to arrive at a correct diagnosis and treatment plan for TDI., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: Tertiary surveys aim to detect injuries missed in the initial assessment of trauma. We introduced a process by which the trauma nurse specialist performed a number of the tertiary surveys (NTSs) at our paediatric trauma centre., Methods: Data from the first six months following introduction of the NTS were compared to retrospective data from the six months prior to NTS implementation (pre-NTS), when trauma surveys were completed by medical staff., Results: Over the 12-month period, 130 children met the criteria for a tertiary survey. Pre-NTS, 57/62 eligible patients received a tertiary survey, compared to 61/68 during NTS (p=0.77). There were significantly more road traffic crash patients in the NTS group (p=0.008) but no significant differences by demographics, injury pattern, injury severity score or outcomes. New injuries were found in three patients pre-NTS compared to five patients during NTS (odds ratio 1.3 (95%CI 1.3-2.0, p=0.73))., Conclusion: This study conservatively supports the hypothesis that, with training and support, a trauma nurse specialist can perform tertiary surveys as effectively as doctors. A larger study is required to confirm these findings., Competing Interests: Nil.

Objectives: Few studies have explored the oral health training needs and professional self-efficacy (PSE) in both pharmacy support staff and pharmacists related to managing children's dental problems. This study assessed community pharmacy staff perceptions of their (i) training experiences and interests; (ii) PSE; and (iii) whether this was influenced by the pharmacy being part of a minor ailment scheme (MAS), where staff could directly offer advice and issue prescription medications without patients seeing a doctor., Methods: All of the 1851 community pharmacies across London, UK, were invited to participate in an online questionnaire. Staff rated their prior training, perceived need for further training and confidence in giving parents advice related to three dental problems in children (dental pain, mouth ulcers and dental trauma). Information was collected about staff roles and whether the pharmacy was a MAS., Key Findings: From 752 community pharmacies, 846 community pharmacy staff participated. Positive experiences of training were variable but interest in further training for all three dental problems was high. Pharmacy support staff had significantly lower PSE scores than pharmacy professionals (P = 0.009). A significant interaction showed that pharmacy staff who had poorly rated prior training on advising parents about managing their child's dental pain and who did not work in a MAS had lower PSE scores than staff who had highly rated training and who worked in a MAS (P = 0.02)., Conclusions: Minor ailment scheme pharmacies may be an optimal environment for frontline pharmacy support staff to develop higher PSE when combined with good quality oral health training., (© 2020 The Authors. International Journal of Pharmacy Practice published by John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.)

Traumatic dental injury (TDI), one of the common dental diseases, is defined as acute injuries to tooth hard tissues, dental pulp and/or periodontal tissues caused by sudden forces. Based on the Guidelines for the Management of TDI by International Association of Dental Traumatology (2012) and the Recommended Guidelines of the American Association of Endodontists for the Treatment of TDI (2013) for the permanent teeth, and combined with the authors' clinical experiences, the contemporary classification and clinical perspective of TDI were introduced in detail. Dental clinicians should understand and master the international guidelines for the management of TDI, including proper diagnosis, standardized treatments and regular follow-up, so as to obtain the favorable outcomes.

Injury of the tooth pulp is excruciatingly painful and yet the receptors and neural circuit mechanisms that transmit this form of pain remain poorly defined in both the clinic and preclinical rodent models. Easily quantifiable behavioral assessment in the mouse orofacial area remains a major bottleneck in uncovering molecular mechanisms that govern inflammatory pain in the tooth. In this study we sought to address this problem using the Mouse Grimace Scale and a novel approach to the application of mechanical Von Frey hair stimuli. We use a dental pulp injury model that exposes the pulp to the outside environment, a procedure we have previously shown produces inflammation. Using RNAscope technology, we demonstrate an upregulation of genes that contribute to the pain state in the trigeminal ganglia of injured mice. We found that mice with dental pulp injury have greater Mouse Grimace Scores than sham within 24 hours of injury, suggestive of spontaneous pain. We developed a scoring system of mouse refusal to determine thresholds for mechanical stimulation of the face with Von Frey filaments. This method revealed that mice with a unilateral dental injury develop bilateral mechanical allodynia that is delayed relative to the onset of spontaneous pain. This work demonstrates that tooth pain can be quantified in freely behaving mice using approaches common for other types of pain assessment. Harnessing these assays in the orofacial area during gene manipulation should assist in uncovering mechanisms for tooth pulp inflammatory pain and other forms of trigeminal pain.

Traumatic oral injuries in children involve trauma to the dentition and the surrounding oral soft tissue structures. They usually present as an emergency hence their management poses a challenge globally. Treatment of a tooth fracture, displacement or loss is determined by the type and severity of the injury independent of the etiology. It necessitates the experience for behavior management in a child, ascertaining a patient centered diagnosis, formulating a definitive treatment plan, explanation and consent of oral care to the parents or carer with optimal operator skills. This article provides an overview on the types of oral injury in a child patient, their recognition, diagnosis and management based on credible, practical and readily understandable evidence.

Healthy teeth allow us to eat and stay well-nourished. Although primary care clinicians receive limited training about teeth, given the common nature of dental problems, it is important that they understand and recognize normal and abnormal dental conditions and can implement primary and secondary prevention of dental conditions in their practice. PubMed has been used to search the scientific literature for evidence on the following topics: normal dental development, dental abnormalities, malocclusion, teething, dental caries and related epidemiology and prevention, fluoride, dental injury and its management and prevention; and identification, prevention and treatment of gingivitis and periodontal disease. Literature review relied on randomized controlled trials, meta-analyses, systematic reviews, and Cochrane reviews when relevant and available. Other sources of evidence included cohort and case-control studies. Consensus statements and expert opinion were used when there was a paucity of high-quality research studies. The literature has been synthesized on these topics to make them relevant to pediatric primary care clinicians, and as available, the strength of evidence has been characterized when making clinical recommendations., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Dark coronal discoloration is a common outcome of traumatic dental injuries in primary incisors. However, there are only a few research studies on the mechanism that causes dark discoloration, the condition of the pulp, and the preferred treatment of such teeth. This article is a summary of the author's research studies and personal experience regarding dark coronal discoloration of traumatized primary incisors., (© 2019 John Wiley & Sons A/S and American Association of Endodontists.)

Traumatic dental injuries comprise a number of the dental emergency patients who are often seen after hours or on an unscheduled basis in a dental practice environment. Although there are a variety of traumatic dental injuries that can occur, each with their own recommended treatment protocols, the initial evaluation and diagnosis of the traumatized dentition make up a critical aspect of the management of these cases. This article will highlight the key components of a thorough and efficient examination process of the traumatized dentition to include (a) documenting an accurate history of the events causing the injury, (b) performing a systematic clinical examination to include the use of clinical photographs and pulp sensibility tests, (c) obtaining appropriate radiographic images and scans, (d) understanding some considerations unique to evaluating young patients with traumatic injuries, and (e) recognizing the importance of having accurate and thorough documentation of these types of cases. Once the evaluation and diagnosis phase has been completed, the necessary treatment protocols can be initiated in an appropriate manner., (© 2019 John Wiley & Sons A/S and American Association of Endodontists.)

Background/aim: Dental trauma is a public health issue with a high prevalence in children. The aim of this study was to evaluate the level of knowledge of dentists in Rio Grande do Sul, Brazil, of the management of traumatic dental injuries, using the International Association of Dental Traumatology (IADT) Guidelines as a reference., Materials and Methods: An electronic questionnaire investigating personal and professional characteristics and 12 questions about dento-alveolar trauma, was sent to all registered dentists of the Regional Council of Dentistry of Rio Grande do Sul (n=14 753). The respondents were grouped according to the sociodemographic and professional profiles and the data were evaluated by the Student-T test or one-way ANOVA, with Tukey's post-hoc, with α = 5%., Results: A total of 1414 dentists responded to the survey (9.59% response rate). The overall mean self-reported knowledge of dental trauma was 5.87 ± 1.57, of a maximum possible score of 12. Some factors associated with a higher knowledge of the IADT guidelines were: female gender, previous clinical experience, years from qualification, self-reported knowledge, and academic postgraduate degree. Dentists who are specialized in endodontics (6.58 ± 1.63) and pediatric dentistry (6.05 ± 1.44) achieved higher levels of knowledge on dental trauma. Analysis of the characteristics (gender, location, and proportion of specialists) of the respondents confirmed that they were representative of the target population., Conclusion: The overall level of knowledge of dentists from Rio Grande do Sul of the IADT guidelines is moderate. These results highlight the need for continuing education on dento-alveolar trauma in this population., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Dental emergencies present frequently to the emergency department and urgent care centers. Trauma to the teeth includes fractures, luxations, and avulsions, which can be reduced in most cases. Avulsed primary teeth should never be replaced. Mouthguards should be worn in most youth sports to prevent many dental injuries. Dental caries can progress to worsening infection and should be diagnosed and promptly referred. More severe infections may require antibiotics, imaging, or incision and drainage. Dental blocks can assist with analgesia and patient comfort during other procedures., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Writing a constat is a professional skill required of every general physician and dentist. Constats are issued by healthcare providers on the investigating authority's, court's or injured person's request. This document is an official judicial evidence, a record of medical examination, and it is also a medical opinion which can determine the outcome of the subsequent legal process. Incomplete and incorrect injury descriptions make it difficult for forensic experts to form accurate and appropriate opinions. The authors examined 147 dental and oral surgical constats from the Universities of Pécs and Debrecen using multidisciplinary approach (according to terminological, dental, surgical, forensic and criminal legal aspects). Several medical reports contained mistakes in terms of inaccuracies and self-contradictions, terminology and professional medical practice. The documents included 352 injuries (11.1% of which were tooth injuries, 47.7% bone injuries and 41.2% soft-tissue injuries). The low number of attributes per injury (0.64 on average) indicates insufficient documentation. As a result of the comparative analysis, significant differences were found between the documentation of dental injuries and that of other bone injuries pertaining to their information content. We can state that physicians are most consistent when describing bone injuries, while they are less articulate about tooth injuries. The authors provide an overview of the legal consequences of injuries as well as the legal practice regarding tooth injuries in Germany and Austria, and recommend the creation of a nationwide, unified terminology for both dental and trauma departments on nasal and dental injuries. Orv Hetil. 2018; 159(51): 2154-2161.

A 58-year-old woman presented with a 30-day history of a moderately painful enlarging nodule on her upper cutaneous lip. Two weeks prior to presentation, she fell on the sidewalk leading to injuries of the oral mucosa, right temple, and knees. Physical examination revealed a 1.3-cm erythematous crusty nodule on the upper cutaneous lip and vermillion border resembling a keratoacanthoma-type squamous cell carcinoma. With gentle compression, a tooth was expressed from the wound. Dental traumas are usually associated with damage to the surrounding tissues, varying from bruises to deep lacerations. Potential complications include abscess formation and neurovascular damage. Tooth fragments, if undetected at the time of trauma, may remain undiagnosed for longer periods, leading to infection and disfiguring fibrosis., (Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: Dental trauma is not uncommon. The initial management provided at the time of injury is critical in predicting prognosis. However, initial management depends on correct diagnosis. Recently an App named 'Injured Tooth' was made available to diagnose traumatic injuries to the teeth and supporting structures., Aim: To test the diagnostic ability of the Injured Tooth App compared with the conventional method of diagnosing traumatic injuries to the teeth., Design: A cross-sectional study was conducted at three different centres with 176 patients aged 0-15 years, having 201 injured teeth. Diagnosis of the injured teeth in these children at every centre was done independently by one experienced faculty using the traditional method and by a student using the Injured Tooth App., Results: Injured Tooth App gave a correct diagnosis for 197 teeth included in the study. Statistical analysis showed that there was good agreement (Kappa = 0.973) between the diagnosis given by the App and the experienced faculty., Conclusions: The study found that the diagnosis given by the Injured Tooth App was in good agreement with the diagnosis given by an experienced faculty. Hence, the App can be successfully used by dental students to arrive at diagnosis., (© 2018 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Nearly 50% of children will experience dental trauma by the age of 4 years. Timely and effective care is important in the management of dental injuries, as several studies have shown poor outcomes with delayed treatment. The current evidence in the management of dental injuries is primarily from a dentist's perspective, with limited evidence specific to management in the emergency department. The goal of pediatric dental injury management is dictated largely by whether the dentition is primary or permanent. This issue provides a systematic emergency medicine-based approach to address pediatric dental injuries, along with a review of basic dental procedures that will lead to improved dental outcomes.

This paper outlines the involvement of dentists in the treatment of patients following the terror attack at Manchester Arena on 22 May 2017. It predominantly describes the role of the authors - a paediatric dental consultant and maxillofacial surgery dental core trainee (DCT). As a result of the incident a number of patients suffered oro-facial injuries, with many treated at Central Manchester Foundation Trust Hospitals' Manchester Royal Infirmary and Royal Manchester Children's Hospital. The major incident response of the trust is discussed, as are the presentation of blast injuries and corresponding NHS guidance. Two paediatric cases present the role of the paediatric dental consultant in the acute, intermediate and long-term management of these patients. The presentation of unique dento-alveolar injuries in the context of other trauma and their subsequent treatment demanded true multidisciplinary management. The importance of teeth and oral health to physical and psycho-social wellbeing and recovery was clear and recognised by other teams involved in the patients' management. The experience reinforced the overall impact dental health has on physical and psycho-social health, and how a holistic approach is integral to treatment of major trauma.

In all 50 states, health care providers (including dentists) are mandated to report suspected cases of abuse and neglect to social service or law enforcement agencies. The purpose of this report is to review the oral and dental aspects of physical and sexual abuse and dental neglect in children and the role of pediatric care providers and dental providers in evaluating such conditions. This report addresses the evaluation of bite marks as well as perioral and intraoral injuries, infections, and diseases that may raise suspicion for child abuse or neglect. Oral health issues can also be associated with bullying and are commonly seen in human trafficking victims. Some medical providers may receive less education pertaining to oral health and dental injury and disease and may not detect the mouth and gum findings that are related to abuse or neglect as readily as they detect those involving other areas of the body. Therefore, pediatric care providers and dental providers are encouraged to collaborate to increase the prevention, detection, and treatment of these conditions in children., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2017 by the American Academy of Pediatrics and American Academy of Pediatric Dentistry.)

Objective: To retrospectively analyze dentoalveolar trauma in pediatric patients, propose a modified classification, and delineate an approach for its urgent care from the surgeon's perspective., Patients and Methods: Clinical records of patients, attended at the 'A. and P. Kyriakou' Children's Hospital Department of Oral and Maxillofacial Surgery from 2000 to 2015, were retrieved and data were analyzed., Results: A total of 365 cases of dentoalveolar trauma, affecting 363 children and adolescents (221 males and 142 females), with an age range from 1 to 15 years, were treated in the authors' department. The most common injury mechanism was falls. The trauma was graded as class II in most patients (41.65%). The anterior maxilla was injured in the majority of the patients (78.35%). In 230 patients (63%) the trauma involved the primary dentition. Two hundred eighty-nine of the patients were treated with local anesthesia on an emergency basis, while in the rest 76 patients general anesthesia was considered mandatory., Conclusions: Accurate diagnosis, timely treatment, and follow-up are critical for the management of dentoalveolar trauma in pediatric patients. A modified more detailed and severity-specific classification and guidelines for its surgical management may assist practitioners in decision making and effective treatment planning.

Acute dental emergencies are a common chief complaint presenting to emergency departments, and they are increasing substantially in frequency. The diagnosis and management of dental emergencies is a core competency of the emergency clinician, and proper therapeutic strategies can significantly improve cosmetic and functional outcomes for patients. This issue provides a systematic review of the literature on common acute traumatic and atraumatic dental emergencies with a focus on the historical and physical examination findings that must be understood to identify life-threatening infections, relieve pain, salvage natural teeth, and communicate with specialists in the further management of patients after emergency treatment.

Intrusion of permanent teeth is not extensively covered in the literature compared to other injuries. Treatment guidelines have been published and clinical data is accumulating to support the current recommendations, which are illustrated in the three cases here. This review evaluates the current information about management of traumatically intruded permanent teeth. As more data accumulates, uncertainties with respect to both treatment recommendations and long-term outcomes can be expected to be elucidated.

Oral and facial injuries are very common in sport, and can be very expensive to treat. Many of these injuries are preventable with proper pre-competition assessment and suitable well-designed protection. Prompt sideline identification and management of orofacial injuries and appropriate follow-up are crucial to successful outcomes. There have been significant recent advances in both trauma management and mouth guard design and fabrication techniques. Athletes have a unique set of challenges-including collisions, finances, travel and training, dehydration, sport beverages, and high carbohydrate diets-that may compromise their oral health., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The management of adult dental trauma can be a daunting challenge for practitioners at any level. Like medical emergencies, initial management can have a large influence on prognosis. It is important that practitioners understand the basic principles of managing the acute presentations of dental trauma. This article aims to illustrate a step-by-step approach in order to improve the management within general dental practice for better outcomes for patients.

The management of adult dental trauma can be a daunting challenge for practitioners at any level. Like medical emergencies, initial management can have a large influence on prognosis. It is important that practitioners understand the basic principles of managing the acute presentations of dental trauma. This article aims to illustrate a step-by-step approach in order to improve the management within general dental practice for better outcomes for patients.

Introduction: Documentation and evaluation of dental injuries in forensic medicine are rather problematic. It needs a professional work up why dental injuries are out of focus, and how the diagnosis, pattern and treatment are influenced by novel approaches of dentistry., Aim: The aims of the authors were to characterize dental injuries, to compare their own findings to literature data concerning the type and characteristics of injuries, and propose a diagnostic workflow., Method: Expert's reports between 2009 and 2013 at the Department of Forensic Medicine, University of Szeged were reviewed., Results: Review of about 7000 reports revealed only 20 cases with dental injury, which is in contrast with literature data indicating a significantly higher frequency of dental injuries., Conclusions: Although the number of "dental cases" was low, there were several additional cases where the trauma probably affected the teeth but the injury was not documented. In future more attention is needed in forensic evaluation of the mechanism, therapeutic strategy and prognosis of dental injuries.

Severe dental traumatic injuries often involve the supporting bone and soft tissues. This article outlines the current concepts in the management of dentoalveolar fractures for the general dental practitioner with case reports to illustrate management principles and techniques., (© 2016 Australian Dental Association.)

Trauma involving the dentoalveolar region is a frequent occurrence which can result in the fracturing and displacement of teeth, crushing and/or fracturing of bone and soft tissue injuries including contusions, abrasions and lacerations. This review describes the assessment of patients with these injuries, not in a didactic sense by repeating excellent already published classifications and treatment options, but by addressing questions that arise during assessment. It covers trauma first aid, examination of the patient, factors that affect treatment planning decisions, and the importance of communicating treatment options and prognosis to traumatized patients., (© 2016 Australian Dental Association.)

Background: Patients who sustain dental trauma commonly present to their general practitioner (GP) or the emergency department, especial-ly to seek help after hours. It is important, therefore, for medical practitioners to correctly diagnose and manage these patients., Objective: The purpose of this paper is to familiarise GPs with different presentations of dental-related trauma, and a brief management plan for each condition., Discussion: Time is of the utmost importance when dealing with trauma in the dentition. Initial management of dental trauma, primarily by GPs working in rural or remote areas, can have a significant impact on the prognosis of oral hard and soft tissues.

The timeliness of treatment after dental trauma is crucial to successful tooth preservation. This article focuses on the emergency treatment of common forms of dental trauma in athletes, both at the site of the injury and at the dental office. When dental injuries happen to young patients, saving the tooth is an absolute priority, because few long-term replacement solutions can be performed in a growing child. Preserving pulpal vitality of immature teeth is essential to allow continued root development.

In 1985 Andreasen and Andreasen published a paper on the diagnosis of luxation injuries and outlined the importance of standardized clinical, radiographic, and photographic techniques. Now 30 years later, these recommendations remain current in the International Association of Dental Traumatology (IADT) guidelines for the management of dental trauma and describe circumstances surrounding the time of injury, the extent of trauma (e.g., type of luxation injury), healing potential (e.g., stage of root development) as well as information concerning subsequent treatment. The purpose of this review was to include findings for other types of trauma and to discuss more recent studies that augment and/or improve on the original findings from 30 years ago. The present review discusses the use of a standardized clinical registration (pulpal sensibility testing, laser Doppler flowmetry, mobility testing), radiographic survey, and photographic registration of the traumatized patient. Moreover, the value of digital radiographs and recent developments in computer tomography with respect to possible enhancement of the trauma diagnosis are discussed., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Intrusions are considered among the most severe forms of dental trauma and are associated with severe late complications. Usually general dental practitioners are the first to see and treat these children. The present case describes the challenges associated with the diagnosis and treatment of late complications of complete intruded maxillary incisors accompanied by profound buccal displacement in an 8-year-old patient. The treatments performed included root-canal treatment of right central incisor using mineral trioxide aggregate (MTA) and a combination of surgical and orthodontic repositioning of the intruded left incisor. Clinical and radiographic examinations at 2 years' follow-up revealed intact lamina dura and no sign of ankylosis in both incisors, apexogenesis of the right central incisor, and positive response to pulp testing of the left central incisor. The present report emphasizes the need to follow a child with severe dental injury and to consult with trained specialists when needed.

With the growing number of air passengers, flight attendants, leisure pilots, as well as military and airline pilots, dentists may encounter physiological and pathological phenomena precipitated by high altitude. With the introduction of the self-contained breathing apparatus (SCUBA), many of these manifestations caused by changes in atmospheric pressure were reported in association with diving as well. Limited literature exists on this subject. Hence, this article aims to review literature concerning the classification, etiology and manifestations of barodontalgia, as well as important clinical considerations for its management.