Management of avulsions in Switzerland 2007-2010

More than 50% of all European children suffer a dental injury (DI), for which the emergency treatment is usually carried out by a general dentist. The aim of this survey was to assess the management of avulsions in Switzerland as the common treatment procedures used by Swiss dentists in such cases. As yet there are no published data on the treatment of DI in Switzerland.

A 15-item questionnaire was distributed to all members of the Swiss Dental Society containing questions about the dentists' profile, the distribution of dental injuries they had encountered affecting permanent teeth, especially avulsions, the number of treated avulsions and questions about how the dentists had treated an avulsion in the past 3 years.

The response rate was 41% (n = 1350). On average, two avulsions per practitioner had been seen in the past 3 years. The dental practitioners who encountered cases of tooth avulsion treated an average of 2.8 avulsions in that time frame. Most dentists applied conventional intraoral root canal treatment, which was performed on average 9 days after replantation. As the intracanal dressing, calcium hydroxide was used by 69.8% and Ledermix® by 49.3%, while Asphaline® was used by only 1.8% (multiple answers were possible). Seventy-eight percent (78.1%) of the respondents had received postgraduate dental trauma education. Dentists with such an education used Ledermix® significantly more often (P = 0.002), and the time until pulp extirpation was significantly shorter (P < 0.001). The favorite splint after replantation was the Titanium Trauma Splint®, followed by the wire composite splint and the bracket splint, while the aligner was used very rarely. The average splinting time was 11.2 days. Eighty-one percent (81.1%) of the respondents had a tooth rescue box in their office, 41.1% had Emdogain®, 25.9% had tetracycline for local application, and 14.7% had steroids for local application available.

Although only a few patients with avulsions had presented in Swiss dental offices in the past 3 years, their treatment was closely aligned to current guidelines.