Strategies to minimise the consequences of trauma to the teeth

Trauma to the mouth involves not only the teeth but also the dental pulp, the periodontal ligament, bone, gingiva and other associated structures. There are many different types of injuries with varying severity in each case and often more than one injury to a tooth at the same time. Hence, there are many different potential responses of the pulp, peri-radicular and soft tissues following trauma. The responses of the different tissues are inter-related and dependent on each other, which results in many potential consequences of trauma to the teeth. It is imperative that dentists have a thorough understanding of the possible tissue responses so appropriate treatment can be provided to minimise the consequences of trauma. The five main strategies to reduce these consequences are to: 1) perform a thorough examination and accurate diagnosis to identify all injuries and to assess the likely healing responses; 2) reposition and stabilise the teeth and bones to provide optimum conditions for healing; 3) carefully manage soft tissues to help healing; 4) commence root canal treatment immediately in specific situations to prevent external inflammatory resorption; and 5) follow-up and review all traumatised teeth to identify and manage any adverse consequences as soon as they occur in order to minimise their effects on the patient.