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Protecting All Children's Teeth (PACT): A Pediatric Oral Health Training Program
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Key Points
Approximately 50% of children will sustain a tooth injury by the time they reach adolescence.
Tooth injury is more common along males.
The maxillary central incisors are the most common site of dental trauma.
Falls are the most common cause of oral injuries.
Inability to open and laterally deviate the jaw following trauma is concerning for fracture.
Physicians should attempt to locate missing teeth following an accident.
Tooth injury can be divided into 7 main categories.
It is important that the practicing clinician be able to appropriately triage injured patients.
All permanent tooth injuries should be examined by a dentist, with the timeframe dictated by the type of injury.
90% of intruded primary teeth re-erupt within 6 months.
Repositioning and splinting are often required for tooth injuries.
Primary avulsed teeth should not be re-implanted.
It is paramount to reinsert avulsed permanent teeth as soon as possible.
Avulsed teeth should be transported in a tooth storage solution, warm milk, saline, or saliva.
The 4 types of tooth fracture can only be distinguished by radiographs.
Complications of tooth fractures include pulp death, root resorption, and infection.
Aesthetic consequences of tooth injury include tooth discoloration, tooth loss, and misalignment of the permanent dentition.
Anticipatory guidance can aid in prevention of tooth injury.
Pediatric health professionals have a unique opportunity to provide anticipatory guidance and help prevent injury.
It is important to reinforce helmet and mouth guard use at routine visits.
The AAP recommends against trampoline use in all environments.
More than 3 million children and adolescents in the United States are injured annually while participating in sports.
Sports accidents account for 10% to 39% of all dental injuries.
Orthodontic appliances increase the risk for oral injury, so a
custom-fit mouth guard may be recommended.
Mouth guards are divided into 3 basic types: stock, boil and bite, and custom fit.
The American Academy of Pediatric Dentistry recommends proper-fitting mouth guards for all children participating in sports.
Athletes should wear all protective gear for both practices and games, as children are more commonly injured in practice.
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