The Team Approach to Managing Paediatric Dentoalveolar Trauma

The team approach to managing paediatric dentoalveolar trauma

Sheena Kotecha, John Scannell

Birmingham Children’s Hospital

Outline

Types of dentoalveolar injuries Trauma statistics Care pathway Teamwork in trauma management Summary

Dentoalveolar Trauma

Hard tissue injuries Enamel fractures Enamel dentine fracture –

complicated/uncomplicated Root fractures

Soft tissue injuries Subluxation Luxation Avulsion

Enamel Dentine Fracture

Dentoalveolar Trauma

Hard tissue injuries Enamel fractures Enamel dentine fracture –

complicated/uncomplicated Root fractures

Soft tissue injuries Subluxation Luxation Avulsion

Root Fracture

Dentoalveolar Trauma

Hard tissue injuries Enamel fractures Enamel dentine fracture –

complicated/uncomplicated Root fractures

Soft tissue injuries Subluxation Luxation Avulsion

Lateral Luxation

Dentoalveolar Trauma

Hard tissue injuries Enamel fractures Enamel dentine fracture –

complicated/uncomplicated Root fractures

Soft tissue injuries Subluxation Luxation Avulsion

Avulsion

Trauma Statistics

1062 patients between 2003-2006 309 with dentoalveolar injuries 207 male 102 female 0-3 yrs: 84 4-7 yrs: 100 8-11 yrs: 73 12-15 yrs: 52

Referral Source

0

20

40

60

80

100

Per

cent

age

(%)

Regional Self-referral GDP/GMP

Referral source of trauma patients

Aetiology

11

66

3 4 8 80

20

40

60

80

100

Percen

tag

e (

%)

Aetiology of dentoalveolar trauma

Injury Type

0102030405060708090

100

Per

cent

age

(%)

Luxation Fracture Avulsion AlveolarFracture

Other

Relative incidence of dentoalveolar injuries

Care Pathway

Triage nurse

ED doctor

Maxillofacial SHO

Paediatric Dentist

Other dental speciality PDS

Teamwork in Avulsion

Triage Nurse Telephone advice – storage medium and attend

ED asap Where is the tooth? – mouth, swallowed, inhaled,

lost, with patient? Contact ED doctor/maxillofacial SHO

ED Doctor Medical History Assess other injuries

Radiology Department

Teamwork

Triage Nurse Telephone advice – storage medium and attend

ED asap Where is the tooth? – mouth, swallowed, inhaled,

lost, with patient? Contact ED doctor/maxillofacial SHO

ED Doctor Medical History Assess other injuries

Teamwork

Dental SHO Assess dental injuries Re-implant tooth Splint

Maxillofacial Technician Construct splint

ED Nursing staff Technical assistance Patient management

Splints

Teamwork

Dental SHO Assess dental injuries Re-implant tooth Splint

Maxillofacial Technician Construct splint

ED Nursing staff Technical assistance Patient management

Teamwork

Paediatric Dentist Review and treat as necessary Referral

Other dental speciality Orthodontics Prosthetics Restorative Oral Surgery

PDS

Summary

Patients with dentoalveolar trauma are managed by various health professionals:

Within the same hospital Between different hospitals Between professionals in different settings

Relies on effective communication and teamwork.

Acknowledgements

Mrs Victoria Clark Mr Andrew Monaghan

Any Questions?

Thank you