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
