Pediatric emergency medicine trisk 3244 3244
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percussion and is often accompanied by gingival bleeding. Moderate to severely
mobile teeth, especially if permanent, may require splinting to aid in optimal
healing and prevent aspiration. These injuries should be referred to the dental
service as soon as possible. Mobile primary teeth are commonly extracted to
prevent aspiration.
Intruded teeth are those that are displaced directly into the socket. Complete
intrusion may result in the tooth not being visible, giving the false appearance of
being avulsed. Thus, an intraoral dental radiograph must be obtained to make the
proper diagnosis. The prognosis for maintaining pulpal vitality of an intruded
tooth is poor because of the severe pulpal compression at the apex of the tooth.
Intruded primary teeth can be either extracted or allowed to spontaneously
reerupt, depending on the severity of the intrusion, proximity to its succedaneous
tooth, and condition of the surrounding bone and soft tissues. Intrusive injuries in
the permanent dentition often require repositioning and splinting; however, in
some instances good outcomes are achieved if the tooth is allowed to
spontaneously reerupt. Pulpal treatment (endodontics) is almost always needed
because the pulp usually becomes nonvital and if left untreated the necrosis can
cause root resorption and periapical infection. Compression fractures of the
alveolar socket and anterior nasal spine may be seen radiographically and need
immediate attention by a dentist.
