Multidisciplinary Approach to Dental Trauma

Long-awaited summers in Indiana begin with warm sunshine, blooming peonies, and for dental professionals, with the unavoidable Saturday morning phone call: “My child was hit by a baseball and their front tooth fell out!”

Avulsions of permanent teeth account for 0.5-16 percent of dental trauma cases. The American Association of Endodontists (AAE) and the International Association of Dental Traumatology (IADT developed the Guidelines for Management of Traumatic Dental Injuries, using literature and expert opinions based on current best evidence and practices.

Avulsion is a significant dental injury. Multidisciplinary team approach, combining the efforts of a general or pediatric dentist, an orthodontist, an endodontist, and other dental and medical specialists is needed to successfully diagnose, manage, and monitor traumatic injuries of avulsed permanent teeth.

Replantation of a permanent tooth is the common treatment of choice. The prognosis of replantation is dependent on two main factors: the maturity of the root (open or closed apex) and the condition of the periodontal ligament (PDL) cells, which is dependent on the extra-alveolar dry time and the storage medium used prior to replantation.