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Trauma to the primary dentition is a common occurrence affecting approximately 1 in 5 young children globally. Damage to the successor tooth may present as a localized enamel defect, dilaceration and disturbed eruption, with subsequent functional and social impact. Appropriate management of acute primary dental trauma, regular review and timely specialist referral upon detection of eruption sequence abnormalities is, therefore, imperative for long-term outcome to be optimal. This article presents a series of four case reports of paediatric patients with a history of severe primary dental trauma that resulted in significant dental anomalies requiring multidisciplinary treatment.
CPD/Clinical Relevance: Information on the consequences of primary dental trauma and the advice to give to affected families is of value.
Article
Trauma to the primary dentition is a common occurrence affecting approximately 1 in 5 young children globally.1 In addition to the initial physical injury to the child, the unerupted, developing permanent dentition may also be impacted to varying degrees of severity. This case series describes the sequelae of primary trauma, its diagnosis and management, therefore enabling delivery of advice and expectation management for paediatric patients and their families.
Damage to the developing permanent dentition following primary dental trauma is uncommon, but arises owing to the close proximity of the primary tooth apex to its successor's developing tooth germ (Table 1). The severity of the developmental disturbance to the permanent tooth reflects the type of trauma sustained, the force of impact, and the child's age and stage of dental development. Mild luxation, extrusion or crown fracture injuries to the primary tooth may result in white-yellow or brown enamel discolouration and hypoplasia of the permanent successor, while severe dental trauma such as avulsion, intrusion and alveolar trauma are likely to be associated with more significant dental abnormality including crown or root dilaceration, sequestration of successor tooth germs and disturbances in eruption.2
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