Podcast 589:  Management of Dental Trauma

<p><strong>Contributor: Peter Bakes, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">Dental fractures are described by the Ellis classifications, which are based on the involvement of layers of the teeth:</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">Ellis I: involvement of the enamel </span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Ellis II: involvement of the enamel and dentin</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Ellis III: involvement of the enamel, dentin, and pulp</span></li> </ul> </li> <li style="font-weight: 400;"><span style="font-weight: 400;">While Ellis I injuries can be sent for dental follow up without intervention, Ellis II/III injuries require</span> <span style= "font-weight: 400;">covering of the exposed dental layers, particularly because bacteria can more easily enter into the pulp</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">Calcium hydroxide (Dycal) is used to cover teeth until patients can get to a dentist.</span></li> </ul> </li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Dental avulsions, or displacement of the tooth from the socket, are time sensitive. Every minute the tooth is not put back in place carries an increased risk of permanent loss. After the tooth is replanted, it requires fixation or bracing</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Dental subluxations can also be secured or braced with dental follow up</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Marte, D, and B Robinson.</span> <a href= "https://coreem.net/core/dental-trauma/#ellis-classification-system-for-dental-fractures"> <span style="font-weight: 400;">Dental Trauma</span></a><span style="font