Perfect smile: Tips for preventing dental trauma

Tooth injuries are more common in children with orthodontic problems and the presence of diseases such as caries, rickets and genetic disorders of the teeth. At school age, boys have a higher incidence of injuries, associated with more active games and sports. The most frequently injured teeth are the upper incisors. Patients with epilepsy, cerebral palsy and children with visual or hearing impairment are in the risk group. Obese children and those with risky behavior are more prone to injuries. Poor socio-economic conditions also increase the risk of injury due to the lack of safe spaces for play and schooling. Traffic accidents often cause dental injuries, associated with facial and skull fractures. Sports are a significant source of dental injuries, particularly team contact sports, martial arts, skating, cycling, and rollerblading and skateboarding. Oral piercing injuries are becoming more common, with potentially serious consequences. Medical procedures such as laryngoscopy, gastroscopy and intubation can also result in dental injuries. Violence plays a significant role in dental injuries, which is often underestimated, especially among adolescents.

Division of dental trauma

Traumas of hard dental tissues and pulp:

• Enamel fracture: Incomplete enamel fracture without loss of tooth substance.
• Enamel fracture: Enamel fracture with tooth tissue loss limited to the enamel.
• Uncomplicated crown fracture: Enamel and dentin fracture without exposed pulp.
• Complicated crown fracture: Enamel and dentin fracture with open pulp.
• Injuries of hard dental tissues, pulp and alveolar process:
• Crown and root fracture: Involves enamel, dentin and cementum, with or without exposed pulp.
• Root fracture: Involves dentin, cementum and pulp.
• Fracture of the mandibular or maxillary wall of the alveolus: Fracture of the alveolar process involving the alveolus.
• Fracture of the mandibular or maxillary alveolar process: Fracture of the alveolar process with or without fracture of the alveolus.

Injuries of periodontal tissues:

• Contusion: Injury to the supporting structures of the tooth without abnormal tooth movement.
• Subluxation: Injury to supporting tooth structures with abnormal tooth movement but no tooth displacement.
• Extrusion luxation: Partial axial displacement of the tooth from the alveolus.
• Lateral luxation: Lateral eccentric displacement of the tooth in the alveolus followed by a comminuted fracture of the alveolar bone.
• Intrusion luxation: Forced insertion of a tooth inside the alveolus.
• Eruption (avulsion, exarticulation): Complete displacement of the tooth from the alveolus.
• Injuries to the gingiva or oral mucosa:
• Laceration of the gingiva or oral mucosa: Injury caused by a sharp object.
• Contusion of the gingiva or oral mucosa: Injury caused by a blunt object without damage to the mucosa.
• Abrasion of the gingiva or oral mucosa: A superficial wound caused by scraping or rubbing the mucosa.raktura alveolarnog nastavka s ili bez frakture alveole.

Prevention of dental trauma

Dental trauma prevention is divided into three levels: primary, secondary and tertiary. Primary prevention includes measures to prevent dental and facial injuries through risk awareness, preventive orthodontic treatment, and the use of face and mouth guards. Secondary prevention includes various treatments of injured teeth in order to preserve their vitality or keep them in the jaw. Tertiary prevention includes procedures for replacing lost tissue and rehabilitation of patients, including procedures such as tooth transplantation, implant placement, and fabrication of crowns, bridges, or prostheses.

Preventive orthodontic treatment

Increasing the incisor overlap by more than 6 mm increases the risk of tooth injury. Insufficient coverage of the maxillary incisors by the upper lip is also a risk factor. In these cases, it is necessary to correct the increased fold with orthodontic appliances or apply myotherapy exercises to lengthen the upper lip and better cover the upper incisors.

Face and teeth protectors

Face and teeth guards can be external or internal. The outer shields are integrated into helmets or head shields, while the internal ones are divided into ready-made, partially adjustable and individual mouth guards.

Ready-made protectors

These protectors are easy to use and inexpensive, but they can make breathing difficult and do not provide full adjustability. Partially adjustable guards are a modification of ready-made guards that allow better adaptation to the structures in the mouth.

Individual protectors

Individual guards are made based on the model of the patient’s jaw and provide maximum adaptability and retention. They are particularly comfortable to wear and provide better protection against injuries.

Functions of dental guards:

• They soften blows and transmit the force of direct blows, preventing fractures or tooth extraction and soft tissue injuries.
• They prevent collision of upper and lower teeth, thereby reducing the risk of tooth, alveolar process or jaw fracture.
• In the case of a blow to the chin, the relief of the teeth in the protector enables stabilization and reduces stress on the mandible and jaw joint, so that the blow is distributed over the entire head.
• By cushioning a blow to the chin, it prevents injuries to the cervical spine, concussion, cerebral hemorrhage and potentially fatal consequences.
• The athlete can replace the partial denture with a protector, which ensures the protection of the remaining teeth and oral structures and reduces the risk of aspiration or swallowing the denture.