Italian guidelines for the prevention and management of dental trauma in children

Abstract

Dental trauma is a frequent occurrence in children and adolescent and a correct diagnosis and treatment are essential for a favourable long-term prognosis. The present Guidelines aim to formulate evidence-based recommendations to assist dentists, paediatricians, surgeons, teachers, school and sport staff, parents in the prevention and first aid of dental trauma in children and to provide a careful assessment of the medico-legal implications, reviewing the first draft of the guidelines published in 2012. A multidisciplinary panel on the behalf of the Italian Ministry of Health and in collaboration with the WHO Collaborating Centre for Epidemiology and Community Dentistry of Milan, developed this document. The following four queries were postulated: 1) Which kind of precautions the health personnel, parents, sports and educational personnel must activate in order to prevent the dental trauma damage? 2) How an orofacial trauma in paediatric patients should be managed either in the Emergency Care Unit and/or in private dental office? 3) What criteria should be adopted by a dentist private practitioner to fill in a certificate in cases of dental and/or tempomandibular joint trauma occurring in children and adolescents? 4) What are the elements that should lead clinicians to suspect a non-accidental dental trauma? A systematic review and analysis of the scientific literature published in English, Italian and French from 2007 to 2017 regarding dental trauma in children and adolescents aged 0–18 years was performed, and about 100 papers were analysed and included. The following four domains were analysed and discussed: Dental Trauma Prevention Strategies and Health Education, First aid in orofacial and dental trauma, Certificate of the dental trauma, Oral and dental signs of child abuse and neglect. Twenty-eight recommendations were draw up and codified by the panel according to the Methodological handbook, produced by the Istituto Superiore di Sanità, in order to guide physicians in the prevention and first aid of dental trauma in children and adolescents. In addition, a careful assessment of the medico-legal implications is reported in this document.

Malaysian dental students’ knowledge of managing dental trauma in children

“…Even though TDI is a preventable condition, 8 a significant number of cases have been identified in the dental setting 9 . Given the high treatment needs and demands related to managing TDI, as well as the importance of appropriate management, dental practitioners must possess the knowledge and skills necessary to successfully address this critical situation.…”

Knowledge of Emergency Management of Avulsed Teeth among Italian Dentists-Questionnaire Study and Next Future Perspectives

“…Theoretical courses, specific training and continuing education programs both in the under- and post-graduate curriculum of dental schools, together with the evaluation of the acquired knowledge, are necessary to guarantee a high standard of care [ 11 ]. Moreover, dental practitioners in Italy should utilize the Italian guidelines for the prevention and management of dental trauma in children to obtain the appropriate information on evidence-based recommendations for the optimal prevention and treatment of avulsed teeth [ 12 , 13 ]. A multidisciplinary panel on the behalf of the Italian Ministry of Health and in collaboration with the WHO Collaborating Centre for Epidemiology and Community Dentistry of Milan developed this document [ 14 ].…”

Manejo de un central deciduo retenido por trauma dental: a propósito de un caso

“…La adecuada evaluación del trauma, es determinante para el pronóstico del tratamiento que se ejecuta en los pacientes y una de las principales dificultades que presentan los estudios que evalúan dientes incluidos, retenidos e impactados, es la ausencia de consenso en la definición de estos términos, siendo común que en el concepto de impactación dental se mezclen estas entidades 10,11 . Sumado a lo anterior, en la mayoría de estos estudios no se toma en cuenta el estado de formación dental de los dientes evaluados, muy posiblemente debido a las dificultades que presenta la determinación del estadio de Nolla en radiografías panorámicas análogas 12,13 , con lo que se puede estar tomando un porcentaje de gérmenes dentales con posibilidades de emerger a la cavidad bucal, y los cuales no representan una anomalía dental 14 .…”