Medical doctors’ knowledge of dental trauma management: A review

Abstract

Education in dental trauma is extremely important to promote knowledge on the assessment and management of a traumatized tooth. Medical doctors are normally only required to manage the emergency phase of traumatic dental injury (TDI) treatment before referring to a dentist, endodontist or oral and maxillofacial surgeon for continuing care. Medical doctors who possess sufficient theoretical knowledge and are competent enough clinically to handle TDI can provide a higher standard of treatment care and ultimately achieve a better patient outcome. The aim of this literature review was to assess the extent of medical doctors’ knowledge of dental trauma management for injuries in the following four areas: (a) tooth structure; (b) to the supporting bone; (c) to the periodontal tissues; and (d) to the soft tissues. Based on the findings from this literature review, an overall deficiency in knowledge and confidence in managing dental trauma has been identified. Knowledge and understanding to categorize TDI using the same classification of dental injuries commonly used amongst dentists would allow medical doctors to better manage and communicate with dental colleagues concerning referral for further care. If the medical education curriculum provided medical doctors with more information and skills for the management of dental trauma and an understanding of the importance of early management, then more favourable outcomes may prevail for dental trauma patients.

Identifying barriers that affect medical doctors’ learning of dental trauma

“…Drawing on the ten studies listed in the scoping review by Yeng et al, 6 the purpose of this review is to identify barriers to learning about dental trauma for medical doctors. The data obtained from these studies should be interpreted with caution due to the diversity of context and methodological variability, such as study and questionnaire design, response rates, and methods of statistical analysis and data processing.…”

“…the lack of written protocol or instructions within hospital facilities; 10,11,16,17 the application of incorrect protocol instructions; 10 a lack of formal education; 6,[9][10][11][13][14][15]17 no dental teaching during medical school; 9,13,14,17,18 and dental trauma being excluded from medical texts or first-aid manuals. [16][17][18] Under lack of training, the issues included: a lack of postgraduate training; 9,11,13-18 a lack of clinical exposure to, and experience of, dental trauma; 9,17,18 a lack of validated training; 9,13,17 inadequate management time and allocated resources to treat dental injuries; [15][16][17] and an absence of dental trauma in emergency residency training programs.…”

“…Inadequate knowledge and a lack of skills and confidence in providing suitable care to dental trauma patients can be partly attributed to the non-existence or at best minimal dental education in the medical curriculum. 6 Teaching medical students to understand and manage dental trauma is important 5 to significantly increase in the knowledge base and skills required for medical doctors to manage these problems. 6 It has been suggested that integrating dental trauma into the medical education program will provide essential knowledge and management skills for doctors.…”

“…5 While medical doctors should not be overburdened with dental management knowledge and skills, having basic knowledge and skills to safely treat and stabilize a dental trauma case would be useful. 6 These are important skills for doctors to obtain early on in their career. Formal lectures, organized seminars and continuing education courses for physicians are all suitable avenues for physicians to gain the necessary understanding.…”

Dental trauma learning facilitators for medical doctors: A viewpoint

“…1 From the literature, medical doctors' knowledge of dental anatomy, appropriate treatment for dental fractures, and managing luxation and avulsion injuries are reported to be inadequate. 2 Identifying this lack of clinical practice in the literature suggests that medical doctors are generally not provided with the necessary clinical training for assessing and managing TDI within a guided learning environment such as a medical school or university teaching hospital. 3…”