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Emergency treatment of orodental injuries: a review.

There has been an increase in the incidence of injuries to the incisor teeth in the primary and permanent dentitions over the last decade; one study reported that roughly 35% of 9-year-old children will have damaged their teeth in some way. Much has been written about dental injuries, and there may be confusion about the appropriate emergency treatment for different types. Classification and understanding of the types of injury are essential before diagnosis and treatment can be undertaken. Although dental injuries can occur singly, they more usually involve a combination of injuries to a tooth and its supporting structures. Prompt, accurate diagnosis and appropriate emergency treatment as outlined in this paper will greatly improve the prognosis for many dentoalveolar injuries. The aim must be to ensure that the third of the population of preteenage children who damage their teeth are not resigned to loss of an incisor in later life because of inaccurate diagnosis and poor treatment of the emergency condition.

Child↗

Sporty but safe.

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Athletic Injuries↗

Intranasal midazolam as an alternative to general anaesthesia in the management of children with oral and maxillofacial trauma.

The study assessed the dosage, clinical sedative effect, and safety of intranasal midazolam in 32 children. Data were complete for 29 patients (21 with lacerations and 8 cases of dental trauma). Sedation was adequate to ensure successful completion of treatment under local with or without topical anaesthetic in 22 of the 29 cases (76%). They became sedated at a mean (SD) of 14 (5) minutes, with completion of treatment at 20 (13) minutes. Sedation was achieved with a mean (SD) of 5 (2)mg of midazolam. There were no signs of respiratory depression or of oxygen desaturation below 94% on pulse oximetry. No supplemental oxygen was required and there were no other complications. We conclude that intranasal midazolam is a safe and effective alternative to general anaesthesia in the definitive treatment of children with oral and maxillofacial injuries.

Administration, Intranasal↗

Child abuse and dentistry: orofacial trauma and its recognition by dentists.

Orofacial trauma was found in 49% of 260 documented cases of child abuse seen during of five-year period at the Children's Hospital Medical Center, Boston. An additional 16% of the cases involved head trauma; the total percentage of head and facial trauma was 65%. Head or facial trauma was the principal reason for admission to the hospital in 45% of the cases. A survey of 537 dentists in Massachusetts showed that the majority were unaware of their legal and social responsibilities to report suspected cases of child abuse. Eleven percent of all dentists surveyed saw orofacial trauma cases that were of a suspicious nature, by only 22 confirmed cases of child abuse were noted by the dentists. Of these, only four were reported to social agencies. In general, oral surgeons and pedodontists saw a higher percentage of these cases and were more aware of their responsibilities than were general practitioners.

Child↗

Mountainbiking--a dangerous sport: comparison with bicycling on oral and maxillofacial trauma.

The popularity of bicycling is reflected in the number of cycling-related oral and maxillofacial injuries. Five hundred and sixty-two injured bicyclists (10.3% of all trauma patients) were registered at the Department of Oral and Maxillofacial Surgery, University of Innsbruck, Austria, between 1991 and 1996, accounting for 31% of all sports-related accidents and 48.4% of all traffic accidents. A review of the patient records revealed more severe injury profiles in sixty mountainbikers, with 55% facial bone fractures, 22% dentoalveolar trauma and 23% soft tissue injuries, compared to 502 street cyclists showing 50.8% dentoalveolar trauma, 34.5% facial bone fractures and 14% soft tissue lesions. The dominant fracture site in bicyclists was the zygoma (30.8%), whereas mountainbikers sustained an impressive 15.2% LeFort I, II and III fractures. Condyle fractures were more common in bicyclists, with 18.8% compared to 10.8% in mountainbikers. Reduction of facial injuries due to cycling-related accidents needs appropriate design of helmets with faceguards and compulsory helmet use for all cyclists, and particularly mountainbikers.

Accidental Falls↗

Surgical management of sports-related traumatic injuries.

The increasing popularity of all sporting events results in increased potential for injury. Despite helmet, facemask, and mouthguard use, the face often remains an exposed area at risk in many sports. Dentists rehabilitating patients after facial injuries should understand their patients' previous injuries and treatment.

Athletic Injuries↗

Children, sports injuries & mouthguards.

As the young athletes in our practices become involved in organized sports or recreational activities, it is important for dentists to take a proactive role and encourage parents of these kids to wear proper protective equipment to prevent oral injuries. Dentists must educate themselves and their young patients about the prevention of such injuries. Prevention is an obligation of dentistry as well as a critical patient responsibility. Safe sports participation should be the goal of any sports program and the dental profession should enthusiastically work to achieve this goal in every community.

Adolescent↗

Otolaryngology and sport scuba diving. Update and guidelines.

There are over a million certified sport scuba divers in the United States today. The sport is growing at an average annual rate of 7%. The vast majority of medical problems associated with scuba diving are related to the head and neck area, especially the ears. This paper provides an update on the physiology and pathophysiology of sport scuba diving. It also offers guidelines for the physician who may be called upon to examine candidates for the sport or to make decisions on continued diving for trained sport divers.

Barotrauma↗