The greatest incidence of trauma to the primary dentition occurs at 2 to 3 years of age, when motor coordination is developing. The most frequently injured teeth are the maxillary incisors.
Injuries to primary teeth include fracture, displacement, and avulsion.
Small fractures of primary teeth may leave a sharp tooth surface and may require smoothing. If the fracture exposes the pulp, either pulp (or endodontic) treatment and crown or extraction may be required. Tooth fractures must be assessed radiographically to determine if root fractures are present.
Displacement injuries need to be evaluated to determine the child’s occlusion and the proximity of the injured primary tooth to the developing permanent tooth. An extruded primary tooth that interferes with a child’s ability to bite (or occlude) should be repositioned or extracted. An intruded tooth not contacting the permanent tooth bud may be allowed to re-erupt. Immediate extraction may be indicated if the radiograph reveals that the intruded tooth contacts the permanent tooth bud. Periodic reevaluation of the intruded tooth is prudent.
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