Dental Trauma



Dental trauma is defined as fractured, displaced, or lost primary or permanent teeth.


  • 30% of children suffer from traumatic dental injuries to the primary dentition, with the highest incidence at 2 to 3 years of age.
  • 22% of children suffer from traumatic dental injuries to the permanent dentition occurring secondary to falls, traffic accidents or bicycles, violence, sports, and physical abuse
  • 70% of cases involve maxillary incisors.
  • Displacement injuries are most common in the primary dentition. Crown fractures are more common in the permanent dentition.

Risk Factors

  • Sex:
    • In the primary dentition, the prevalence of injuries ranges from 31% to 40% in boys and from 16% to 30% in girls.
    • In the permanent dentition, the prevalence of dental trauma in boys ranges from 12% to 33% as opposed to 4–19% in girls.
  • Age:
    • The most common age for trauma in the primary dentition is from 1.5 to 2.5 years of age when the child is learning to walk.
    • In the permanent dentition, the peak age ranges from 8 to 10 years of age.
  • Season:
    • Injuries occur more in summer months than in winter, depending on the population and demographics being studied.
  • Occlusion:
    • Increased “overjet” (protrusion of upper incisors) and insufficient lip closure are predisposing factors to traumatic injuries.

General Prevention

  • Most sports injuries can be prevented with appropriate use of mouth guards.
  • The American Academy for Sports Dentistry lists 40 sports for which it recommend the use of mouth guards, including: acrobatics, baseball, basketball, cycling, discus, shot put, horseback riding, gymnastics, handball, racquetball, squash, judo, karate, rollerblading, rugby, motor cross, parachuting, skiing, soccer, surfing, skateboarding, ice skating, trampoline, tennis, volleyball, wrestling, weight lifting, and water polo.


  • Basic tooth structures: enamel (white outer layer), dentin (yellow inner layer), pulp (nerves, blood vessels, connective tissue), cementum (layer covering roots), periodontal ligament (PDL; supports tooth in socket)
  • Types of injuries (Figure 3)
    • Infraction: fracture of the enamel without loss of tooth structure; a “crack” in the enamel
    • Uncomplicated crown fracture: fracture with loss of tooth substance confined to enamel or dentin and not involving the pulp
    • Complicated crown fracture: fracture involving enamel and dentin with a pulp exposure
    • Crown/root fracture: fracture involving enamel, dentin, and cementum
    • Root fracture: dentin and cementum fracture involving the pulp
    • Concussion: injury to tooth-supporting structures, no abnormal loosening or displacement
    • Subluxation: injury to tooth-supporting structures with abnormal loosening, no displacement
    • Lateral luxation: lateral displacement of the tooth in its socket with fracture of alveolar bone plate
    • Intrusion: tooth forced into the socket and locked into position in the bone
    • Extrusion: tooth displacement partially out of the socket
    • Avulsion: complete displacement totally out of the socket
    • Alveolar process fracture: fracture of alveolar bone containing tooth

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