Tiny teeth, big challenges: dental trauma in the primary dentition

Paediatric dental trauma is a common occurrence internationally and its presentation in the primary dentition creates additional challenges. Beyond the dental implications, patients and families experience significant distress which impacts their ability to engage with treatment or access services. Patients in the primary dentition often have limited dental experience and are unlikely to be acclimatised to treatment. Compared to their adolescent peers, their ability to express themselves comprehensively or participate with verbal communication is reduced. The use of non-verbal behaviour management techniques is therefore crucial. A positive dental experience will contribute to good cooperation in the future. Examination and treatment can be challenging, and management significantly differs between the primary and permanent dentition. Involvement with a child-orientated dental team is encouraged when appropriate, due to their expertise and access to sedation and general anaesthetics. In addition to the consequences of trauma to the primary dentition, there is also risk to the unerupted permanent successors. The likelihood of this damage can be predicted by the age of the child and nature of the traumatic injury. Parents should be supported and advised on oral hygiene, analgesia and understand the potential future consequences. This paper provides an overview of the management of dental trauma in the primary dentition.