PAEDIATRIC DENTISTRY - 3rd Ed. (2005)

(John Hannent) #1

Fig. 12.5 (a) A 12-year-old child presented with an enamel and dentine fracture of
the upper right, permanent central incisor. (b) The lower lip was swollen with a
mucosal laceration. (c) A lateral radiograph confirmed the presence of tooth
fragments in the lip. (d) Fragments were retrieved under local anaesthesia from the
lip.


12.4.4 Intraoral examination


This must be systematic and include the recording of:



  1. Laceration, haemorrhage, and swelling of the oral mucosa and gingiva (668HFig. 12.6).
    Any lacerations should be examined for tooth fragments or other foreign material.
    Lacerations of lips or tongue require suturing but those of the oral mucosa heal very
    quickly and may not need suturing.

  2. Abnormalities of occlusion, tooth displacement, fractured crowns, or cracks in the
    enamel.


The following signs and reactions to tests are particularly helpful:



  1. Mobility. Degree of mobility is estimated in a horizontal and a vertical direction.
    When several teeth move together 'enblock' a fracture of the alveolar process is
    suspected. Excessive mobility may also suggest root fracture or tooth displacement.

  2. Reaction to percussion. In a horizontal and vertical direction and compared against

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