Primary Tooth Trauma — ORE Part 1 MCQ

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EasyPaediatric DentistryPrimary Tooth TraumaORE Part 1

A 4-year-old child presents following trauma to a primary upper central incisor. The tooth is tender and mobile but remains in its normal position. It is not excessively mobile, does not interfere with the bite, and there are no signs of infection. What is the most appropriate management?

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Correct answer: C — Provide supportive care and arrange review

This is subluxation of a primary incisor: mobility and tenderness without displacement. In an undisplaced tooth that is not excessively mobile and does not traumatise the occlusion, management is conservative: give supportive advice (soft diet, appropriate analgesia if needed, and good oral hygiene) and arrange dental review to monitor for pulpal or infective complications. Extraction is reserved when mobility is excessive or the tooth is traumatised by the bite. Repositioning is inappropriate because the tooth has not been displaced. Splinting is not routinely required for this uncomplicated primary-tooth injury, and pulp treatment is not undertaken acutely in the absence of pulpal pathology. The key discriminator is the absence of displacement, marked mobility and occlusal interference.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP), Management of Acute Dental Problems: “Injuries to the mouth, face and jaws”, current web guidance, https://www.acutedentalproblems.sdcep.org.uk/guidance/management-of-oral-conditions/less-common-oral-conditions/injuries-to-the-mouth-face-and-jaws/