The treatment of dental injuries following facial (or any other) trauma usually lies within general dental practice or a restorative dental specialist. Tooth avulsion is probably the only exception as knocked out teeth may more often be replanted in a hospital or emergency room environment. In some instances, dental implants can be placed as an immediate alternative to replantation of a missing tooth or a tooth with a root fracture that is deemed unrestorable. This is not necessarily a matter of finance or interest – it is because general hospital departments are not equipped with the necessary resources and instruments to do this type of work in most countries. Therefore, the bones and soft tissues affected by trauma may often be quickly and effectively repaired within a maxillofacial surgery hospital environment, but damaged teeth (even vitally important front teeth) may not. Only a general dentist or restorative specialist will have this type of equipment.
Dental status and interventions
Limited mouth opening, either from trismus or post-operative elastic traction (or, very rarely nowadays wire intermaxillary fixation) makes oral hygiene much more difficult but even more necessary. Dental intervention is limited to the most basic of application of obtundent (pain-curbing) dressings. This is one of many reasons why open reduction and internal fixation of facial fractures is the international gold standard treatment.
Following facial trauma, maintenance of good daily oral hygiene can be difficult, especially where the damage is still healing and painful, and/or if other injuries make manual tasks difficult. Keeping the oral cavity as clean and plaque free as possible is strongly recommended, quite like in any other ‘normal’ situation. However, the acute situation may require special care and temporarily there may be need to accept help with some or all self-care procedures. Over time, with the onset of recovery and healing, there are also going to be noticeable shifts of all these activities from difficult, unpleasant or clumsy to return to a far easier oral-hygiene regime. Not least, some of these shifts and changes in practical daily routines are associated with an improved mood when first signs of recovery become obvious.
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