ED Pathway for Dental Trauma or Infection URL: https://www.chop.edu/clinical-pathway/dental-trauma-or-infectionclinical-pathway Authors: E Szydlowski, MD; M Herring, MD; K Castelo, CRNP; B Pagliaro, RN; H Giannakopoulos, DDS, MD; E Hajishengallis, DDS, PhD Posted: August 2019 ASSESSMENT OF TRAUMATIC DENTAL EMERGENCIES CLINICAL PEARLS AND PITFALLS In patients with TDIs, carefully assess for associated injuries to the CNS, cervical spine, orbits, and jaw Airway obstruction in the setting of facial trauma may be the result of an aspirated tooth or blood in the oral cavity and pharynx Mucosal ecchymoses at the floor of the mouth or vestibular area are highly suggestive of mandibular fractures Primary teeth in the process of exfoliation may be confused with TDI Be alert to the possibility of nonaccidental trauma (child abuse) if the history is not consistent with the observed injuries Current Evidence The most emergent concern in a child with dental trauma is to evaluate for associated facial injuries and airway obstruction Obstruction can result from accumulation of blood in the oral cavity and pharynx Alternatively, the etiology may be a tooth aspirated by a child, or a fractured mandible causing the tongue to fall backward against the posterior pharynx Beyond airway obstruction and life-threatening injuries, trauma to the jaw, dentition, or soft tissues requires careful evaluation and treatment Inadequate recognition and management of these injuries can lead to suboptimal cosmetic and functional outcomes Goals of Treatment The care of pediatric patients with maxillofacial and dental trauma should follow the basic tenets of emergency medicine, starting with evaluation and management