Dental Trauma

Dental Trauma

For the patients involved this is a major life event. A variety of problems can all cause traumatic injuries but the solutions are often similar. The common feature is that a sudden change occurs that needs urgent sometimes irreversible treatment that can profoundly alter your smile. The limited timescale, the costs, the emotional distress are all focussed on one event. We have the experience in dental implantology, cosmetic dentistry and endodontics to guide patients through a difficult time to maximise the end result and minimise the distress.

Case 1 (Childhood injury returns over many years)

A common general scenario involves a damaged upper front teeth as child or teenager. Over the years the initial filling repairs fail and steadily increase in size. Eventually root treatment is required and the post retained crowns are placed . Over time maybe one of the teeth fails due to the root splitting around the post crown.

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At this point the adjacent teeth are either in a similar condition due to the original trauma. If this is the case few people would choose to add additional loading and link the compromised teeth together in a dental bridge. In other cases if the surrounding teeth were not affected by the original trauma and remain in good condition few patients wish to start another tooth on the same restorative path.
If the surrounding teeth are healthy and the bite is suitable we often recommend an adhesive bridge or a dental implant.

If the surrounding teeth are compromised a dental implant is generally preferred to a removable denture.

Case 2 (Recent road accident)

A 55 year old female had a cycling accident on a foreign holiday which shattered the existing 3 unit bridge and adjacent crown. The holiday insurance covered the cost of sealing the shattered roots and repairing the soft tissue trauma to the lips. The patient came to us on her return one week after the original accident with considerable pain and four missing front teeth. Within a six days we had controlled the pain and provided a temporary replacement for the missing teeth. We were quickly able to assess the tooth that could be salvaged and remove the remaining shattered roots in such a way that additional stress on the adjacent bone was minimised. The timing and techniques used to manage the case improved the healing response and maximised the final result.

The case required clear and prompt assessment of endodontic issues , trauma, and Astratech dental implants.

Case 3 (Assaulted one year ago)

A 30year old male patient was assaulted and two front teeth were knocked out. The hospital managed to reimplant the teeth but the alignment was altered and the teeth now appeared very crooked. After a subsequent infection we agreed to remove both teeth and replace them with a dental implant bridge. The bridge only required one dental implant fixture which controlled costs. The treatment was arranged so that at no time was the patient without “ front teeth”. The implant fixture placement was scheduled to maximise the healing potential following extraction.

During the healing phase, additional cosmetic work, such as “enlighten” tooth whitening and cast ceramic (porcelain) Lumineers were coordinated to improve the natural colour and alignment of the adjacent teeth.

The case required orthodontic assessment, endodontic assessment, cosmetic dentistry and also implant dentistry. We were able to take responsibility for all aspects of the case and provide a clear and comprehensive solution.

The end result treated the pain and infection, controlled the costs, ensured a good final appearance that maximised the favourable aspects available to our management.

Case 4 (Road accident 10 years ago)

A 30 year old male patient lost four lower incisor teeth in a car accident 10 years ago. The insurance claim paid at the time assumed that dental implants could only be placed if a substantial bone graft could be moved from the patients own hip bone. Due to the extended surgery required the patient declined and settled for a denture.

10 years later as a new patient to our practice we used a new technique to image the bone and simulate some proposed implant positions. We were able to confirm that additional bone grafts were not required if the missing volume was replaced by pink porcelain to simulate the gingival tissues. Careful smile analysis showed that this would provide a good aesthetic result invisible to even close friends and family.

The implants were placed and restored as planned. During the implant healing time the upper teeth were aligned, heavily filled teeth were crowned or veneered, the basic colour was freshened up by whitening. The end result appeared healthy natural and fresh.

The case required cosmetic dentistry, invisible orthodontics, and implantology. We were able to provide all treatment under one roof with a clear coordinated plan.

WELCOME BACK From Tuesday 9th June

The final preparations to welcoming you back are underway and the Team is looking forward to seeing you again. Your safety is our top priority and we are planning a phased return starting with urgent treatment and assessment. This will mean that there will be a transition where protocols will change according to the up to date guidance. The following are part of the first phase guidance

1. The week before any previously booked appointment you must contact us to confirm the details of that appointment .
2. Timings will be staggered to reduce patient waiting
3. You will be required to complete a Covid status declaration and have your temperature taken.
4. Fully charge your phone, hydrate , visit the toilet and minimise personal belongings before setting off
5. Call 10 minutes prior to entering the building (we want to minimise the paths that cross)
6. Don’t bring friends or family members or children that do not have an appointment, Social distancing will be much easier for us to coordinate if the numbers are restricted.
7. We are trialling payment as you arrive, this will mean that future amendments might be required but it will smooth your flow through the practice.
8. Please avoid cash or cheque payments the best payment methods are apple / google pay however card payments and BACS are also fine
9. We love to catch up but right now is not the time. We will ask you to leave the practice once your appointment has finished. Social distancing will be much easier for us to coordinate if we can prepare for the next patient to enter the building.

Please look for the additional and updated guidance.


Dr Rob Tennet
The StJohns Dental Practice


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