Article
Dental Trauma: A Practical Guide to Diagnosis and Management
In recent years, the name Serpil Djemal has become synonymous with the diagnosis and treatment of dental trauma, having established a dedicated adult dental trauma unit in London, and having spent a generous amount of her time teaching others how to manage dental trauma. With this in mind, she has assembled a wide variety of contributors to this book, mainly from King's College Hospital, but also from Oxford, Manchester and Kuwait. Given that many clinicians will have only limited knowledge in dealing with dental trauma, this book presents the wide variety of experience and knowledge that has been gained in the Trauma unit.
Chapter 1, by Serpil Djemal and Martin Kelleher, is, appropriately, on first principles. This includes history taking, intra- and extra-oral examination, investigations and management, but also stresses the need for photographs and the emotional aspects of dental trauma, something which could readily be overlooked, in this reviewer's opinion. Splinting of traumatized teeth is something upon which opinion has been divided in the past, and Chapter 2 makes clear recommendations that flexible splinting is preferable and provides a detailed account of ‘how to do it’. Table 2.2 is possibly the most useful in the book, given that it presents recommended splinting times for nine different types of injury, another matter upon which opinion has been divided in the past.
In what this reviewer considered to be an eminently appropriate order, subsequent chapters deal with increasingly difficult fractures to treat, namely infractions (an intra-enamel fracture) and enamel fractures, enamel–dentine fractures, enamel–dentine–pulp fractures, crown-root fractures, and root fractures, before moving on to concussion and subluxation, extrusion, lateral luxation, intrusion and avulsion, and, lastly, dento-alveolar fractures. All chapters are generously illustrated with treated cases and diagrams, before the book is brought to a close with a chapter, by James Darcey, on the long-term consequences of dental trauma, including an excellent section on root resorption.
The stated aim of the book is ‘to reduce anxiety for the dentist by providing relevant and useful information alongside protocols to assist in treating patients who have sustained traumatic dental injuries’. It succeeds laudably in this aim, aided by copious case examples built up during the treatment of 1769 adult patients and 3912 injured teeth between 2012 and 2018. For general dentists, it is a most useful resource to have to hand for the difficult day when a patient presents in the practice with a traumatic dental emergency.