Acute Dental Trauma

Acute dental trauma is a serious injury to one or more parts of your mouth. Your injury may include damage to any of your teeth, the tooth socket, the tooth root, or your jaw. You can also have injuries to the soft tissues of your mouth. These include your tongue, cheeks, gums, and lips. Severe injuries can expose the soft pulp inside the tooth.

Dental trauma usually occurs from a direct hit to your mouth or jaw. Accidents, such as falling off a bicycle or a car accident can cause dental trauma. A direct hit can also happen during sports activities.

The signs and symptoms of acute dental trauma are the following: tooth damage, bleeding or bruising, facial fracture, tooth or bite change.

Treatment will depend on the type of dental trauma. A tooth that moves slightly may heal on its own. A soft tissue wound may be closed using stitches.

Tooth repair procedures can be beneficial as well as any of the following: pain medicine, antibiotics, Td vaccine (diphtheria and tetanus) and mouthwash.

Without treatment, you an infection may develop. A tooth may also become discolored or stay out of place. A chipped tooth with a sharp edge may cut the tongue or other soft tissues around it or the patient may lose one or more teeth.

IN PARTICULAR…
PEDIATRICS
Acute Respiratory Infections in Children

Acute respiratory infections (ARIs) are classified as upper respiratory tract infections (URIs) or lower respiratory tract infections (LRIs). The upper respiratory tract consists of the airways from the nostrils to the vocal cords in the larynx, including the paranasal sinuses and the middle ear. The lower respiratory tract covers the continuation of the airways from the trachea and bronchi to the bronchioles and the alveoli. ARIs are not confined to the respiratory tract and have systemic effects because of possible extension of infection or microbial toxins, inflammation, and reduced lung function. Diphtheria, pertussis (whooping cough), and measles are vaccine-preventable diseases that may have a respiratory tract component but also affect other systems.

Except during the neonatal period, ARIs are the most common causes of both illness and mortality in children under five, who average three to six episodes of ARIs annually. The World Health Organization (WHO) estimates that 2 million children under five die of pneumonia each year.

Upper Respiratory Tract Infections
URIs are the most common infectious diseases. They include rhinitis (common cold), sinusitis, ear infections, acute pharyngitis or tonsillopharyngitis, epiglottitis, and laryngitis—of which ear infections and pharyngitis cause the more severe complications (deafness and acute rheumatic fever, respectively). The vast majority of URIs have a viral etiology. Rhinoviruses account for 25 to 30 percent of URIs; respiratory syncytial viruses (RSVs), parainfluenza and influenza viruses, human metapneumovirus, and adenoviruses for 25 to 35 percent; corona viruses for 10 percent; and unidentified viruses for the remainder.

Because most URIs are self-limiting, their complications are more important than the infections. Acute viral infections predispose children to bacterial infections of the sinuses and middle ear, and aspiration of infected secretions and cells can result in LRIs.

Acute Pharyngitis
Acute pharyngitis is caused by viruses in more than 70 percent of cases in young children. Mild pharyngeal redness and swelling and tonsil enlargement are typical. Streptococcal infection is rare in children under five and more common in older children. Acute pharyngitis in conjunction with the development of a membrane on the throat is nearly always caused by Corynebacterium diphtheriae in developing countries. However, with the almost universal vaccination of infants with the DTP (diphtheria-tetanus-pertussis) vaccine, diphtheria is rare.

Lower Respiratory Tract Infections
The common LRIs in children are pneumonia and bronchiolitis. The respiratory rate is a valuable clinical sign for diagnosing acute LRI in children who are coughing and breathing rapidly.

Currently, the most common causes of viral LRIs are RSVs. They tend to be highly seasonal, unlike parainfluenza viruses, the next most common cause of viral LRIs. The epidemiology of influenza viruses in children in developing countries deserves urgent investigation because safe and effective vaccines are available. Before the effective use of measles vaccine, the measles virus was the most important viral cause of respiratory tract–related morbidity and mortality in children in developing countries.

Both bacteria and viruses can cause pneumonia. Bacterial pneumonia is often caused by Streptococcus pneumoniae (pneumococcus) or Haemophilus influenzae, mostly type b (Hib), or other streptococci. Just 8 to 12 of the many types of pneumococcus cause most cases of bacterial pneumonia, although the specific types may vary between adults and children and between geographic locations.

Interventions to control ARIs can be divided into four basic categories: immunization against specific pathogens, early diagnosis and treatment of disease, improvements in nutrition, and safer environments. The first two fall within the purview of the health system, whereas the last two fall under public health and require multisectoral involvement.