Amy Dukoff
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 EETH
REACT to trauma in various ways. Their response can cause immediate
changes or delayed changes that can take weeks or years to become apparent.
The traumatic experience may cause gradual changes in the root-canal system
that do not become apparent until years later.
A good dental history is important to identify the type of trauma.
Trauma can be due to abnormal occlusal contacts. It may have been
caused by a recent blow to the tooth in question. Further investigation
may reveal an injury that occurred many years earlier. When you are
taking the history, it is important to determine how, when, and where the
injury occurred. The corresponding symptoms at the time of injury
are also important, along with the progression of symptoms. The patient
will usually provide the important facts if prompted carefully and thoroughly.
The clinical examination has many parts, proceeding
through neurologic, external, intraoral soft tissue, hard tissue, and radiographic
phases of examination. Vital tests are also needed. After all
the information has been gathered, a diagnosis can be made.
Trauma will cause a pulpitis. Determining
whether the pulpitis is reversible or irreversible may take more than one
appointment. Sometimes in a recent trauma with percussion tenderness
alone and in normal occlusion, the symptoms may resolve and no treatment
will be needed.
At other times, if the pain is intermittent over a year, then irreversible
pulpitis may be suspected. And at still other times, you may see
a change in the shade of the clinical crown over the span of years.
Furthermore, on radiographic interpretation, calcification or internal
resorbtion may be seen.
Keen observation of the tooth in question is imperative.
Close examination is a must for diagnosis and subquent treatment.
September-October 2001
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Keen
observation and close examination are imperative.
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