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Children often experience impalement trauma when they fall while holding objects in their mouths. While most cases heal without complications, here we report a case of buccal abscess formation after toothbrush trauma. A two-year-old boy fell while running with a toothbrush in his mouth, which punctured his right buccal mucosa. The following day, he presented to a pediatrician with a fever and buccal swelling and was treated with oral antibiotics. However, the buccal swelling did not improve, and the patient was referred to our department. Four days after the visit, the buccal swelling and fever worsened, requiring hospitalization, intravenous antibiotics, and drainage. The inflammation quickly disappeared following treatment, with no recurrence. Prophylactic antibiotic administration for oral impalement trauma is controversial. Our results suggest that prophylactic antibiotics covering both anaerobic and aerobic bacteria are necessary in cases of toothbrush-related oral trauma, where multiple bacterial infections may occur.

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Introducción: las lesiones traumáticas provocan alteraciones biológicas, psicológicas y sociales en los niños y adolescentes que la padecen. Objetivo: caracterizar a los escolares con lesiones traumáticas en dientes permanentes, jóvenes de la Clínica Estomatológica Héroes de Bolivia, de Las Tunas, en el período septiembre de 2017 a septiembre de 2019. Materiales y métodos: se realizó un estudio descriptivo transversal en escolares de la clínica estomatológica "Héroes de Bolivia". La población estudio estuvo constituido por 169 escolares que por muestreo probabilístico se estableció, incluyendo a los escolares de 5 a 11 años, con lesiones traumáticas en dientes permanentes anteriores. Las variables estudiadas fueron: edad, sexo, presencia del trauma y tipo según la clasificación de Ingeborg Jacobsen, dientes lesionados, etiología y lugar donde ocurrió la lesión. Se utilizó un formulario. Resultados: el grupo de 9 años con un 21,3 % y el sexo masculino con 113 afectados resultaron los más representativos. El 56,2 % presentó fractura no complicada de corona. El 70,4 % correspondió a incisivos centrales superiores. Las caídas y las prácticas de deporte con 37,2 % y 29,0 % respectivamente fueron las principales causas y el 41,4 % de los traumatismos dentarios ocurrieron en las instituciones escolares. Conclusiones: las lesiones traumáticas de dientes permanentes jóvenes fueron más frecuentes a la edad de 9 años y en el sexo masculino. Las lesiones más frecuentes fue la fractura no complicada de corona y los incisivos centrales superiores los más afectados.

Introduction: traumatic injuries cause biological, psychological and social alterations in children and adolescent who suffer them. Objective: to characterize schoolchildren with traumatic lesions in their young permanent teeth, from Heroes de Bolivia Dental Clinic, Las Tunas, in the period from September 2017 to September 2019. Materials and methods: a cross-sectional descriptive study was conducted in schoolchildren treated at Heroes de Bolivia Dental Clinic. The study population, selected by probabilistic sampling, consisted of 169 schoolchildren aged 5 to 11 years, with traumatic injuries in anterior permanent teeth. The variables studied were: age, gender, presence of trauma and kind according to Ingeborg Jacobsen classification, injured teeth, etiology and place where the lesion occurred. Results: the 9-years-old group, with 21.3 %, and male gender, with 113 children affected, resulted the most representative. 56.2 % presented uncomplicated crown fracture. 70.4 % corresponded to upper central incisors. Falls and sport practices, with 37.2 % and 29.0 % respectively, were the main causes, and 41.4 % of the dental injuries occurred in schools. Conclusions: traumatic injuries of young permanent teeth were more frequent at the age of 9, and in males. The most frequent injury was non-complicated crown fracture, and upper central incisors were the most affected.

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An uncommon case of monomicrobial Clostridioides difficile septicemia in a 63-year-old man was reported in Zhejiang, China. Once diagnosed, vancomycin treatment cleared the infections. The patient had no remarkable medical history, and the inspection showed no overt gastrointestinal symptoms, though C. difficile was detected in his stool samples. However, we later defined that the C. difficile strain isolated from the blood sample was different from the one isolated from his stool using the whole genome sequencing analysis. By retrospective analysis of his medical record, we noticed that the man had a recent tooth extraction thus the bacterium may have invaded through the root canal. Therefore, we suggest that oral C. difficile colonization may be a potential risk factor for severe C. difficile septicemia, which could be clinically alarming.

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Young children often present at the emergency department (ED) with foreign bodies in their mouths, including the occasional bottles and cans. Previous reports of tongue entrapment have presented cases where bottles were mostly made of glass or metal. A 4-year-old girl presented to the ED with her tongue entrapped in a uniquely designed plastic bottle. Attempts at conservative methods of removal such as gentle traction, breaking of the vacuum seal and use of lubricants were unsuccessful. The child was brought to the operating theatre for further management. Anaesthesia induction with a facemask was not possible as the plastic bottle was protruding from the tongue and would not allow an adequate seal around the nose and mouth. To overcome such challenges of a shared airway and workspace, the child was placed under intravenous propofol sedation initially until the prompt removal of foreign body allowed subsequent mask placement and oral intubation. The foreign body was eventually removed by sectioning the inflexible plastic into two pieces with a water-cooled high speed dental diamond bur. The child remained stable intra-operatively and subsequent post-operative recovery was uneventful. This report highlights the importance of multidisciplinary coordination to reduce delays when liberating the entrapped tongue so as to minimize potential complications from the injury.

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ABSTRACT: Dental trauma is a serious injury that occurs frequently in children and adolescents, requiring urgent dental care. The upper central incisors are the most vulnerable teeth to such traumatic injuries, which can lead to bite restrictions, difficulties in phonation and esthetical questions. The aim of this study was to report the success of a conserva tive approach carried out on a 7-year-old patient, victim of multiple dental trauma, involving permanent and deciduous teeth. The male patient fell from his own height, causing soft tissue lacerations and dento-alveolar traumatism in both deciduous and permanent teeth. Complementary examinations (periapical radiographs and computed tomography) were carried out. Based on the diagnoses the patient was referred to specialists for appropriate treatment. The present report highlights the importanc e of an early diagnosis, suitable treatment and follow-up of patients after an alveoli-dental trauma and shows the direct relationship of this approach with the prognosis of the patient and the tooth.

RESUMEN: El trauma dentario es una lesión grave que ocurre con frecuencia en niños y adolescentes y requiere atención dental urgente. Los incisivos centrales superiores son las piezas dentarias más vulnerables a dichos traumas, pudiendo generar restricciones en la mordida, la fonación y a nivel estético. El objetivo de este estudio fue reportar el éxito de un enfoque conservador llevado a cabo en un niño de 7 años de edad, víctima de un trauma dentario múltiple, que involucró tanto dientes temporales como permanentes. El paciente masculino, cayó desde su propia altura, causando laceraciones en los tejidos blandos y traumatismo dento- alveolar en piezas de ambas denticiones. Se llevaron a cabo exámenes complementarios (radiografías periapicales y tomografía computarizada). Basado en el diagnóstico, el paciente fue referido a especialistas para realizar el tratamiento apropiado. El presente reporte destaca la importancia de un diagnóstico precoz, un tratamiento adecuado y el seguimiento de los pacientes luego de un trauma dento-alveolar, y cómo este enfoque muestra relación directa con el pronóstico del paciente y del diente.

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Oral diseases are often ignored in public health policy within the Arab world, despite being a prevalent public health problem exerting a significant continuous increasing socioeconomic cost. This review paper explored the current status of the common oral diseases (dental caries, periodontal disease, oral cancer, and oro-facial trauma) in the Arab world through a literature search of the PubMed, Scopus, Google Scholar, and Google databases between 1998 and 2021. The literature available revealed sufficient evidence to support that oral diseases are highly prevalent in Arab nations. Collective, multi-sectorial action to reduce and eliminate oral diseases among the Arab population has become an urgent need.

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Accidents involving dental prostheses are unusual but relevant, which may result in complications in the upper respiratory airways and esophagus. A 47-year-old male patient with Creutzfeldt-Jacob disease (CJD), completely dependent on care, was reported by his family to have a partial obstruction and intraoral bleeding after swallowing his upper Removable Partial Denture (RPD). After difficulties in the endoscopy procedure, a surgical approach by exploratory cervicotomy to remove the prosthetic device was conducted, without postoperative complications. Considering individual impairments and the patients' advanced age, the removal of dental prostheses during sleep or for patients under intensive care is a preventive strategy to reduce comorbidities in patients with unstable health conditions.

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Working dogs serve different functions based on their trained purpose. Due to the nature of their work, they are prone to traumatic dentoalveolar injuries (TDIs). TDIs include tooth wear, fracture, discoloration, and displacement. Undiagnosed or untreated TDIs result in pain, which could lead to poor performance. Veterinarians should educate handlers on potential injuries and perform a thorough oral examination and appropriate diagnostics to identify any oral abnormalities and initiate treatment. The primary goal of treatment is to return dogs to normal function so that they can continue to perform their assigned duty at maximum performance.

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Cerebral palsy (CP) is a condition caused by brain damage before, during, or shortly after birth. Communication can be a challenge when treating patients with CP. Some patients can communicate verbally, while others use augmentative alternative communication tools or have individualized means of communication. Therefore, professional dental treatment in individuals with CP is challenging, especially if the patient is affected by dental trauma and requires emergency treatment. This report shows how individualized communication skills assessment allowed us to successfully manage a 9-year-old patient with CP, who suffered extrusive luxation of the permanent lower incisor. In the present case, the teeth were repositioned briefly after the trauma had occurred and then stabilized with a flexible splint according to international guidelines. The teeth remained vital and periodontal repair was observed during the 4-year follow-up.

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The difficulty in providing stability to the coronal segment makes cervical root fracture one of the most challenging dental traumatic injury. This type of injury is less frequent in children. However, due to their serious consequences and poor prognosis, tooth loss may occur. This report presents the management of a case of cervical root fracture in an 11-year-old patient with epilepsy. The stabilization of the root-fractured tooth with a splint failed due to the recurrent seizures the patient had. Coronal fragment was removed and vital root submergence was performed in order to support the alveolar growth. The natural tooth crown was incorporated into a modified Nance appliance to meet the esthetic and functional requirements of the patient. After 5-year follow-up, this treatment approach has seemed to offer a long-term provisional and satisfactory solution to the consequences of a cervical root fracture injury.

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Self-inflicted injury to oral mucosa is a rare entity. These injuries can be premeditated, accidental, or can result from an abnormal habit. These uncommon gingival injuries can sometimes test the clinician's diagnostic abilities as well as treatment planning skills. In conventional treatment, removal of etiology and application of topical drugs is usually sufficient for healing. However, some cases require alternative or adjunctive wound healing methods. Low-level laser therapy (LLLT) has been reported to be effective in pain management and improvement in wound healing through promotion, fortification, and commissioning of cellular cycle to generate productive and substitute cells. This report presents a case of 25-year-old female with complaints of a painful, nonhealing wound on the palate for last 6 months. She had an unusual habit of keeping burning matchsticks in her mouth. Although she had quit the habit 2 months ago after psychiatric counseling, the wound on her palate did not show any improvement in symptoms. Based on the history and clinical findings, diagnosis of chronic wound by self-inflicted thermal injury was made. LLLT was administered on the wound every 48 hours for next 10 days. The burn wound healed completely after five applications of LLLT.

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Bit and bridle accessories improperly fitted in ridden horses can cause oral trauma such as bone spurs, commissure ulceration, and tongue lacerations. This study was used to identify, grade, and compare the types of oral traumas commonly found within polo ponies and race horses. Injuries were assessed visually and by palpation on the tongue, lips' commissures, and interdental space. A total of 50 polo ponies and 50 race horses were sampled in the South of England. A Poisson model was successfully fitted to the data (p < .001), and the variables of discipline (p < .001), injury type (p < .001), and age (p < .001) were significant. Race horses with snaffle bits were predisposed to significantly higher severities and prevalence of oral trauma than were polo ponies in gag bits. Only polo ponies were observed with tongue trauma. Race horses had higher severities of injuries in the commissures and bone spurs. Positive correlations were found between age and/or time in sport and induced biting injuries. Polo ponies had been playing longer before the occurrence of injuries.

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We report the first example, to our knowledge, of a frictional keratosis from exuberant sucking in a breastfeeding infant. A 2-month-old girl was referred for evaluation of a well-demarcated, nonsloughing white keratotic plaque of the lower lip mucosa, just inside the vermilion border. The plaque had a slightly irregular surface, had no surrounding erythema, and was the only such plaque in the mouth. It had been present for at least 3 weeks and had been unsuccessfully treated by her pediatrician via oral Mycostatin (nystatin). Her parents sought a second opinion when the infant was prescribed a full course of oral Diflucan (fluconazole). A cytopathology smear (Papanicolaou test) revealed abundant mature keratinocytes with no evidence of Candida. The mother admitted that the infant "worked hard" at sucking during breastfeeding and continued sucking long after feeding. The parents were unaware of any other habit or potential irritation of the lips. After 3 months of age the infant's sucking pattern became more "normal" and the keratosis disappeared; it did not recur during 3 years of follow-up. We propose the term "breastfeeding keratosis" for this entity.

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AIM: To provide clinicians with useful information for immediate diagnosis and management of impacted maxillary incisors due to trauma. METHODS: We present a case of post-traumatic impaction of a central right maxillary incisor in a young patient. The treatment plan consisted in the interceptive management (surgical and orthodontic), the valuation of the necessary space to move the impacted tooth in the normal position and the biomechanical approach for anchorage, avoiding prosthetic/implants replacement. RESULTS: THE THERAPY OF AN IMPACTED MAXILLARY INCISOR DUE TO TRAUMA REQUIRES A MULTIDISCIPLINARY APPROACH: orthodontic, surgical, endodontic and periodontal considerations are essential for successful treatment. CONCLUSIONS: SURGICAL EXPOSURE AND ORTHODONTIC TRACTION IS THE TREATMENT MOST OFTEN USED IN CASE OF POSTTRAUMATIC IMPACTED INCISOR: this technique in fact can lead to suitable results at the periodontal, occlusal and esthetics levels at an early stage and more definitively than with other treatment options.

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OBJECTIVE: This study aimed to evaluate oral and maxillofacial trauma caused by falls during epileptic seizures. METHOD: A prospective case-control study was carried out among patients recruited from both the Epileptic Outpatient Clinic and the Emergency Room of Hospital de Base during 2006. The study group was composed of patients with epilepsy that had been diagnosed by a specialist. Oral and maxillofacial trauma was diagnosed using a questionnaire together with physical and radiographic examinations. A control group was formed from non-epileptic relatives or neighbors of the patients. The two groups were compared with regard to the number and type of oral and maxillofacial trauma events suffered. Odds ratios with a 95 percent confidence interval, dependency analysis and the Pearson c² test were used for statistical analysis, and the significance level was set at p≤0.05. RESULTS: A total of 159 patients with epilepsy (91 males; 57.3 percent) and 68 control individuals (28 males; 41.1 percent) were enrolled in the study. The frequencies of oromaxillary trauma in the study and control groups were 23.9 percent and 4.4 percent, respectively. Generalized tonic-clonic, generalized and non-classified seizures were strongly associated with trauma. The commonest lesions were fractures of dental tooth crowns (32.9 percent), followed by tooth avulsion (7.6 percent), tooth luxation (5 percent) and fracturing of prostheses in edentulous patients (3.8 percent). CONCLUSION: This work shows that injuries to the face and teeth are statistically more common in patients with epilepsy than in the general population, and that individuals who suffer seizures without aura are the most affected.

OBJETIVO: O objetivo desse estudo foi avaliar a relação da epilepsia sobre as ocorrências de trauma dento-alveolar e maxilofacial causados por quedas. MÉTODO: Estudo caso-controle prospectivo foi conduzido no ambulatório de epilepsia e do Pronto Atendimento do Hospital de Base de São José do Rio Preto-SP no ano de 2006. Pacientes do grupo caso foram diagnosticados pelo neurologista chefe (sênior) especialista em epilepsia e avaliados quanto ao trauma oral e maxilo-facial pelo pesquisador, por meio de questionário, exame clínico e radiográfico, por ordem de chegada. O grupo controle (GC) foi constituído incluindo indivíduos sem crises, que fossem familiares ou vizinhos próximos dos pacientes com diagnóstico de epilepsia. Intervalo de confiança 95 por cento, ODD, análise de dependência (ANADEP) e c² de Pearson foram utilizados para análise estatística e se adotou nível de significância de p≤0,05. RESULTADOS: Analisaram-se 159 pacientes com epilepsia, dos quais 91(57,3 por cento) masculinos e 68 do GC, dos quais 28 (41,1 por cento) masculinos. A frequência do trauma oro-maxilar em paciente com epilepsia foi 23,9 por cento e no GC foi de 4,4. As crises tônico-clônicas generalizadas, crises generalizadas e as não classificadas estão fortemente co-relacionadas ao trauma. Fraturas das coroas dentais (32,9 por cento), seguidas de avulsão dentária (7,6 por cento), luxação dentária (5 por cento) e fratura da prótese em pacientes edêntulos (3,8 por cento) foram as lesões mais encontradas. CONCLUSÃO: O trabalho mostra que os ferimentos na face e dentes são frequentes em pacientes com crises epilépticas quando comparados ao GC, sendo as pessoas com crises sem a aura as mais afetadas.

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