Quick correction! At 10:01, I talk about replanting primary teeth. However, this is no longer recommended because replanting them can cause damage to the permanent successor.
Hi Ryan I went for an interview today 35years qualified and retired from private practice was asked all about trauma .I have been studying your lectures for the past few weeks.I got it all in today at the interview.What would I do without you. From a dedicated dentist in Ireland
Hello , thanks for all these videos and effort. You make students life better. I want to check with you about treatment of avulsed primary tooth, I think it shouldn't be replanted in any case according to AAPD. Also, about pink cervical area it's related to internal resorption not external. Really thank you for everything ♥️
I had a permenant tooth 22 at age 14? Reimplanted successfully. I am 68 years old. Very fortunate. I do have a 6 mm CAL pocket. The tooth is rotated and crowded. I have general horizontal bone loss 3 or 4 mm pockets 3areas light bleeding. I am fortunate. Thank you Ryan. I am only a hygienist studying fir boards. I hope to get a job teaching on the clinic floor with dental students. You’re work is very helpful. New grads and students are fortunate to have you.
I guess it must be time based? Clot formation in the socket takes about 20-40 mins so if 30 mins have passed since Extrusion Luxation then I believe we'll extract. pubmed.ncbi.nlm.nih.gov/31939367/
hello sir you have said in correction on bootcamp that less than 3mm extrusion means no treatment soo no splintng for 2 weeks right as shown in the slide in video
Hi Dr. Ryan, Thank you for your videos! I listen to and learn from the lessons you explain with great curiosity. I am grateful for this. Could you share the notes from the lessons you explained in PDF format?
Hello nice content bt have few doubts... R u sure that we can reimplant primary tooth if it's out of mouth for less than 30 min? Coz I always read that we shd not reimplant primary tooth whatever time it's out of mouth.... Another doubt that in intrusion of primary tooth treatment will not be always extraction coz it can injure permanent tooth bud while intruding.... One more doubt in extrusion of primary tooth can we reposition it if pt comes early coz quiet possible that if push it inside we can injure permanent tooth bud... I hope u will consider my doubts nd give me reference
This has been extremely helpful and detailed in helping me prepare for boards and licensure exams. Thanks for your skills. Where did you do your Pedo residency?
I usually recommend the Shock Doctor mouthguard for patients with braces. You do NOT want to use the custom boil ones because they will stick to and damage the appliances when you first make them.
Hi dr ryan i ve quick question regarding child abuse...if we notice sign and symptoms of child abuse what would we do 1st complete the treatment and report or 1st report and then complete the treatment?
Hallo Is it really possible and necessary to do the splint at the primary teeth? Considering the child compliance and age? Thanks for sharing your experience with us 👍
Hi Dr, my two year old tripped while running bumped in too an old edgy chair gum first and started to bleed when I checked his mouth by slightly moving his upper lip his gum moved away from his tooth and delicately I checked his teeth and they are intact and in place. But am worried about the gum moving with lip, I haven’t tried to check the same way since(happened tonight and it’s holiday) am awake constantly checking for bleeding just in case it starts again. Am worried what can I do till the morning ie till I take him to the dentist? He is ok now aside from swelling and slight pain when he tried to eat a biscuit before he slept. Is this common or should I worry more than I am already worried? By the way the affected gum is his upper part of the front right teeth. Any advice till the dentists open in the morning would help? Thank you for the video. Love
Hiii My 19 month old recently had an intrusion to her front tooth. So much so that the tooth cannot be seen. Her pediatric dentist told me today that they just want to wait and see if it comes back down. I understand that process but would there be any nerve damage or improper positioning of the permanent tooth when it’s time for it to come down? Also with it being all the way up in the gum line what would be the possibility of it even coming back down?
Hey rayan Many thanks for your data , I would like to double check replant of primary tooth in case it get avulsed as there will be risk to hurt permanent tooth structure !? Please advise
Hello Ryan! The pink spot mentioned in the cervical external root resorption, wouldn't actually be related to Internal root resorption instead? Thanks!
External cervical resorption can result in a pinkish spot as well, but you are correct that the classic "pink tooth of Mummery" is the result of internal resorption where pulp material spreads to fill in the resorbed, balloon-like canal.
Testing vitality immediately after trauma is very unreliable, so you usually have to wait a few weeks before getting a reliable test with cold test or EPT (and also note that EPT for primary teeth is extremely unreliable and never really used). And apex you would assess via radiograph.
@@mentaldental hey, please reply as we were asked the same Question in exam.... what are pulp vitality test for primary teeth......I am confused do we perform pulp vitality test in primary teeth or not & if we do.... which test are performed...... please do reply....
No, we generally do not do pulp vitality testing for primary teeth. They have large pulp chambers and the test is not conducive to young children. The diagnosis for primary teeth can be attained via clinical and radiographic examination. The diagnoses are generally not as ambiguous as they can be for permanent teeth.
If a tooth is lost at an early age ,and if the mother insists on having a replacement option what would be a safe option Then considering the child is 3 years old
I suppose you could use a kiddie partial, but rarely if ever do parents ask for replacement for a baby tooth that would be coming out eventually anyway!
Hey Dr. Ryan, Thank you for your videos! I have a quick question about child abuse reporting. When should dentists report the abuse? For example, let's say that you have a pedo pt and notice some signs of physical abuse. Do you notify an assistant to report to authorities right away (during the appointment) or do you report it after the appointment? Thank you! :)
Are you asking about the order of these steps? I'm not entirely sure, but I would say either treat, record, then report or record, report, then treat depending on the nature and severity of the injury.
Hello Dr. Ryan, Thank you for your wonderful videos. What would you suggest if the fracture is vertical in a primary tooth , splitting the crown into two half in an early age (around 2 years) ? would splitting help or extraction is better. what do you suggest?
Going back, I wish I could've gotten a second opinion for my sons front teeth on top. He had an injury, the teeth bumped into the coffee table and one of them was a little tilted. He was having cavities filled and they came out mid surgery telling us both teeth were injured and would need to be pulled, to not negatively affect the adult teeth. They told us they could see that the adult teeth were in position to come in sometime soon.. my son was about 3 at the time... His 2 front teeth are still not even BEGINNING to come in.... And he's 7 now. I hope they didn't mess up his teeth forever! ;(
At 7 years old they should be erupting any day now but your best option right now is to take your kid to the dentist, and take radiographs of the anterior maxilary area from different perspectives (periapical x-ray, occlusal x-ray, panthomography) to check the status of the permanent teeth, if they are erupting or not or if they have their apices (roots) correctly forming and only after that can your dentist start to diagnose what's going on. Don't blame yourself as a mother, usually these types of injuries sort themselves out, the dentists had a correct approach all things considering, some things can only be corroborated and checked up with follow ups and other diagnosing tools. But right now that's your best plan of action, or even take him to a odontopediatric specialist just in case the teeth lost part of their eruptive potencial. The sooner he gets treated, the better the prognosis and the less expensive the treatments should be.
@@jacobyne what a great response, thank you! You were right to say "any day now" because just about a week ago, one of the 2 erupted and TODAY he saw the other one has now too! So relieved! I started to worry, because it always seemed that kids lose their front teeth around 5/kindergarten, and permanent start coming in soon thereafter! So your comment was reassuring, thank you!
I love your videos. i really like the way how you explain everything. You made look everything super easy. if you don't mind please let me ask you something. I don't know if you have already covered this type of question in your Pt management series but I have a question about of what you just said in your last slide. Under what ethical principal would you consider reporting a suspicious child abuse? Thanks for your help. getting the slides from patron have helped to save so much time making notes. I'm glad that I'm a member of it. Thanks for what you do for all of us.
What an interesting question. If I had to pick, I would say it falls under nonmaleficence. Because not reporting it means you would be potentially allowing harm to continue.
Thanks for bringing this up! Yes, you are correct and I agree with what you learned. And that is exactly what the AAPD recommends. The information I present for board exam prep is mostly from Mosby’s and this one of the few times I generally disagree with their recommendation (the only time I would ever consider replanting a primary tooth is if it happened right in front of me and could be kept healthy as a space maintainer).
Quick correction! At 10:01, I talk about replanting primary teeth. However, this is no longer recommended because replanting them can cause damage to the permanent successor.
Thank you
Hi Ryan I went for an interview today 35years qualified and retired from private practice was asked all about trauma .I have been studying your lectures for the past few weeks.I got it all in today at the interview.What would I do without you.
From a dedicated dentist in Ireland
Hello , thanks for all these videos and effort. You make students life better.
I want to check with you about treatment of avulsed primary tooth, I think it shouldn't be replanted in any case according to AAPD.
Also, about pink cervical area it's related to internal resorption not external.
Really thank you for everything ♥️
I had a permenant tooth 22 at age 14? Reimplanted successfully. I am 68 years old. Very fortunate. I do have a 6 mm CAL pocket. The tooth is rotated and crowded. I have general horizontal bone loss 3 or 4 mm pockets 3areas light bleeding. I am fortunate. Thank you Ryan. I am only a hygienist studying fir boards. I hope to get a job teaching on the clinic floor with dental students. You’re work is very helpful. New grads and students are fortunate to have you.
Thanks for watching! For more high yield dental content, subscribe to Mental Dental today: ruclips.net/user/mentaldental
For extrusion, how will you confirm the periapical clotting?
I guess it must be time based? Clot formation in the socket takes about 20-40 mins so if 30 mins have passed since Extrusion Luxation then I believe we'll extract.
pubmed.ncbi.nlm.nih.gov/31939367/
Epic presentation as usual 🤌🤌🤌
Thank you so much! 🙏🏼
NEVER, NEVER reimplant avulsed primary tooth
Informative video... Thanks for making such videos..
Kindly update this video regarding recommendation on trauma to primary teeth
Thank you very much for video ❤
hello sir you have said in correction on bootcamp that less than 3mm extrusion means no treatment soo no splintng for 2 weeks right as shown in the slide in video
Quick question, do we have to perform endo on avulsed teeth right away or after 1-2 weeks of replanting?
Hi Dr. Ryan,
Thank you for your videos!
I listen to and learn from the lessons you explain with great curiosity. I am grateful for this. Could you share the notes from the lessons you explained in PDF format?
Yes! You can find out how to get them on my website at www.mentaldental.com/faq
@@mentaldental thank you so much Dr. Ryan :)
Hello nice content bt have few doubts... R u sure that we can reimplant primary tooth if it's out of mouth for less than 30 min? Coz I always read that we shd not reimplant primary tooth whatever time it's out of mouth.... Another doubt that in intrusion of primary tooth treatment will not be always extraction coz it can injure permanent tooth bud while intruding.... One more doubt in extrusion of primary tooth can we reposition it if pt comes early coz quiet possible that if push it inside we can injure permanent tooth bud... I hope u will consider my doubts nd give me reference
Thank you doc !!!!
You are brilliant!!!
This has been extremely helpful and detailed in helping me prepare for boards and licensure exams. Thanks for your skills. Where did you do your Pedo residency?
Please dr what is the best mouth guard for patient with orthodontics
I usually recommend the Shock Doctor mouthguard for patients with braces. You do NOT want to use the custom boil ones because they will stick to and damage the appliances when you first make them.
Hi dr ryan i ve quick question regarding child abuse...if we notice sign and symptoms of child abuse what would we do 1st complete the treatment and report or 1st report and then complete the treatment?
Hallo
Is it really possible and necessary to do the splint at the primary teeth?
Considering the child compliance and age?
Thanks for sharing your experience with us 👍
Hi Ryan..please clear this dialemma..the best storage medium for the avulsed tooth is Hanks or milk???please please reply🙏🏻thanks😊
Hi, latest guideline from iadt lists milk as 1 option, 2 is hanks sol
Hi Dr, my two year old tripped while running bumped in too an old edgy chair gum first and started to bleed when I checked his mouth by slightly moving his upper lip his gum moved away from his tooth and delicately I checked his teeth and they are intact and in place. But am worried about the gum moving with lip, I haven’t tried to check the same way since(happened tonight and it’s holiday) am awake constantly checking for bleeding just in case it starts again. Am worried what can I do till the morning ie till I take him to the dentist? He is ok now aside from swelling and slight pain when he tried to eat a biscuit before he slept. Is this common or should I worry more than I am already worried? By the way the affected gum is his upper part of the front right teeth. Any advice till the dentists open in the morning would help? Thank you for the video. Love
Hiii My 19 month old recently had an intrusion to her front tooth. So much so that the tooth cannot be seen. Her pediatric dentist told me today that they just want to wait and see if it comes back down. I understand that process but would there be any nerve damage or improper positioning of the permanent tooth when it’s time for it to come down? Also with it being all the way up in the gum line what would be the possibility of it even coming back down?
Thanks for these videos. I have a question regarding to which institution/organization has the dentist to report about the child abuse?
It depends on the state you are in, but you would call child protective services or the law enforcement agency in your area.
Hey rayan
Many thanks for your data , I would like to double check replant of primary tooth in case it get avulsed as there will be risk to hurt permanent tooth structure !? Please advise
Thanks for great lecture .
You’re welcome! Glad you enjoyed it 😊
thank you very much, Dr!
Hello Ryan!
The pink spot mentioned in the cervical external root resorption, wouldn't actually be related to Internal root resorption instead?
Thanks!
External cervical resorption can result in a pinkish spot as well, but you are correct that the classic "pink tooth of Mummery" is the result of internal resorption where pulp material spreads to fill in the resorbed, balloon-like canal.
Is this based on the 2020 iadt guidelines sir?
what may be the reason of extrusion
What test would you use to test trauma primary tooth for vitality? If tooth has opened apex? closed apex? Thank you
Testing vitality immediately after trauma is very unreliable, so you usually have to wait a few weeks before getting a reliable test with cold test or EPT (and also note that EPT for primary teeth is extremely unreliable and never really used). And apex you would assess via radiograph.
@@mentaldental hey, please reply as we were asked the same Question in exam.... what are pulp vitality test for primary teeth......I am confused do we perform pulp vitality test in primary teeth or not & if we do.... which test are performed...... please do reply....
No, we generally do not do pulp vitality testing for primary teeth. They have large pulp chambers and the test is not conducive to young children. The diagnosis for primary teeth can be attained via clinical and radiographic examination. The diagnoses are generally not as ambiguous as they can be for permanent teeth.
@@mentaldental thank you Ryan ☺️
If a tooth is lost at an early age ,and if the mother insists on having a replacement option what would be a safe option Then considering the child is 3 years old
I suppose you could use a kiddie partial, but rarely if ever do parents ask for replacement for a baby tooth that would be coming out eventually anyway!
thanks dr from africa ethiopia
Hey Dr. Ryan,
Thank you for your videos! I have a quick question about child abuse reporting. When should dentists report the abuse? For example, let's say that you have a pedo pt and notice some signs of physical abuse. Do you notify an assistant to report to authorities right away (during the appointment) or do you report it after the appointment?
Thank you! :)
You're welcome! Ideally they would document findings and report to the authorities as soon as possible.
Ryan, for child abuse do we treat, record and report??
Are you asking about the order of these steps? I'm not entirely sure, but I would say either treat, record, then report or record, report, then treat depending on the nature and severity of the injury.
Hello Dr. Ryan, Thank you for your wonderful videos. What would you suggest if the fracture is vertical in a primary tooth , splitting the crown into two half in an early age (around 2 years) ? would splitting help or extraction is better. what do you suggest?
They say in case of evulsion better to not replant
Yes, I agree with you! For avulsion of a primary tooth, it is really not recommended to replant it.
What about trauma to immature permanent teeth 😟
I talk about this topic in my Endodontics video on trauma!
@@mentaldental thank you 😃✨
Going back, I wish I could've gotten a second opinion for my sons front teeth on top. He had an injury, the teeth bumped into the coffee table and one of them was a little tilted. He was having cavities filled and they came out mid surgery telling us both teeth were injured and would need to be pulled, to not negatively affect the adult teeth. They told us they could see that the adult teeth were in position to come in sometime soon.. my son was about 3 at the time... His 2 front teeth are still not even BEGINNING to come in.... And he's 7 now. I hope they didn't mess up his teeth forever! ;(
At 7 years old they should be erupting any day now but your best option right now is to take your kid to the dentist, and take radiographs of the anterior maxilary area from different perspectives (periapical x-ray, occlusal x-ray, panthomography) to check the status of the permanent teeth, if they are erupting or not or if they have their apices (roots) correctly forming and only after that can your dentist start to diagnose what's going on.
Don't blame yourself as a mother, usually these types of injuries sort themselves out, the dentists had a correct approach all things considering, some things can only be corroborated and checked up with follow ups and other diagnosing tools.
But right now that's your best plan of action, or even take him to a odontopediatric specialist just in case the teeth lost part of their eruptive potencial. The sooner he gets treated, the better the prognosis and the less expensive the treatments should be.
@@jacobyne what a great response, thank you! You were right to say "any day now" because just about a week ago, one of the 2 erupted and TODAY he saw the other one has now too! So relieved! I started to worry, because it always seemed that kids lose their front teeth around 5/kindergarten, and permanent start coming in soon thereafter! So your comment was reassuring, thank you!
I love your videos. i really like the way how you explain everything. You made look everything super easy. if you don't mind please let me ask you something. I don't know if you have already covered this type of question in your Pt management series but I have a question about of what you just said in your last slide. Under what ethical principal would you consider reporting a suspicious child abuse? Thanks for your help. getting the slides from patron have helped to save so much time making notes. I'm glad that I'm a member of it. Thanks for what you do for all of us.
What an interesting question. If I had to pick, I would say it falls under nonmaleficence. Because not reporting it means you would be potentially allowing harm to continue.
Mental Dental thanks. You are the best.
@@mentaldental Hi. I think so it should be under Beneficence as report neglect/ abuse comes under Beneficence. What do you think?
Thanks
We learned to not attempt to replant primary teeth, no point really
Thanks for bringing this up! Yes, you are correct and I agree with what you learned. And that is exactly what the AAPD recommends. The information I present for board exam prep is mostly from Mosby’s and this one of the few times I generally disagree with their recommendation (the only time I would ever consider replanting a primary tooth is if it happened right in front of me and could be kept healthy as a space maintainer).
million like
You just avoided why boys are more at risk lmao