Dental Trauma Prevention and Oral Habit Therapy

Etiological Factors of Traumatic Injuries

1) Oral predisposing factors: Labial proclination of maxillary anterior teeth.

2) Environmental factors: Material deprivation and emotionally stressful states, including non-nuclear families, parental abuse, ADHD children, and obese children.

3) Behavioral factors: Falls, collisions, and physical limitations such as epilepsy.

Preventive Measures for Dental Trauma

• 1) Educational: Informing the public and patients about risks.
• 2) Primary Prevention: Preventing circumstances that lead to injury.
  • A) Safe home environment (childproofing).
  • B) Safe playground surfaces.
  • C) Use of car seatbelts.
• 3) Secondary Prevention: Preventing or reducing injury severity and adverse sequelae.
• 4) Tertiary Prevention: Rehabilitating the injured person and replacing lost teeth due to injury.

Functions of Intra-Oral Protectors

1. Hold lip and cheek soft tissue away from the teeth.
2. Cushion and spread the force of impact.
3. Prevent opposing teeth contact.
4. Hold the jaws apart.
5. Provide resilient support for the mandible.
6. Fill space and support adjacent teeth.

Requirements for Intra-Oral Protectors

1. Made of resilient material.
2. Retentive.
3. Comfortable for the wearer.
4. Protect both teeth and soft tissues.
5. Easily washed.
6. Maintain a normal occlusal relationship.

Types of Mouth Protectors

Stock Prefabricated Protectors

Made of rubber or plastic and available in sports shops in sizes Small, Medium, and Large.

• Advantages: Inexpensive and readily available.
• Disadvantages: Poor retention, bulky (impairs speech), potential airway danger, and low compliance.

Mouth-Formed Boil and Bite Protectors

• Advantages: Inexpensive, available, less bulky than stock protectors, and quick to construct.
• Disadvantages: Risk of burning the mouth from hot temperatures, thin areas may lack extension, they deteriorate over time, and they are difficult to adjust.

Custom-Made Protectors

• Advantages: Most retentive, most comfortable, lack excessive bulk, do not encroach on freeway space, provide coverage of vulnerable areas, and are adaptable to orthodontic appliances.
• Disadvantages: Most expensive option.

Oral Cancer Preventive Measures

1. Stop the use of tobacco and alcohol.
2. Attend dental check-ups every 3 months for an oral cancer exam and professional cleaning.
3. Use lip balm with sunscreen to decrease the sun's effect on the lips.
4. Eat a diet rich in fruits and vegetables.
5. Perform self-examinations of the oral cavity for any abnormalities.
6. If a sore is not gone within 2 weeks, tell your dentist.

Habit Therapy for Children

1) Reminder Therapy: For the child who wants to stop a habit but needs help to stop completely. An adhesive bandage on the offending finger acts as a constant reminder not to place the finger or digit in the mouth. This must be neutral and not used as a punishment.

2) Reward Therapy: A contract between the child and the parent or dentist. If the child discontinues the habit for a specified period, they receive a reward. The reward must be special enough to motivate them; more child involvement leads to more success.

3) Appliance Therapy: Used only when reminder and reward therapies have failed. It is not a punishment but a permanent reminder. Side effects may include eating difficulty, speech problems, and disturbed sleep. The appliance should be left in the mouth for 6 months to extinguish the habit.